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The Association of periOperative Registered Nurses (AORN), with a membership base of 40,000 RNs and representing the interests of 140,000 perioperative registered nurses in the U.S., has announced it will target seven states in 2011 to enact RN as Circulator. The perioperative RN, through professional and patient-centered expertise, is the primary patient advocate in the operating room and is responsible for monitoring all aspects of the patient's condition. The presence of the RN in the circulating role throughout each surgical procedure is essential for timely delivery of quality surgical care and optimal patient outcomes.
The seven targeted states, Iowa, Massachusetts, Michigan, Minnesota, North Carolina, Ohio, and Virginia, were identified following an interview-based survey of hospitals and ambulatory surgery centers by the AORN Advocacy leaders. Many of these states indicated a strong desire to assure patient safety through the use of an RN circulator for each patient during each surgery.
At least 34 states have legislative or regulatory language specific to the RN serving in the role of circulator in hospitals, ambulatory surgical centers, or both. Twenty-three of these states require that the perioperative RN be present in each operating room throughout each surgical or invasive procedure. Many State Boards of Nursing and the Center for Medicare and Medicaid Services affirm through public directives, advisory opinions, practice guidelines, or regulations that the circulating role belongs to the RN.
The National Academy of Sciences Institute on Medicine recently published a landmark study on the future of nursing. "While its recommendations to expand the role of nurses in all aspects of healthcare are far reaching, the underlying premise is that integrity of the registered nurse in their professional and singular focus to improve patient safety," says AORNs executive director and CEO, Linda Groah, RN MSN, CNOR, CNAA, FAAN. "Now is the time to make a clear statement in favor of patient safety for all surgical patients hospital CEOs, nurse executives and surgeons need to work with their state organizations to enact RN as Circulator legislation."
This requirement is timely at this moment of change in the healthcare system as patient safety becomes a central area of focus. Hospitals and ASCs have not routinely documented the use of an RN Circulator as part of their patient safety improvement and oversight efforts thus placing at risk the continued use of an RN as Circulator as the standard of care established by AORN recommended practices and Medicares conditions for coverage for hospitals.