13 Scope of Practice and Standards Additions to Inform Your Practice

Every edition of AORN’s Guidelines for Perioperative Practice begins with Perioperative Nursing: Scope and Standards of Practice (Standards). These Standards describe the who, what, where, when, why and how of perioperative practice to achieve positive patient outcomes consistent with nurses’ social commitment to society as advocates for surgical patients.

Every five years AORN reviews and updates the Standards and the latest reflects important additions that all perioperative nurses should be familiar with, according to AORN CEO and Executive Director Linda Groah, MSN, RN, CNOR, NEA-BC, FAAN.

For example, in the past five years, advances in technologies have influenced the move of more surgical procedures to outpatient care. Response through the COVID-19 pandemic has increased advancements in telehealth, and a more honest and informed look at equitable care has put the spotlight on healthcare disparities and other unique needs for surgical patients. 

“Perioperative nursing is constantly changing to meet the needs of the surgical patient and we must ensure that the scope and standards of practice that direct our approach to perioperative nursing care reflect these advances,” Groah says.

Why Our Standards of Perioperative Nursing Practice Matter

The Standards provide a mechanism to delineate the responsibilities of RNs engaged in practice in the perioperative setting, which serve as the basis for many different facets of care, Groah explains. For example, perioperative nursing job descriptions, quality monitoring and health system evaluations leverage language and descriptions from the Standards. Additionally, they inform the development and evaluation of delivery models of nursing care and raise awareness of current trends in perioperative practice.

The Standards also align with the broader nursing community by incorporating language from three important resources from the American Nurses Association:

• Code of Ethics for Nurses with Interpretive Statements, which lists the explications that establish the ethical framework for RNs across all roles, levels, and settings.
• Nursing’s Social Policy Statement: The Essence of the Profession, which conceptualizes nursing practice, describes the social context of nursing, and provides the definition of nursing.
• Nursing: Scope and Standards of Practice, 4th edition, which outlines the expectations of the professional role of the RN, includes the scope of practice statement for nursing, and identifies the Standards of Professional Nursing Practice and their accompanying competencies.

“Building on these ANA resources, our Standards describe the scope of perioperative nursing practice, and identify our specialty’s Standards of Practice and Standards of Professional Performance and accompanying competencies,” Groah notes.

She acknowledges the wide range of professions outside of nursing that refer to the Standards, including legislators, regulators, legal counsel, and even patients and their families who each look to these Standards to understand what constitutes the perioperative nursing specialty.

Updates in the 2022 Scope and Standards of Perioperative Nursing Practice

Major updates to both the standards and the scope of practice portions of the Standards focus on new additions.

Here’s a look at the key 2022 additions in the two sections:

1. Changes to Scope of Practice
   The additions in this section are wide-reaching and comprehensive, addressing current trends in practice and education, including:

• Importance of evidence-based practice in perioperative nursing
• Current trends and issues impacting perioperative nursing care, such as telehealth, team communication and social determinants of health
• Movement of surgery into the outpatient setting
• Changes in education for perioperative nursing
• Perioperative-patient focused care model
• Implications of ethics in perioperative nursing practice
• Impact of technology on care of the surgical patient

2. Changes to Standards of Practice
   The perioperative standards of practice and related competencies are identified for each standard for the graduate level prepared RN, including the advance practice registered nurse. New standards added in this section include:

• Ethics
• Advocacy
• Respectful and equitable practice
• Scholarly enquiry
• Environmental health
• Resource Utilization