Uma, Rynie U.

HRN: 21-33-47  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/16/2022
AMPICILLIN 500MG (VIAL)
05/16/2022
05/23/2022
IV
500mg
Q6h
Gunshot Wound
Waiting Final Action 
05/16/2022
AMPICILLIN 500MG (VIAL)
05/16/2022
05/23/2022
IV
500mg
Q6h
Gunshot Wound
Waiting Final Action 
05/18/2022
CEFTRIAXONE 1G (VIAL)
05/18/2022
05/24/2022
IVT
800mg
Q12
Pneumothorax, Hemothorax, Left
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: