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  • Pre Op Antibiotic Audit Form

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    ERWIN
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    This document is a surgical antibiotic prophylaxis audit form from the Philippine Heart Center. It contains criteria to audit antibiotic administration for patients undergoing surgery in three phases: pre-operative, intra-operative, and post-operative. Nurses are to check yes, no, or leave comments indicating if the criteria for appropriate antibiotic administration were met at each phase of surgery.

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    This document is a surgical antibiotic prophylaxis audit form from the Philippine Heart Center. It contains criteria to audit antibiotic administration for patients undergoing surgery in three phases: pre-operative, intra-operative, and post-operative. Nurses are to check yes, no, or leave comments indicating if the criteria for appropriate antibiotic administration were met at each phase of surgery.

    Copyright:

    © All Rights Reserved
    Download as ODT, PDF, TXT or read online from Scribd
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    Download as odt, pdf, or txt
    15 views1 page

    Pre Op Antibiotic Audit Form

    Uploaded by

    ERWIN
    This document is a surgical antibiotic prophylaxis audit form from the Philippine Heart Center. It contains criteria to audit antibiotic administration for patients undergoing surgery in three phases: pre-operative, intra-operative, and post-operative. Nurses are to check yes, no, or leave comments indicating if the criteria for appropriate antibiotic administration were met at each phase of surgery.

    Copyright:

    © All Rights Reserved
    Download as ODT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as odt, pdf, or txt
    of 1

    PHILIPPINE HEART CENTER

    East Avenue, Quezon City

    SURGICAL ANTIBIOTIC PROPHYLAXIS AUDIT FORM

    Patient: Surgeon/Anesthesiologist: /

    PHASE CRITERIA YES NO COMMENTS


    PRE-OPERATIVE The prescribed antibiotic/s was/were the
    (PRIOR TO INCISION) recommended antibiotic/s for the operation.
    The patient received the correct dose/s for
    his/her weight.
    The antibiotic/s had/have been given within
    60 minutes prior to skin incision.
    INTRA-OPERATIVE The patient had been re-dosed accordingly.
    (INCISION TO CLOSURE)
    POST OPERATIVE The antibiotic/s had/have been discontinued
    (POST CLOSURE) after the procedure.

    Name and Signature of Circulating Nurse:_________________________ Date:___________

    PHILIPPINE HEART CENTER


    East Avenue, Quezon City

    SURGICAL ANTIBIOTIC PROPHYLAXIS AUDIT FORM

    Patient: Surgeon/Anesthesiologist: /

    PHASE CRITERIA YES NO COMMENTS


    PRE-OPERATIVE The prescribed antibiotic/s was/were the
    (PRIOR TO INCISION) recommended antibiotic/s for the operation.
    The patient received the correct dose/s for
    his/her weight.
    The antibiotic/s had/have been given within
    60 minutes prior to skin incision.
    INTRA-OPERATIVE The patient had been re-dosed accordingly.
    (INCISION TO CLOSURE)
    POST OPERATIVE The antibiotic/s had/have been discontinued
    (POST CLOSURE) after the procedure.

    Name and Signature of Circulating Nurse:_________________________ Date:___________

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