New statement addresses sales reps in the OR
New statement addresses sales reps in the OR
A new position statement on the role of the health care industry representative in the operating room is designed to help the perioperative team maintain the patient’s safety, right to privacy, and confidentiality when a representative is in the operating room.
Development of the statement follows a case at Beth Israel Medical Center in New York City where a patient died after a procedure in which a sales representative operated the electrosurgery system. (For more information, see Same-Day Surgery, February 1999, p. 19.) The statement, from the Denver-based Association of periOperative Registered Nurses (AORN), recommends the following precepts:
1. Develop policy in collaboration with the facility’s risk management and/or legal counsel to ensure compliance with applicable laws.
2. Develop a system that addresses informed patient consent regarding the presence and role of a health care industry representative in the operating room during a surgical procedure. This system should include documentation in the medical records.
3. As the patient’s advocate, the RN responsible for the patient’s care during the procedure is accountable for maintaining the patient’s safety, privacy, dignity, and confidentiality. To achieve this, the RN should monitor the sales representative’s activities whenever possible and facilitate the representative’s service to the patient and the perioperative team. The RN should be informed prior to the procedure that a health care industry representatives will be present and about his or her purpose for being there.
4. Perioperative team members are responsible for acquiring instruction on new procedures, techniques, technology, and equipment with which they are not familiar prior to their use in a surgical procedure. The health care industry representative may provide this instruction. The facility should maintain evidence of documented competencies for health care professionals, especially when introducing new procedures, techniques, technology, and equipment as required by the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL.
5. Develop a system that documents that the representative has completed instruction in the principles of asepsis, fire and safety protocols, infection control practices, bloodborne patho-gens, and patient’s rights. Based on community standards, this might range from maintaining up-to-date documentation provided by the health care industry representative’s employing company to providing facility-specific instruction and training. (See story on AORN training course, p. 88.)
6. The sales representative’s presence and purpose should be prescheduled with the designated operating room management authority and the surgeon in accordance with facility policy.
7. The representative should wear identification while in the facility.
8. Develop a system that clearly delineates limits on the representative’s activities in the operating room based on community standards. The representative should not scrub in.
9. A representative with specialized training may perform remote calibration to adjust devices to meet the surgeon’s specifications (e.g., pacemakers, laser technicians).
10. The facility’s service provider must review and approve medical equipment and other complex devices prior to their use. "Service provider" is defined as a "group with the responsibility to provide inspection and/or other maintenance services on a specific piece of equipment."
11. Have a clearly defined mechanism to address departures from established policy.
(Reprinted with permission. Position Statement on the Role of the Health Care Industry Representative in the Operating Room. Denver: Association of periOperative Registered Nurses; May 2000.)
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