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Registration, licensure, and accountability.
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Affective competencies.
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Successful delegation skills enhance patient care.
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Surgical technologists regulation placed on legislative agendas across the country.
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Are we repeating history by using surgical assistants?
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Intraoperative use of unlicensed assistive personnel. Healthtrust v Cantrell.
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The evolving role of advanced practice nurses in surgery.
Health care reform has created many opportunities for advanced practice nurses and for OR nurses who want to go beyond traditional circulating and scrub roles. This article will briefly differentiate between expanded and advanced nursing practice and offer a definition and conceptual model for the surgical arena. Literature will be reviewed related to development, evaluation, and practice issues of the emerging role of the surgical advanced practice nurse.
Development and implementation of a perioperative assistant training program.
Due to health care reform, many institutions have had to examine the way they deliver patient care. This article describes how, in response to this challenge, an interdisciplinary OR team at North Shore University Hospital, Manhasset, NY, developed and implemented the role of perioperative assistant in the OR. The authors describe the education curriculum for program completion, along with specific results. The program's difficulties and challenges are described, as well as what was learned as the program proceeded. The authors stress that program implementation depended on the efforts of all staff members, their willingness to help develop the perioperative assistant role, and their ability to function as a team.
Professional collaboration includes recognition of every surgical team member's role.
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An orientation program for unlicensed assistive personnel.
The nursing profession has worked with unlicensed assistive personnel (UAP) for decades; however, with the budget cuts resulting from health care redesign, some health care providers have expressed apprehension about UAP roles (eg, nurse aides, orderlies, unit clerks). Staff members in the perioperative services department at Children's Hospital Medical Center, Cincinnati, have defined a UAP role that enhances the OR's efficiency in patient care and maintains the cost-effective measures outlined in the facility's strategic goals. A key element in the success of this perioperative UAP role implementation has been the development of a competency-based orientation program that helps UAP develop and maintain their specific skills.
RN liability exposure for delegated acts.
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Using a case scenario approach to evaluate age-specific competencies.
Age-specific competencies for staff members having direct patient contact is a requirement of the Joint Commission on Accreditation of Healthcare Organizations. This article addresses an annual competency evaluation of perioperative staff members relating to age-specific criteria. Several types of case scenarios were developed and given to staff members (eg, RNs, surgical technologists, OR assistants, postanesthesia care unit attendants) according to their specific job descriptions and responsibilities within the surgical services department. A case scenario format was used because of the variety of health care personnel and the ability to manipulate the scenarios according to the needs of patients, staff members, and the institution. The evaluation tools were meant to adequately assess staff members' abilities to care for patients throughout the life span.
Perioperative assistants are a new resource.
In the current health care environment, buzzwords such as redesign, reengineering, restructuring, right-sizing, customer service, diversity, quality, multiskilled workers, and unlicensed assistive personnel conjure up many notions about how perioperative nurses can meet the needs and wants of their patients. Unlicensed assistive personnel are becoming commonplace in our hospitals and have assumed a variety of positions and functions. This article describes a project that one hospital undertook to create unlicensed, multiskilled workers in the perioperative area.
Delegation of patient care responsibilities to unlicensed assistive personnel.
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Surgical technologists on the move.
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Washington State's HB 2458 would provide registration for surgical technologists.
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