Visitor Supervision

Guidelines:

• The perioperative RN is the gatekeeper of the OR
• Perioperative nursing practice is an art and a science that includes scientific principles, best practices, and patient advocacy
• Visitors including students, family, and other non-OR personnel should have approval to be in the OR and be supervised while in the OR
• Visitors must maintain compliance with institutional policies

Considerations:

• Pediatric Perioperative Patient:
  • Parental Presence on Induction
  • Clear communication of process
  • Assign personnel to escort parent out after induction
  • Team collaboration to determine appropriateness of parental presence on induction
  • Ensure HIPAA compliance for family in semi-restricted and restricted areas

Nurse’s role:

• Student or non-OR personnel must be:
  • Authorized to be in the surgical suite
  • Wearing identification, preferably with photo
  • Wearing surgical attire
  • Wearing appropriate PPE
• The perioperative RN will:
  • Supervise visitors in the OR
  • Be vigilant to maintain sterility
  • Communicate presence of visitors to the surgical team during time-out
  • Document the name, school/role, and time the visitor is in the OR per institutional policy

Pitfalls:

• The perioperative RN:
  • Is accountable for the patient’s outcome as a result of the nursing care delivered during the operative procedure
  • Core nursing activities may not be performed by anyone who is not a nurse employed by the health care organization
    • Assessment, nursing diagnosis, outcome identification, planning, implementation, evaluation

Examples:

• You are supervising a nursing student in the OR and they ask you if they can do the surgical count with the scrub tech.
  • Surgical counts require at least one RN
  • Surgical counts are a core perioperative nursing activity
  • Surgical counts cannot be delegated

Linchpins (Key Points):

• The perioperative RN is the gatekeeper of the OR
• The perioperative RN must be vigilant to maintain an aseptic environment
• Visitors must be in compliance with institutional policies
• Visitors must wear surgical attire and appropriate PPE