Avoid recommendations on these subjects

Type of anesthesia; invasive intraoperative monitoring such as pulmonary artery (PA) catheters or transesophageal echocardiography (TEE)

These decisions are best left to the anesthesiologist

Per rectum (PR) meds in any surgery with bowel manipulation (including abdominal surgery, cystectomy, prostatectomy, and gynecologic surgery)

PR medications may affect the surgical site

Diet advancement with abdominal surgery

Let the surgery team advance the diet

Discuss with the surgical team before making recommendations or writing orders on these subjects

Venous thromboembolism (VTE) chemoprophylaxis

Good to recommend, but first discuss bleeding risk with the surgery team

Anticoagulation, including antiplatelet agents

Bleeding risk needs to be discussed with the surgery team

Pain medications

Pain medications should be handled by a single team or service to maintain consistency

Transfusion of blood products

If a patient truly requires a transfusion, it is best to discuss with the surgery team first (see Chap. 26)

Antibiotics

The possibility of infection should be discussed with the surgical team; prophylactic antibiotics are generally discontinued within 24 h of surgery. Antibiotic use risks Clostridium difficile infection, antibiotic-associated diarrhea, antibiotic resistance, and side effects