Your Guide to 2019 Guidelines

The 2019 edition of Guidelines for Perioperative Practice provides a critical look at the latest evidence for practice that brings big changes to some long-standing "sacred cows" in the OR, such as when to cover the sterile field.

The long-awaited Safe Patient Handling and Movement guideline is also included in this latest edition, providing ergonomic tools to determine appropriate staffing and devices that should be applied in daily practice.

“AORN is dedicated to supporting your practice by critically appraising and synthesizing evidence to make recommendations that enhance your decision making rather than a one-size-fits-all approach, so that our guidelines are relevant to your individual patient encounters,” says Amber Wood, MSN, RN, CNOR, CIC, FAPIC, AORN’s Editor-in-Chief of Guidelines for Perioperative Practice.

Enhancing Practice Decisions with Evidence

There’s no time like the present to begin implementing practice changes that adhere to the most current AORN guidance. Here is a round-up of some of the major 2019 recommendations in six guidelines to adopt in your practice setting:

Sterile Technique: Updated

The updated Guideline for Sterile Technique includes a new recommendation to not only cover the sterile field during delays, but also to cover portions of the sterile field that are not in immediate use.

Several other updates in this guideline recommend the following:

• Determine the need for physically monitoring the covered sterile field based on individual facility decision,
• Position the OR table within the unidirectional ultraclean air delivery system (laminar air flow),
• Wear a surgical helmet system when exposure to blood or body fluids is anticipated, and
• Limit OR door openings.

Safe Patient Handling and Movement: New

Eight recommendations in this new guideline address the evidence for safe handling and movement related to topics such as culture of safety, ergonomic design and practices, patient assessment, competence, and product selection tailored to perioperative patients and team members. It also includes seven ergonomic tools to help teams make safe decisions in specific perioperative patient handling and movement scenarios, including:

• Lateral transfer of a patient from a stretcher to an OR bed;
• Lifting and holding the patient’s legs, arms, and head while prepping;
• Solutions for prolonged standing;
• Tissue retraction;
• Lifting and carrying supplies and equipment; and
• Pushing, pulling and moving equipment on wheels.

Design and Maintenance: New Focus

Restructured to only address evidence-based design, construction and maintenance recommendations for all areas within the perioperative setting, the guideline applies to a wide range of phases involved in creating safe OR spaces, including:

• Rethinking traffic pattern area designations for unrestricted, semi-restricted and restricted areas;
• Following the patient through perioperative care to plan intuitive design that supports better throughput efficiency and patient safety; and
• Standardizing maintenance planning for daily operations.

Safe Environment of Care: New Focus

Restructured to only address care activities in the OR environment, this guideline addresses the evidence for mitigating environmental care risks such as distractions, fire safety, and staff exposure to hazards. The patient and staff risks addressed in this guidance include the following:

• Conducting a preoperative fire risk assessment as a team,
• Taking precautions to reduce the risk for exposure to thermal injuries from patient warming techniques,
• Mitigating staff exposure to waste anesthesia gasses and chemicals, and
• Minimizing noise and distractions created by personnel as well as equipment and devices.

Sterilization: Updated

This update provides more detailed and evidence-based practices within each step of the sterilization process, including for immediate-use steam sterilization (IUSS). Several of these important recommendations for the complete sterilization process address the following:

• Follow the complete sterilization process to ensure saturated steam under pressure is used to sterilize heat- and moisture-stable items unless otherwise indicated by the device manufacturer;
• Perform sterilization in an area intended, designed, and equipped for sterilization processes; and
• Monitor sterilization processes in all areas of the facility where sterilization processes are performed.

Transmission-Based Precautions: Updated

With a new title, this guideline addressing practice precautions to prevent transmission of pathogens in the perioperative setting covers a number of new recommendations that address the following:

• When and how to doff and don personal protective equipment (PPE), as well as recommended strategies for a health care organization to address barriers and educational opportunities for correct PPE practices;
• Selecting gown and mask type according to task and degree of anticipated exposure;
• Wearing PPE during patient transport activities; and
• Requiring visitors to wear PPE when visiting patients who require transmission-based precautions.

Improving Implementation Support

The 2019 edition of Guidelines for Perioperative Practice has been redesigned with several features that make finding information in the guidelines easier. These include a new table of contents for each guideline to find topics easier, and an acronym list within each guideline to keep track of abbreviations.

Preorder your 2019 edition of Guidelines for Perioperative Practice today, and lock in 2018 pricing.

FREE RESOURCES FOR MEMBERS

Guideline Essentials: Easily implement evidence-based practices for the updated guidelines with members-only resources and tools:

• Quick Views: photos, illustrations, videos, and an overview of the guideline
• Gap Analysis Tools: Tools to assess areas in which your facility may not be compliant with the guidelines.
• Policy & Procedure Templates: Ready-to-use customizable templates for developing your facility’s policies and procedures
• Competency Verification Tools: Ready-to-use customizable templates for verifying competency to meet facility requirements