RI Passes Legislation Requiring RN Circulators

Publish Date: June 22, 2016


Over the weekend, in the early morning hours of Saturday, the Rhode Island General Assembly passed legislation to ensure there is an RN Circulator in every hospital and freestanding ambulatory surgical center operating room. The two companion bills, H7448 SUB A and S2469 SUB A, will soon be transmitted to the Governor’s office for action.

While having an RN Circulator for every patient in every operating room is a best practice, several states lack strong patient safety laws and regulations which require hospitals and ASCs to follow this best practice at all times. With the passage of and approval on this legislation, Rhode Island will join over 30 states that address the role of an RN Circulator and will become the 25th state to have what AORN considers a strong law or regulation. AORN is excited to see Rhode Island make the safety of patients a top priority.

Specifically, House bill 7448 SUB A and Senate bill 2469 SUBA amend Chapter 23-17 of the Rhode Island General Laws, Licensing of Health Care Facilities, by including definitions of circulating nurse and perioperative nurse and clearly stating the department of health shall not issue or renew a license to a facility unless it has adopted policies and procedures to have a minimum of one circulating nurse physically present in each operating room for the duration of each surgical procedure. The definition in the legislation of circulating nurse is: a “registered nurse licensed to practice in the state of Rhode Island who is educated and trained in perioperative nursing”; and perioperative nursing is defined as: a “specialized area of nursing practice that involves the planning, coordination, delivery, and evaluation of nursing care to patients whose protective reflexes or self-care abilities are potentially compromised during surgical procedures.”

Because AORN maintains that every patient deserves to have an RN Circulator present as an advocate to improve surgical outcomes, and because some perioperative nurses have expressed concerns about whether the best practice of having an RN Circulator for every patient in every OR is consistently employed in their facility, AORN pursues state legislation and regulations that promote patient safety by requiring an RN Circulator for every patient.

“While AORN Government Affairs employs different strategies from state to state in order to ensure every surgical patient has an RN circulator for the duration of a procedure, there are elements that are key to success in every state: patience, persistence, and the active involvement of AORN members,” says Danielle Glover, MPA, AORN Government Affairs Manager.

From the beginning, AORN partnered with members in Rhode Island and the Rhode Island State Nurses Association (RISNA) to educate legislators on the role of the RN Circulator and identify supporters. Representative Joe McNamara, Chairman of the House Health, Education and Welfare Committee, and Senator Cynthia Coyne, member of the Senate Health and Human Services Committee, were not just the primary sponsors of H7448 and S2469, they were champions of patient safety when they spoke to their colleagues about the need for this legislation in Rhode Island.

Legislative efforts are dynamic, ever changing, and require flexibility and collaboration. AORN, RISNA, and AORN members were able to build a coalition of supporters, and everyone worked with the bill sponsors and stakeholders to adjust the bills as necessary.

“As perioperative nurses, it is important that we are advocates for patients in the OR but also in our statehouses. Legislators need to hear nurses’ perspectives and our stories. I am thrilled Rhode Island made patient safety a priority by passing this legislation. This effort required hard work, but it was worth it,” said Julie-ann Greenhalgh BSN, RN, CNOR, AORN Rhode Island member.

Find out if your state has laws or regulations addressing RN Circulators here. If you have concerns about your facility’s policies or practices regarding circulating nurses, or you are interested in helping with legislation in your state to require an RN circulator for every patient in every operating room, please contact Danielle Glover.