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OR v. procedure room: 6 things to know

Publish Date: 3/13/2013
While an operating room and procedure room are both spaces where invasive procedures are performed, the differences between the two surgical rooms go significantly beyond just their names. It is critical for perioperative professionals to know about these differences to ensure patients receive their care in the most appropriate space, says Ramona Conner, MSN, RN, CNOR, manager of standards and recommended practices for AORN.

Here are six important things to know about ORs and procedure rooms.

1. "Invasive procedure" is a broad term commonly used to describe procedures ranging from a simple injection to a major surgical procedure. Invasive procedures should be performed in locations suitable to the technical requirements of the procedure with consideration of infection control and anesthetic risks and goals. The perioperative RN should collaborate with the surgeon, anesthesia professional and infection preventionist to differentiate those procedures that carry a high risk of infection, either by exposure of a usually sterile body cavity to the external environment or by implantation of a foreign object(s) into a normally sterile site.

2. OR can be defined as follows: The portion of the surgical suite within the restricted area. It is designed and equipped for performing surgical operations or invasive procedures which require an aseptic surgical field. The room environment is controlled by special heating, ventilation and air conditioning parameters, and access is limited to authorized personnel wearing proper surgical attire.

Any form of anesthesia may be administered in an OR, as long as proper anesthesia gas administration devices are present and exhaust systems are provided.

3. Procedure room can be defined as follows: A room designated for the performance of invasive procedures which do not require a restricted environment but may require the use of sterile instruments or supplies. Moderate sedation, minimal sedation and local anesthesia may be administered in a procedure room.

4. One example of a procedure appropriate for a procedure room is a pain injection, says Byron Burlingame, MS, RN, CNOR, perioperative nursing specialist in AORN's Center for Nursing Practice. "You still have the sterile field, the doctor generally wears a mask and sterile gloves but you do not need the additional environmental requirements."

Another example is corrective laser eye procedures, Conner says.

5. An example of an eye procedure that should be performed in an OR is a corneal transplant. "If you're performing an intraocular eye procedure that requires opening the eye, you need an OR," Conner says. "You're placing tissue or an implant in an orifice or a body cavity that isn't normally exposed to the environment."

6. "Any procedure that can be performed in a procedure room can be done in an OR but not vice versa," says Burlingame.

But this does not mean the OR should be the default space for procedures. "You don't want to provide extraordinary levels of care when it's not warranted," Conner says. "The OR is a very expensive place. There are also productivity management issues as well as patient satisfaction issues. ORs can be very scary places. As a patient, if you don't need to be in one, you'd probably rather avoid it."

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