POSITION STATEMENT
Patient Safety
POSITION STATEMENT
AORN believes that
 every patient has the right to receive the highest quality of perioperative nursing care in
every surgical or invasive procedure setting;
 all health care providers must collaborate and strive to create an environment of patient
safety; and
 every patient experiencing a surgical or invasive procedure deserves to have an RN
providing care throughout the perioperative experience, including an RN in the role of
circulator.1
AORN is committed to promoting patient safety by advancing the profession through scholarly
inquiry to identify, verify, and expand the body of perioperative nursing knowledge.2 AORN, as a
leader in patient safety, is dedicated to reducing error, educating health care providers and
patients about safe practices, and creating innovative and collaborative strategies to strengthen
the culture of safety.2
RATIONALE
Perioperative patients are vulnerable to injury, because of diminished or absent sensations of
pain, the inability to act on those sensations, and the inability to communicate or make personal
care decisions. These vulnerabilities increase patients’ risks and require that health care
providers value patient safety as the fundamental priority. The perioperative setting is a high-risk
environment that may have an adverse effect on patient outcomes, including the potential for
infection, hemorrhage, nerve injury, burns, wrong-site surgery, or death. A variety of factors may
cause adverse events to occur. Vital components of a safe, team-based perioperative
environment include effective communication, institutional culture, and the use of appropriate
staffing patterns.3-8
The safety of patients undergoing operative or other invasive procedures is the primary
responsibility of the perioperative RN. AORN’s Perioperative Standards and Recommended
Practices define the scope, responsibilities, and dimensions of professional perioperative
nursing practice. The standards guide individual practitioners in performing safe and effective
care, and are reflected in the value-based behaviors and priorities of the profession. The
recommended practices describe optimal perioperative nursing practices, promote patient and
health care worker safety, and should be used to guide policy and procedure development in
surgical and invasive procedure settings.2
The Perioperative Nursing Data Set (PNDS) is another resource for the perioperative RN to use
in planning, implementing, and evaluating care. It describes patient care interventions and
actions that can be taken to protect the patient and promote positive patient outcomes and the
resources required to accomplish the expected outcomes.9
The perioperative RN establishes a professional bond with the patient through patient
advocacy.2 The patient-nurse bond is further strengthened through nursing interventions that
promote optimal outcomes. The patient’s physical and emotional needs are entrusted to the
perioperative RN by the patient and his or her designated support person(s), who also expect
that the care provided will be safely and effectively delivered by the entire health care team.
REFERENCES
1. AORN position statement on one perioperative registered nurse circulator dedicated to every
patient undergoing a surgical or other invasive procedure. In: Perioperative Standards and
Recommended Practices. Denver, CO: AORN, Inc; 2010:724-726.
http://www.aorn.org/PracticeResources/AORNPositionStatements/Position_RegisteredNurseCir
culator/ AccessedJanuary 20, 2011.
2. Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2011.
3. Wachter RM. Patient safety at ten: unmistakable progress, troubling gaps. Health Aff
(Millwood). 2010;29(1):165-173.
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2009.0785 Accessed January 20,
2011.
4. Greenberg CC, Rogenbogen SE, Studdert DM, et al. Patterns of communication breakdowns
resulting in injury to surgical patients. J Am Coll Surg. 2007;204(4):533-540.
http://www.rmf.harvard.edu/files/documents/events/Buried_20081117/Greenberg.pdf. Accessed
January 20, 2011.
5. US Government Accountability Office (GAO). Patient Safety Act: HHS is in the process of
implementing the act, so its effectiveness cannot yet be evaluated. GAO-10-281. January 2010.
http://www.gao.gov/new.items/d10281.pdf. Accessed January 20, 2011.
6. Kenney LK. Collaborating to support those involved in adverse events. Focus on Patient
Safety. 2009;12(4):6-7. http://npsf.org/paf/npsfp/fo/pdf/Focus_Volume_12_Issue_4.pdf.
Accessed January 20, 2011.
7. Davenport DL, Henderson WG, Mosca CL, Khuri SF, Mentzer RM Jr, and the participants of
the Working Conditions of Surgery Residents and Quality Care Study. Risk-adjusted morbidity
in teaching hospitals correlates with reported levels of communication and collaboration on
surgical teams but not with scale measures of teamwork climate, safety climate, or working
conditions. J Am Coll Surg. 2007;205(6):778-784.
http://www.surgicalpatientsafety.facs.org/disseminate/jacs-davenport.pdf. Accessed January 20,
2011.
8. Stone PW, Mooney-Kane C, Larson EL, et al. Nurse working conditions and patient safety
outcomes. Med Care. 2007;45(6):571-578.
9. Petersen C, ed. Perioperative Nursing Data Set. 3rd ed. Denver, CO: AORN, Inc; 2010.
RESOURCES
AHRQ PSNet Patient Safety Network. Agency for Healthcare Research and Quality.
http://www.psnet.ahrq.gov/index.aspx. Accessed January 20, 2011.
2
Human Factors in Health Care Tool Kit. AORN.org.
http://www.aorn.org/PracticeResources/ToolKits/HumanFactorsInHealthCareToolKit/. Accessed
January 20, 2011.
Original approved by the House of Delegates, San Diego, March 2004
Revision approved by the House of Delegates, March 2007
Revision; approved by the Board of Directors, February 2011
Sunset review, February 2016
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