AORN Statement on Resuming Elective Surgery

[LoveThemSox, BSN, RN]

What are your thoughts on this statement? I read through it after hearing that my hospital is planning to increase the number of surgeries in as little as two weeks. I feel this is waaay too soon considering we still have increasing positive cases in our state and city, and have had a steady number of positive cases in our hospital. After reading the AORN statement I was dismayed to see how vague it was and I’m now afraid our hospital and many others will use it as a blanket approval to start up the ORs again. I am well aware we are the revenue driver for this “non-profit” hospital which ties directly to paying staff, but I truly don’t feel like staff safety is a consideration at all. The AORN statement doesn’t include defined statements for testing all surgical patients and documentation of a recent (again, how do we define recent?) negative test prior to elective surgery. It’s completely left up to individual facilities which is a recipe for cutting corners. The most concrete statement is regarding the 14 day period of “sustained reduction” of Covid cases. That is so vague! How is “sustained reduction” defined? One fewer case each day for 14 days? Depending on how many cases you have at the start, that could be a large decrease or a drop in the bucket. Our administration says we have not done any cases on PUIs that have been found to later be confirmed positive, but I feel that’s pure luck at this point NOT an endorsement to start doing more cases. We have done Covid positive cases and I think we are taking as much precaution as possible with those. But I think it’s irresponsible to simply start increasing cases in 2 weeks and not treat every case with the assumption that it has the potential to later test positive. As a country I feel we have been under-testing and do not have a good sense of how widespread this virus truly is, given the rates of asymptomatic carriers and those transmitting it prior to showing symptoms.
Has anyone else’s facility been discussing resuming elective cases? What is the Covid outbreak like in your area? What do you think about the AORN statement?

[Rose_Queen, BSN, MSN, RN]

Typically, AORN keeps everything fairly vague- guidelines, and now this. They also refer a lot to “interdisciplinary team” decision making. The reality is, the setting where the work takes place affects how well AORN guidelines and other things can be followed. There even used to be a rather confusing Periop101 exam question related to that.

My facility is indeed talking about restarting surgeries. However, it won’t be full speed ahead. Surgeries were triaged- life sustaining or cancellation would be life altering- keep moving. Ambiguous or appealed by surgeons goes for review. A certain list was made no go. So the tentative plan for ramping up is to start with the ambiguous/appealed cases are green lighted while the ones on the certain list are still in a holding pattern.