Critical Care Pharmacy Specialty Recertification Literature Study: Module 1A-B (Cert # L219136)

ACPE Numbers: Various – see listing below
Pre-Sale Date: 03/17/2021
Content Release Date: 04/14/2021
Expiration Dates: 10/19/2021
Activity Type: Application-based
CE Credits: 10.00 hours (BPS and ACPE)
Activity Fee: $55 (ASHP member); $110 (non-member)

Accreditation for Pharmacists

ASHP is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Target Audience

These Literature Studies are designed to help board-certified pharmacists who are seeking recertification credit hours to maintain their Board of Pharmacy Specialties (BPS).

Activity Overview

The Literature Study Module is intended for board certified pharmacists in need of recertification credit and is designed based on the content outline developed by the Board of Pharmacy Specialties (BPS). This module consists of 2 online home study activities (see table below). Each activity is designed to assess the learners’ ability to analyze and apply peer-selected contemporary articles to practice and includes a short video for enhanced learning and understanding. 

Module 1A: Devices: This module focuses on infectious diseases. It includes articles related to antimicrobial dosing, treatment of methicillin-resistant Staphylococcus aureus bloodstream infections, and surgical prophylaxis. 

Module 1B: This module includes articles related to the management of the critically ill patient. It includes guidelines related to management of cerebral edema and bleeding in patients on oral anticoagulants, in addition to literature on the use of sedation in critically ill patients, and neurmoscular blockade in acute respiratory distress syndrome. 

Learners will be required to review the content and complete the associated online assessments. The learner must be able to correctly answer the questions based upon their interpretation of the content, as well as “baseline specialty specific knowledge and/or easily retrievable information.” For purposes of this Literature Study, “baseline specialty specific knowledge and/or easily retrievable information” is defined as product labeling and well-established standards of practice in the specialty practice. 

These activities are part of the ASHP professional development program for BCCCP recertification approved by the BPS.

Recertification Credit*

Board certified pharmacists are eligible to receive up to 10 hours of recertification credit for completing this module. To earn recertification credit, learners must review the activity content and successfully complete the online assessments by the deadline. Only completed assessments will be eligible for credit; no partial or incomplete assessments will be processed. You are allowed only one attempt to successfully complete this assessment.

Learning Activity

ACPE Number

Credit Hours

*Assessment Pass Point

Pharmacotherapy and Critical Care Literature Study Module 1A: Infectious diseases

0204-0000-21-957-H01-P

6

73%
Critical Care Pharmacy Literature Study Module 1B: Critical Care Updates

0204-0000-21-964-H01-P

4

75%

 

Articles and Learning Objectives 

Module 1A: Infectious diseases
0204-0000-21-957-H01-P

This module focuses on infectious diseases. It includes articles related to antimicrobial dosing, treatment of methicillin-resistant Staphylococcus aureus bloodstream infections, and surgical prophylaxis. 

Rybak MJ, Le J, Lodise TP et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Am J Health-Syst Pharm. 2020; 77:835-63.

Learning Objectives:

  • Describe the revised consensus guideline from the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) for therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus (MRSA) infections.
  • Apply dosing and therapeutic monitoring recommendations for vancomycin in patients with serious methicillin-resistant Staphylococcus aureus (MRSA) infections based on the 2020  revised consensus guideline and review from the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP). 

Cusumano JA, Klinker KP, Huttner A et al. Towards precision medicine: therapeutic drug monitoring-guided dosing of vancomycin and beta-lactam antibiotics to maximize effectiveness and minimize toxicity. Am J Health-Syst Pharm. 2020; 77:1104-12. 

Learning Objectives:

  • Describe the use of precision dosing through therapeutic drug monitoring of vancomycin and beta-lactam antibiotics to maximize effectiveness and minimize toxicity in critically ill, obese, and older adult.
  • Develop recommendations for the use of precision dosing through therapeutic drug monitoring of vancomycin and beta-lactam antibiotics to maximize effectiveness and minimize toxicity in critically ill, obese, and older adult. 

Abdul-Aziz MH, Alffenaar JWC, Bassetti M et al. Antimicrobial therapeutic drug monitoring in critically ill adult patients: a position paper. Intensive Care Med. 2020: 46:1127-53. 

Learning Objectives:

  • Describe the position paper from the European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT), and International Society of Antimicrobial Chemotherapy (ISAC) about the use of therapeutic drug monitoring (TDM) for antimicrobial agents in critically ill adults.
  • Develop recommendations for the use of therapeutic drug monitoring (TDM) for antibacterial, antifungal, and antiviral agents as part of routine clinical practice for critically ill adults. 

Lodise TP, Rosenkranz SL, Finnemeyer M et al. The Emperor's New Clothes: PRospective Observational Evaluation of the Association Between Initial VancomycIn Exposure and Failure Rates Among ADult HospitalizEd Patients With Methicillin-resistant Staphylococcus aureus Bloodstream Infections (PROVIDE). Clin Infect Dis. 2020; 70:1536-45. 

Learning Objectives:

  • Apply the efficacy and safety findings from the PROVIDE study to the dosing of vancomycin based on area-under-the-curve (AUC) thresholds in hospitalized adults with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections.
  • Recommend appropriate vancomycin dosing and pharmacokinetic monitoring for hospitalized adults with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections.

Tong SYC, Lye DC, Yahav D et al. Effect of vancomycin or daptomycin with vs without an antistaphylococcal β-lactam on mortality, bacteremia, relapse, or treatment failure in patients with MRSA bacteremia: a randomized clinical trial. JAMA. 2020; 323:527-37. 

Learning Objectives:

  • Describe the methods used in the CAMERA2 study of the addition of an antistaphylococcal ß-lactam antibiotic to standard vancomycin or daptomycin therapy for adults with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia.
  • Apply the efficacy and safety findings from the study of adding an antistaphylococcal ß-lactam antibiotic to standard vancomycin or daptomycin therapy for adults with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia.
  • Develop recommendations for the addition of an antistaphylococcal beta-lactam to standard vancomycin or daptomycin therapy for adults with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. 

Branch-Elliman W, O’Brien W, Strymish J et al. Association of duration and type of surgical prophylaxis with antimicrobial-associated adverse events. JAMA Surg. 2019; 154:590-8. 

Learning Objectives:

  • Describe the study of the association of the type and duration of postoperative antimicrobial prophylaxis with adverse events.
  • Develop recommendations for the type and duration of postoperative antimicrobial prophylaxis.

Module 1B: Critical Care Updates
ACPE Number: 0204-0000-21-964-H01-P

This module includes articles related to the management of the critically ill patient. It includes guidelines related to management of cerebral edema and bleeding in patients on oral anticoagulants, in addition to literature on the use of sedation in critically ill patients, and neurmoscular blockade in acute respiratory distress syndrome. 

Cook AM, Jones GM et al. Guidelines for the acute treatment of cerebral edema in neurocritical care patients. Neurocrit Care. 2020; 32:647-666.

Learning Objectives:

  • Describe the Neurocritical Care Society guidelines for the acute treatment of cerebral edema in neurocritical care patients
  • Develop recommendations for the acute treatment of cerebral edema in patients with subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), bacterial or tubercular meningitis, or hepatic encephalopathy (HE). 

Tomaselli GF, Maheffey KW, Cuker A et al. 2020 ACC expert consensus decision pathway on management of bleeding in patients on oral anticoagulants. J Am Coll Cardiol. 2020; 76:594-622. 

Learning Objectives:

  • Describe the 2020 American College of Cardiology (ACC) expert consensus decision pathway on management of bleeding in patients receiving oral anticoagulants.
  • Develop recommendations for the management of bleeding in patients receiving direct-acting oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). 

Shehabi Y, Howe BD, Bellomo R et al. Early sedation with dexmedetomidine in critically ill patients. N Engl J Med. 2019; 380:2506-17. 

Learning Objectives:

  • Describe the Sedation Practice in Intensive Care Evaluation (SPICE) III study of dexmedetomidine use for early sedation in critically ill adults undergoing mechanical ventilation.
  • Develop recommendations for the use of early sedation in critically ill adults undergoing mechanical ventilation. 

Olsen HT, Nedergaard HK, Strøm T et al. Nonsedation or light sedation in critically ill, mechanically ventilated patients. N Engl J Med. 2020; 382:1103-11. 

Learning Objectives:

  • Describe the NONSEDA study comparing (1) no sedation with (2) light sedation plus daily interruption of sedation in critically ill, mechanically ventilated patients.
  • Develop recommendations for the use of sedation in critically ill, mechanically ventilated patients. 

The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network. Early neuromuscular blockade in the acute respiratory distress syndrome. N Engl J Med. 2019. 380:1997-2008. 

Learning Objectives:

  • Describe the Reevaluation of Systemic Early Neuromuscular Blockade (ROSE) trial.
  • Develop recommendations for the use of early continuous neuromuscular blockade in patients with acute respiratory distress syndrome (ARDS) receiving mechanical ventilation. 

Faculty

Full Faculty Bios

Monique Bidell, Pharm.D., BCPS
Infectious Diseases Clinical Pharmacist
Massachusetts General Hospital
Boston, Massachuettes 

Trang Trinh, Pharm.D., M.P.H., BCPS, BCIDP
Assistant Professor of Clinical Pharmacy
UCSF School of Pharmacy
San Francisco, CA

Quinn Czosnowski, Pharm.D., BCCCP
Clinical Pharmacy Specialist, Critical Care
IU Health - Methodist Hospital
Indianapolis, Indiana  

G. Morgan Jones, Pharm.D., BCCCP, FCCM
Clinical Pharmacy Specialist - Neurocritical Care
Methodist University Hospital
Assistant Professor of Neurology, Neurosurgery, and Clinical Pharmacy and Translational Sciences
University of Tennessee Health Sciences Center
Memphis, Tennessee 

Yaman Kaakeh, Pharm.D., BCPS, BCNSP, CNSC, BCCCP
Partner
Salus Vitae Group
West Lafayette, Indiana 

Heather Torbic, Pharm.D., BCPS, BCCCP
Medical ICU Clinical Pharmacy Specialist
Cleveland Clinic
Cleveland, Ohio 

Trent Towne, Pharm.D., BCPS
Associate Professor of Pharmacy Practice
Manchester University College of Pharmacy and Health Sciences
Clinical Pharmacy Specialist, Infectious Disease
Parkview Health System
Fort Wayne, Indiana 

Content Matter Experts

Angela Bingham, Pharm.D., BCPS, BCNSP, BCCCP, FASPEN, FCCP
Interim Vice Chair and Associate Professor of Clinical Pharmacy, PGY2 Critical Care Pharmacy
Residency Program Director, Residency Programs Coordinator
Philadelphia College of Pharmacy, University of the Sciences
Philadelphia, Pennsylvania
Critical Care Clinical Pharmacy Specialist
Cooper University Hospital
Camden, New Jersey

Mary Hess, PharmD, FASHP, FCCM, FCCP, BCCCP
Associate Dean (on separate line) - Professor, Pharmacy Practice
Jefferson College of Pharmacy
Philadelphia, Pennsylvania 

Paul Szumita, Pharm.D., BCCCP, BCPS, FASHP, FCCM
Director of Clinical Pharmacy
Brigham & Women’s Hospital
Boston, Massachusetts 

Reviewers

Susan R. Dombrowski, M.S., R.Ph.
Anna M. Wodlinger-Jackson, Pharm.D., BCPS 

Field Testers

John Austin, Pharm.D., BCPS, BCCCP
Amber Bush, Pharm.D., BCPS, BCCCP
Jennifer  Catlin, Pharm.D., BCPS, BCCCP
Laura Celmins, Pharm.D., BCPS, BCCCP
Calvin Diep, Pharm.D., BCCCP
Roxana Dumitru, Pharm.D., BCPS, BCCCP
Karly Erickson, Pharm.D., BCPS, BCCCP
Stefanie Forman, Pharm.D., BCPS, BCCCP
Mercedes Fraga, Pharm.D., BCPS, BCIDP, BCCCP
Melanie Goodberlet, Pharm.D., BCCCP, BCPS
Julie Haase, Pharm.D., BCPS, BCCCP
Arzo Hamidi, Pharm.D., BCCCP
Brianne Hansen, Pharm.D., BCPS, BCCCP
Coleen Hart, Pharm.D, BCPS, BCCCP
Laila Hasham, Pharm.D.
Ashley Hawthorne, Pharm.D, BCCCP
Joe Kramer, Pharm.D., BCPS, BCCCP
Jacky Lee, Pharm.D., BCPS, BCCCP
Justin Lin, Pharm.D., BCPS, BCCCP
Jane  Litwak, Pharm.D., BCCCP
Courtney McKinney, Pharm.D., BCPS, BCCCP
Michael McQuade, Pharm.D., BCCCP, BCPS
Lilian Ooi, Pharm.D., BCPS, BCCCP
Daniel Padgett, Pharm.D., BCPS, BCCCP
Christine Parker, Pharm.D., BCPS, BCCCP
Jaimini Patel, Pharm.D., BCCCP
Daitiara Perez, Pharm.D., BCPS, BCCCP
Alyssa Polotti, Pharm.D., BCCCP
Breyanna Reachi, Pharm.D., BCCCP
David Reynolds, Pharm.D., BCPS, BCCCP
Alyssa Robertson, Pharm.D., BCPS, BCCCP
Kathryn Rolefs, Pharm.D., BCPS, BCCCP
Alexandria Rydz, Pharm.D., BCCCP
Elena Serpico, Pharm.D., BCCCP
Zachary Smith, Pharm.D., BCPS, BCCCP
Chelsea Wampole, Pharm.D., BCCCP
Brittany Wills, Pharm.D., BCCCP
H. Andrew Wilsey, Pharm.D., BCCCP
Kelsey Zapata, Pharm.D., BCPS, BCCCP 

Disclosures

In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support and the Accreditation Council for Pharmacy Education’s Standards for Commercial Support, ASHP requires that all individuals involved in the development of activity content disclose their relevant financial relationships. A person has a relevant financial relationship if the individual of his or her spouse/partner has a financial relationship (e.g. employee, consultant, research grant recipient, speakers bureau, or stockholder) in any amount occurring the in the last 12 months with a commercial interest whose products or series may be discussed in the educational activity content over which the individual has control. The existence of these relationships is provided for the information of participants and should not be assumed to have an adverse impact on the content. 

All faculty and planners for ASHP education activities are qualified and selected by ASHP and required to disclose any relevant financial relationships with commercial interests. ASHP identifies and resolves conflicts of interest prior to an individual’s participation in development of content for an educational activity. Anyone who refuses to disclose relevant financial relationships must be disqualified from any involvement with a continuing pharmacy education activity. 

All planners, presenters, and reviewers of this session report no financial relationships relevant to this activity. 

Methods and CE Requirements

Activities consist of educational materials, assessments, and activity evaluations. In order to receive continuing pharmacy education credit, learners must:

  • Complete the attestation statement
  • Review all content
  • Complete and pass the assessments
  • Complete the evaluations 

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

System Technical Requirements

Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating web sites. 

View the minimum technical and system requirements for learning activities. 

Development

These activities were developed by ASHP.