Perioperative refers to around the time of surgery, encompassing the expanse of time following when the patient goes into the hospital, clinic, or doctor’s office for surgery until the patient is discharged home. With numerous variables introducing potential malicious pathways for error, perioperative practices are supported largely by standardized practices.
This is the focus of the Association of periOperative Registered Nurses (AORN), which offers continuing education and clinical practice resources that strive to assure optimal outcomes in medical care. In uniting and empowering surgical nurses, health care organizations, and the industry, the professional organization is also responsible for the AORN Guidelines for Perioperative Practice.
Developed through a highly academic approach, guidelines approved by the AORN Recommended Practices Advisory Board and subsequently published by the AORN offer approaches for assuring patient and worker safety, providing aseptic conditions, and granting the safe and effective use of medical devices. They are drafted with the utmost knowledge thanks to evidence-based practices, which are formulated by thoroughly delving into scientific literature during a review process. This assures the veracity of the information provided.
AORN MAN-836D-2016: Guideline for Hand Hygiene details guidance for hand hygiene and surgical hand antisepsis in the perioperative setting. This is seemingly simple but crucial. Hand hygiene is widely accepted as a method of preventing the spread of illness in everyday use, so, in the surgical setting, hand washing and good hygiene practices prevent health care associated infections. Reducing or preventing these can help avoid increased use of antibiotics, delayed wound healing, extended hospital stay, pain and suffering, and even mortality.
With transient and resident microorganisms present normally on the hands, the AORN MAN-836D-2016 guideline is purposed with helping to remove soil and transient microorganisms from perioperative team members and suppress the growth of resident microorganisms during the surgical procedure. In limiting the risk of a patient developing a surgical site infection, the guideline covers washing hands, managing fingernails, and appropriate jewelry.
AORN MAN-847F-2018: Guideline for a Safe Environment of Care, Part 1 is a broader document, detailing guidance for cultivating a safe environment of care for patients, perioperative personnel, and the equipment used in the perioperative setting. It includes recommendations surrounding musculoskeletal injury, fire safety, electrical equipment, clinical and alert alarms, blanket- and solution-warming cabinets, medical gas cylinders, waste anesthesia gases, latex, chemicals, and hazardous waste.
AORN MAN-843D-2018: Guideline for Care of Patients Undergoing Pneumatic Tourniquet-Assisted Procedures covers the use of pneumatic tourniquets—including testing, applying, and cleaning equipment—to occlude blood flow, obtain a near-bloodless field for extremity surgery, or confine a bolus of anesthetic in an extremity for intravenous regional anesthesia. According to the document, a survey of 398 surgeons working in 71 health care organizations indicated an estimated 63,484 procedures involved a pneumatic tourniquet.
Additional Guidelines for Perioperative Practice published by AORN include: