Neonatal Gentamicin Care Bundle Compliance Chart Page 2
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2Neonatal gentamicin care bundle compliance chart
If gentamicin was not administered within one hour of the
prescribed dose time then please indicate any relevant reasons:
(The information given below can be audited by the data review
team to assist in understanding process issues relating to non-
compliance with element four of the care bundle.)
No addressograph
Level not taken
Not prescribed but due
Level result not available
Prescription not signed
Abnormal level result
Incorrect drug
No weight
Incorrect date
Other: ___________________
Incorrect time
_______________________________
Incorrect frequency
_______________________________
Incorrect route
_______________________________
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