Clinical Issues—May 2013

Abstract

This Month Immunization recommendations for perioperative observers Key words: immunization, vaccine, vaccination, perioperative observers, perioperative visitors. Legislation related to the immunization of perioperative observers Key words: immunization, vaccine, vaccination, perioperative observers, perioperative visitors, students, immunization legislation, immunization regulation, immunization law. Scrubbed personnel who are sneezing Key words: sneezing, coughing, saliva, mucus, surgical mask. Length of time after which a surgical mask should be changed Key words: surgical masks, wet, soiled, filtration efficiency, microbial barrier. Removing surgical head coverings Key words: surgical head coverings, perioperative areas, microbial dispersal. Surgical wound classification change after glove perforation Key words: surgical wound classification, glove perforation, major break, sterile technique, wound contamination.

AORN Position Statement on the Role of the Health Care Industry Representative in Perioperative and Invasive Procedure Settings

“…Consistent procedures, whether or not the health care industry representative has previous perioperative experience (eg, RN, surgical technologist), so that all representatives are expected to follow the same guidelines and restrictions. Restrictions specifying that health care industry representatives do not provide direct patient care and are not allowed to participate in sterile field activities. Processes for approving health care industry representatives with specialized education to perform calibration or synchronization to adjust or program devices (eg, implanted electronic devices, radio‐frequency devices, lasers) under the direction of the physician. Processes for notifying the health care organization's designated authority in advance when persons in training from the representative's organization will be accompanying an experienced health care industry representative for the purposes of orientation. Processes for informing the perioperative team that a health care industry representative will be present during a specific procedure. Processes for inspecting loaned equipment or sterilizing loaned instruments before the invasive procedure 4 Requirements for tuberculosis (TB) testing and vaccinations as recommended by AORN and the health care organization's infection prevention personnel 6,9,18 Orientation requirements for health care industry representatives that include education in the following areas: relevant devices, equipment, or supplies specific to the procedure in which they will be involved 6 ; compliance with the Health Insurance Portability and Accountability Act (HIPAA) 5 and all matters relating to patient rights and confidentiality 1 ; expected attire 7 in the perioperative invasive procedure area (eg, requiring a different colored hat for health care industry representatives in addition to photo identification and surgical attire); traffic patterns in the perioperative suite 11 ; compliance with hand hygiene practices 12 ; expected conduct related to aseptic principles and sterile techniques 6,10 ; compliance with Occupational Safety and Health Administration (OSHA) requirements 19 for prevention of infectious disease transmission and exposure to bloodborne pathogens 9,19 ; compliance with occupational safety information (eg, biohazardous waste, electrical, radiation) and other safety protocols 6,8,20 ; fire safety and evacuation routes 20 ; and conduct consistent with the “AdvaMed code of ethics on interactions with health care professionals.” 6,21 Designated individuals (eg, supply chain management personnel) who are responsible for authorizing the health care industry representative's presence. Criteria on which to base the approval of the health care industry representative's presence, including time limit during which the health care industry representative will be allowed in the perioperative suite, 4 appropriate identification (ie, photo identification badge),…”

“…Requirements for tuberculosis (TB) testing and vaccinations as recommended by AORN and the health care organization's infection prevention personnel 6,9,18 Orientation requirements for health care industry representatives that include education in the following areas: relevant devices, equipment, or supplies specific to the procedure in which they will be involved 6 ; compliance with the Health Insurance Portability and Accountability Act (HIPAA) 5 and all matters relating to patient rights and confidentiality 1 ; expected attire 7 in the perioperative invasive procedure area (eg, requiring a different colored hat for health care industry representatives in addition to photo identification and surgical attire); traffic patterns in the perioperative suite 11 ; compliance with hand hygiene practices 12 ; expected conduct related to aseptic principles and sterile techniques 6,10 ; compliance with Occupational Safety and Health Administration (OSHA) requirements 19 for prevention of infectious disease transmission and exposure to bloodborne pathogens 9,19 ; compliance with occupational safety information (eg, biohazardous waste, electrical, radiation) and other safety protocols 6,8,20 ; fire safety and evacuation routes 20 ; and conduct consistent with the “AdvaMed code of ethics on interactions with health care professionals.” 6,21 Designated individuals (eg, supply chain management personnel) who are responsible for authorizing the health care industry representative's presence. Criteria on which to base the approval of the health care industry representative's presence, including time limit during which the health care industry representative will be allowed in the perioperative suite, 4 appropriate identification (ie, photo identification badge), 4,7 completion of orientation requirements (eg, AORN OR protocol course 22 ) as designated in the health care organization's policy and procedure, 4,6 attestation from the health care industry representative's company that a background verification was performed upon hire, 6 and documentation of a TB test and vaccinations required by the health care organization's policies and procedures and infection prevention personnel 9,6,18 …”

“…Requirements for tuberculosis (TB) testing and vaccinations as recommended by AORN and the health care organization's infection prevention personnel 6,9,18 …”

“…Criteria on which to base the approval of the health care industry representative's presence, including time limit during which the health care industry representative will be allowed in the perioperative suite, 4 appropriate identification (ie, photo identification badge), 4,7 completion of orientation requirements (eg, AORN OR protocol course 22 ) as designated in the health care organization's policy and procedure, 4,6 attestation from the health care industry representative's company that a background verification was performed upon hire, 6 and documentation of a TB test and vaccinations required by the health care organization's policies and procedures and infection prevention personnel 9,6,18 …”

“…Comply with the health care organization's policies and procedures to obtain permission from the surgeon, obtain authorization from the designated authority, obtain authorization in advance from the designated authority for persons from the representative's organization who will be accompanying an experienced health care representative for the purposes of orientation, bring equipment and instruments for inspection or sterilization before use, and wear proper identification, preferably a photo identification badge 4,7 Update documentation of TB test and vaccinations as required by the health care organization's policies and procedures and infection prevention personnel 6,9,18 Comply with the “AdvaMed code of ethics on interactions with health care professionals.” 21 Comply with the health care organization's policies and procedures to complete orientation as a health care industry representative and requirements for ongoing education in the following areas: relevant devices, equipment, or supplies specific to the procedure in which he or she will be involved 6 ; patient rights and confidentiality requirements included in HIPAA 5 ; expected attire in the perioperative invasive procedure area 7 ; traffic patterns in the perioperative suite 11 ; hand hygiene practices 12 ; expected conduct related to aseptic principles and sterile techniques 6,10 ; prevention of infectious disease transmission and exposure to bloodborne pathogens according to OSHA requirements 6,9,19 ; occupational safety information (eg, biohazardous waste, electrical, radiation) and other relevant safety protocols 6,8,20 ; and fire safety and evacuation routes 20 …”