Perioperative Pharmacy Services Certificate

   
The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education with Commendation.

This certificate is intended for pharmacists seeking to expand their knowledge and skills in perioperative pharmacy practice.

Introduction to Perioperative Pharmacy Services and Surgical Personnel
ACPE #: 0204-0000-25-759-H04-P
Application-based
2.5 contact hours 

Learning Objectives:

• Describe the scope of perioperative pharmacy services.
• Describe the perioperative patient process.
• Identify pharmacist responsibilities as a member of the perioperative care team.
• Compare key differences for pharmacists between perioperative and traditional inpatient pharmacy practice settings.
• Identify pharmacy technician responsibilities in perioperative pharmacy services.
• Compare key differences for pharmacy technicians between perioperative and traditional inpatient pharmacy practice settings.
• Match surgery staff to their roles and responsibilities.
• Identify perioperative personnel who have access to medications, and those with the authority to administer medications. 

Practicing in the Perioperative Environment
ACPE #: 0204-0000-25-760-H01-P
Application-based
2.25 contact hours 

Learning Objectives:

• Identify perioperative areas and the garbing requirements for each area.
• Explain common infection prevention practices in the perioperative setting.
• Define common terminology used in the perioperative setting.
• Match common perioperative terms to their corresponding abbreviations.
• Identify documentation by surgical, anesthesia, and perioperative nursing professionals that, when taken together, provide a complete description of a patient's course of perioperative care.
• Interpret documentation to identify medications administered intraoperatively.
• Compare the various roles of pharmacists in ambulatory surgery center settings.
• Describe drug distribution models in ambulatory surgery center settings.
• Identify the elements of a comprehensive pharmacist site inspection survey in an ambulatory surgery center. 

Common Surgical Procedures
ACPE #: 0204-0000-25-761-H01-P
Application-based
2 contact hours 

Learning Objectives:

• Identify common surgeries of the brain, eyes, ears, nose, throat, and neck, and their intended outcomes.
• Identify common surgeries of the chest and abdomen, and their intended outcomes.
• Identify common urologic, colon, rectal, and endoscopic surgeries, and their intended outcomes.
• Identify common gynecologic, obstetric, and pediatric surgeries, and their intended outcomes.
• Identify common orthopedic, spinal, and podiatric surgeries and their intended outcomes.
• Identify common vascular, oncology, and plastic surgeries and their intended outcomes. 

Medication Distribution and Technologies in Perioperative Settings
ACPE #: 0204-0000-25-762-H04-P
Application-based
1.75 contact hours 

Learning Objectives:

• Compare the medication use processes in the operative setting versus traditional patient care units.
• Describe the use of medication distribution and administration technologies in surgical areas.
• Describe best practices for the optimal use of automated dispensing cabinets (ADCs) in perioperative settings including, but not limited to, types and locations of ADCs and medication safety strategies.
• Explain the purpose and benefits of controlled substance diversion prevention programs in perioperative areas.
• Describe strategies for oversight of the following points in the controlled substance use process that are at high risk of diversion: procurement; preparation and dispensing; administration; and returns, waste, and disposal. 

Preparing Sterile Products in Surgical Environments
ACPE #: 0204-0000-25-763-H07-P
Application-based
1.75 contact hours 

Learning Objectives:

• Identify sterile compounding needs for surgical procedures.
• Apply United States Pharmacopeia (USP) chapters <797> and <800> requirements to procedural areas.
• Differentiate administration, preparation per approved labeling, and immediate use.
• Develop an in-service for personnel who mix immediate use compounds.
• Describe fundamental principles of sterile compounding in surgical settings.
• Identify personal protective equipment required for hazardous drug compounding and administration including, but not limited to, intravesical chemotherapy.
• Describe situations when additional testing and special techniques must be utilized when compounding ophthalmic preparations.
• Describe situations when sterile filtration and/or preservative-free ingredients must be utilized when compounding preparations used during specific types of surgical procedures. 

Medication Safety & Quality and Regulatory & Accreditation Compliance in Perioperative Settings
ACPE #: 0204-0000-25-764-H05-P
Application-based
1.5 contact hours 

Learning Objectives:

• Describe recommended medication error prevention strategies applicable to perioperative settings as outlined in guidelines published by organizations supportive of perioperative medication safety.
• Explain the applicability of regulatory compliance, and certification and accreditation, to operating room satellite pharmacies and ambulatory surgery centers.
• Explain external quality measures related to, and can be impacted by, perioperative pharmacy services.
• Describe opportunities for improving perioperative pharmacy services specifically, and care of surgical patients more broadly. 

Transitions of Care Considerations for Surgical Patients
ACPE #: 0204-0000-25-765-H01-P
Application-based
1.5 contact hours 

Learning Objectives:

• Explain why medication reconciliation is essential to the provision of safe patient care.
• Describe the process for obtaining an accurate and comprehensive medication history.
• Prioritize when medication reconciliation should be performed.
• Explain factors to take into consideration when determining patients' home medications that should be held or continued during the perioperative period, as well as when medications can be resumed postoperatively.
• Identify risks and benefits of specific medications and medication classes during the perioperative period.
• Recommend specific medications and medication classes to place on hold in the perioperative period based on an assessment of risks versus benefits.
• Identify common barriers to safe and efficient discharges for postoperative patients.
• Apply strategies to improve medication safety for postoperative patients at discharge.
• Develop a formalized discharge process to improve coordination of care and patient safety.
• Summarize the risks associated with the use of opioids in postoperative patients.
• Describe clinical scenarios when prescribing opioids at discharge for postoperative patients is appropriate.
• Recommend durations of therapy of opioid prescriptions and follow up plans that mitigate the risks of opioid therapy in postoperative patients. 

Management of Hemostasis, Antithrombotic Therapy, and Thromboembolism in Surgical Patients - Part 1
ACPE #: 0204-0000-25-766-H01-P
Application-based
3 contact hours 

Learning Objectives:

• Describe the fundamental skills for clinical pharmacy practice in the perioperative setting.
• Summarize the risks for bleeding and thrombotic complications related to invasive procedures.
• Discuss approaches for anticoagulation management when an invasive procedure is planned or occurring.
• Determine the need to hold or bridge anticoagulation therapy prior to and following an invasive procedure.
• Explain the drug-specific considerations for anticoagulant and anti-platelet agents when an invasive procedure is planned.
• Develop a plan to restart anticoagulation therapy following an invasive procedure.
• Describe challenges that can occur during perioperative management of anticoagulant and antiplatelet agents in acutely and critically ill patients.
• Summarize factors pharmacists should consider when adapting anticoagulant therapy to acutely ill patients.
• Implement precision-based antithrombotic therapy management plans in complex patients requiring an invasive procedure.
• Summarize available anticoagulant medications and methods to reverse their effects.
• Describe approaches to anticoagulation reversal, including drug therapy options for reversal.
• Design an anticoagulant-specific anticoagulation reversal plan. 

Management of Hemostasis, Antithrombotic Therapy, and Thromboembolism in Surgical Patients - Part 2
ACPE #: 0204-0000-25-767-H01-P
Application-based
2 contact hours 

Learning Objectives:

• Describe the skills and considerations needed to make decisions about the use of concentrated blood products during the perioperative period.
• Explain how to assess a bleeding event related to an invasive procedure.
• Develop and implement a plan for the use of concentrated clotting factors for the prevention or treatment of bleeding secondary to invasive procedures.
• Explain the risks associated with antithrombotic therapy in patients receiving regional anesthesia, as well as recommendations for mitigating these risks.
• Identify factors increasing the risks for venous thromboembolism and bleeding in surgical patients.
• Recommend safe and effective thromboprophylaxis regimens for surgical patients. 

Surgical Infection Prophylaxis and Treatment
ACPE #: 0204-0000-25-768-H01-P
Application-based
1.25 contact hours 

Learning Objectives:

• Recommend preoperative nasal decolonization strategies to prevent surgical site infections (SSIs).
• Describe the use of common surgical scrubs to prevent SSIs.
• Recommend appropriate antibiotic prophylaxis based on the type of surgical procedure.
• Adjust antibiotic dosing based on patient weight.
• Select the appropriate preoperative time frame within which to administer prophylactic antibiotics.
• Recommend redosing intervals for antibiotic prophylaxis during prolonged surgeries.
• Describe the appropriate duration of postoperative prophylaxis.
• Identify the causes, risk factors, and common pathogens associated with surgical site infections.
• Recommend appropriate treatments for surgical site infections including, but not limited to, antibiotic therapy.
• Describe quality measures related to the use of surgical antibiotic prophylaxis. 

Anesthesia Pharmacotherapy - Part 1
ACPE #: 0204-0000-25-769-H01-P
Application-based
2.75 contact hours 

Learning Objectives:

• Identify the stages of anesthesia and the pharmacotherapeutic interventions used to manage the physiologic changes that occur with each stage.
• Recognize complications associated with anesthesia stage II and the potential pharmacologic interventions to manage these complications.
• List the progression of anesthetic stages for both induction and emergence of anesthesia.
• Describe the phases of care for post-anesthesia recovery and common pharmacologic interventions utilized during these phases.
• Summarize the concept and purpose of general anesthesia.
• Explain the mechanisms of action of general anesthetic agents.
• Describe the techniques used for the administration of general anesthesia including airway management devices, monitoring systems, and the steps involved in inducing and maintaining anesthesia.
• Describe the pharmacologic properties of common inhaled anesthetic agents.
• Describe the pathophysiology and treatment of malignant hyperthermia.
• Explain the definition and clinical applications of monitored anesthesia care (MAC), as well as how it differs from general anesthesia and conscious sedation.
• Describe the common pharmacological agents used for MAC including their mechanisms of action, advantages, and potential adverse effects.
• Discuss the criteria for selecting patients suitable for MAC including medical history, type of procedure, and potential risk factors. 

Anesthesia Pharmacotherapy - Part 2
ACPE #: 0204-0000-25-770-H01-P
Application-based
2.25 contact hours 

Learning Objectives:

• Describe the mechanism of action of local anesthetics.
• Categorize local anesthetics based on their structure.
• Identify specific considerations for commonly used local anesthetics.
• Discuss how additives enhance local anesthetics.
• Develop a plan for managing local anesthetic toxicity.
• Identify common local anesthetic agents used in regional anesthesia techniques and their application based on pharmacologic principles.
• Explain common adjuvants to regional procedures and understand the evidence supporting their use.
• Describe adverse drug reactions (ADRs) associated with regional anesthetic drugs and their treatment.
• Describe considerations for anesthesia that are unique to the pediatric population.
• Adjust anesthesia medications and doses for pediatrics patients based on variations in size and comorbidities.
• Describe the physiological changes associated with obesity that impact anesthesia management including respiratory function, cardiovascular considerations, and pharmacokinetics.
• Identify specific medications utilized in bariatric surgeries.
• Describe anticipated complications and outcomes associated with anesthesia in bariatric surgical patients. 

Non-Anesthesia Medications Utilized During the Perioperative Period
ACPE #: 0204-0000-25-771-H01-P
Application-based
2.25 contact hours 

Learning Objectives:

• Compare bowel preparations and their role in colorectal examinations.
• Compare the components of intravenous (IV) fluid options frequently utilized in the perioperative setting.
• Recommend optimal IV fluids for use in the perioperative period based on patient-specific factors.
• Describe the application of dyes in fluorescence-guided surgery and intraoperative imaging.
• Discuss the role of cement and irrigations for surgical site management.
• Identify common etiologies of perioperative cardiac arrest.
• Discuss management of pre-cardiac arrest scenarios in the perioperative setting.
• Modify adult and pediatric acute life support (ALS) algorithms and interventions for application to the perioperative setting. 

Symptom Management in the Postoperative Period
ACPE #: 0204-0000-25-772-H01-P
Application-based
2.75 contact hours 

Learning Objectives:

• Describe the desired outcomes of enhanced recovery protocols.
• List recommendations of enhanced recovery protocols with strong evidence.
• Recommend medication therapy for a patient as part of an enhanced recovery protocol.
• Summarize pharmacologic options for the management of postoperative pain including suggested use, contraindications, and adverse effects.
• Recommend treatment options as part of a multimodal pain management regimen for individuals following surgery.
• Identify risk factors for adults and children for postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting.
• Discuss strategies to decrease patients' baseline risk for PONV.
• Evaluate current antiemetic agents and non-pharmacological therapies used in the management of PONV.
• Compare pharmacologic agents for optimizing bowel function in the postoperative period.
• Explain options for ileus prevention and treatment.
• Create a plan to manage postoperative shivering with pharmacologic and non-pharmacologic options. 

In accordance with our accreditor’s Standards of Integrity and Independence in Accredited Continuing Education, ASHP requires that all individuals in control of content disclose all financial relationships with ineligible companies. An individual has a relevant financial relationship if they have had a financial relationship with ineligible company in any dollar amount in the past 24 months and the educational content that the individual controls is related to the business lines or products of the ineligible company.

An ineligible company is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The presence or absence of relevant financial relationships will be disclosed to the activity audience. 

All other persons in control of content do not have any relevant financial relationships with an ineligible company. As defined by the Standards of Integrity and Independence in Accredited Continuing Education definition of ineligible company. All relevant financial relationships have been mitigated prior to the CE activity.

Each activity consists of audio, video, and/or PDFs and evaluations. Learners must review all content and complete the evaluations to receive continuing pharmacy education credit for each activity. 

Follow the prompts to claim, view, or print the statement of credit within 60 days after completing the activity. 

Important Note – ACPE 60 Day Deadline: 

Per ACPE requirements, CPE credit must be claimed within 60 days of being earned. To verify that you have completed the required steps and to ensure your credits have been reported to CPE Monitor, check your NABP profile account to validate that your credits were transferred successfully before the ACPE 60-day deadline. After the 60-day deadline, ASHP will no longer be able to award credit for this activity.

The ASHP PROFESSIONAL CERTIFICATES℠ educational product line contains learning activities that are ACPE-accredited knowledge and application-based continuing education. This is not an ACPE Certificate Program. Upon successful completion of the activities, the learner will be able to download an ASHP Professional Certificate.