Paler, Bb. Girl .

HRN: 22-54-07  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/18/2023
AMPICILLIN 500MG (VIAL)
01/18/2023
01/25/2023
IVTT
125mg
Q12
Psnb
Waiting Final Action 
01/18/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
01/18/2023
01/25/2023
IVTT
12mg
Q24
Psnb
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: