E

PRESIDENT’S MESSAGE

http://dx.doi.org/10.1016/j.aorn.2014

� AORN, Inc, 2014

Our Pursuit of ExcellenceVICTORIA M. STEELMANPhD, RN, CNOR, FAAN, AORN PRESIDENT

xcellence is providing high-quality, cost-

effective care or services based on the best

evidence available. Excellence is more than a

word or a stationary outcome; it is an ever-changing

goal. As new evidence becomes available, expecta-

tions change and the bar is raised. It is our contin-

uous pursuit of excellence that is the passion that

drives perioperative nursing and allows us to be the

best that we can be as individual nurses and collec-

tively as an organization. Many AORN initiatives

are planned for 2014 to support our pursuit of ex-

cellence, including developing evidence-based clin-

ical practice guidelines, responding to changes in

health care and to our patients, enhancing patient sa-

fety, and preparing perioperative nurses for the future.

EVIDENCE-BASED PRACTICE

This year, AORN will further refine our recom-

mended practices (RP) documents to reflect the

industry standard for evidence-based practice.

AORN Headquarters staff members and the Rec-

ommended Practices Advisory Board are scheduled

to revise some of the RP documents, including the

recommended practices for

n surgical attire,

n cleaning and care of instruments and powered

equipment,

n managing the patient receiving moderate

sedation/analgesia and local anesthesia,

.01.015

n preoperative patient skin antisepsis,

n prevention of unplanned perioperative hypo-

thermia, and

n management of specimens.

This team also will develop a new RP document for

autologous tissue management.

The RP authors and the Recommended Practices

Advisory Board will continue rating the level of

supporting evidence to produce documents that will

be accepted by the National Guideline Clearing-

house.1 This acceptance ensures that our documents

are credible and respected by health care pro-

fessionals and accrediting agencies. To ensure that

these documents are relevant, we rely on your input

when draft documents are posted on the AORN

web site for public comment.

CHANGES IN HEALTH CARE

Informational technology plays a key role in health

care reform. It is essential that nurses measure the

care that we provide, identify opportunities for

improvement, and share the knowledge gained. In

this way, we demonstrate the value of perioperative

nursing. AORN staff members have made signifi-

cant progress in integrating Syntegrity� into

health care information systems, but, this year,

the Perioperative Nursing Data Set and Syntegrity

will be further refined by the AORN staff and

the Perioperative Nursing Data Set Committee

April 2014 Vol 99 No 4 � AORN Journal j 449

April 2014 Vol 99 No 4 PRESIDENT’S MESSAGE

members. The Syntegrity Committee will be

moving forward by developing two care plans:

“Care of the patient with diabetes” and “Care

of the patient with morbid obesity.” We will

be showcasing examples of how integration of

Syntegrity can and has been used to improve the

quality and efficiency of perioperative nursing

care. We rely on you to discuss Syntegrity with

your information system vendors, which, in turn,

helps promote a consumer demand for this product.

The Board of Directors also is responding to

other evolving changes in health care, one of which

is the expectation of active patient involvement

in decision-making. The Board of Directors has

established a task force to develop a report, Guiding

Principles for Perioperative Patient Engagement.

This work builds on a recently published white

paper from the Nursing Alliance for Quality Care,

Fostering Successful Patient and Family Engagement:

Nursing’s Critical Role,2 and will reflect the unique

nature of perioperative nursing.

Other changes in health care are related to

technological advances. In collaboration with the

Association for Radiologic & Imaging Nursing, the

AORN National Committee on Education will be

developing competencies for perioperative nursing

care of patients who are treated in hybrid ORs. This

committee also will be responding to a national

epidemic of obesity by continuing their work on

an educational module for care of the patient un-

dergoing bariatric surgery.

PATIENT SAFETY

The cost of health care has driven a change in the

locations in which surgery is being performed, re-

sulting in an increase in office-based surgery. To

enhance our understanding of safety practices used

in office-based surgery, the AORN Nursing Research

Committee will be surveying personnel in office

settings to identify their familiarity with safety

practices and how frequently they use these prac-

tices. The knowledge gained will serve as a base-

line for identifying what services and products

450 j AORN Journal

AORN might develop in the future to promote

patient safety in office-based surgery.

We will be promoting patient safety through

other initiatives as well. During the past year, we

have seen hurricanes, tornadoes, floods, mass

shootings, and terrorist activities. We have heard

from members that they need additional resources

to support management decisions related to these

events. Although there are individual reports of

how to improve emergency processes published in

the AORN Journal,3 AORN is developing targeted

resources for perioperative leaders to use in pre-

paring for and responding to emergencies. The

members of the newly formed Emergency Pre-

paredness Task Force will assess AORN member

needs, determine what resources are already avail-

able, and develop these additional resources.

Another key component of patient safety is

communication. This June, we celebrate the 10th

anniversary of National Time Out Day. Building on

our success with this collaborative effort, we will

focus on fully integrating and improving surgical

briefings and debriefings through our Safe Surgery

Task Force. From June to December this year,

AORN will host a competition on YouTube�,

selecting the video clip of the best examples of

briefings and debriefings. Stay tuned for more in-

formation about this exciting initiative, and plan to

showcase work from your facility.

FUTURE PERIOPERATIVE NURSES

To ensure that we have highly skilled perioperative

nurses in the future, the Transition into Practice

Task Force will be updating resources for pro-

moting inclusion of perioperative nursing in nurs-

ing education programs based on national priorities

in health care. The Institute of Medicine report on

the Future of Nursing identified nurse residency

programs as a key strategy.4 This task force also

will be developing perioperative case studies for

use in these nurse residency programs.

Education is also changing, with new technology

and techniques that have been demonstrated to

PRESIDENT’S MESSAGE www.aornjournal.org

enhance learning. The Simulation Task Force

will be developing a template for multidisci-

plinary simulations and an initial set of simula-

tions on high-priority topics that perioperative

educators can use to teach these concepts to

perioperative team members.

CONCLUSION

As perioperative nurses, our pursuit of excellence

will never end. I have shared some of the work that

will be undertaken this year in support of this pur-

suit. It takes all of us working together to ensure

that our products and services are relevant and

respected, and that they reflect the best evidence

available. On behalf of the AORN Board of

Directors, I thank all of the volunteers and staff

members who dedicate their time to providing you

with the resources that you need to provide excel-

lent patient care, and all of you who share our

pursuit of excellence.

Editor’s notes: The second edition of the Periop-

erative Nursing Data Set (PNDS) was superseded

by the third edition (PNDS 3) in 2011. The PNDS 3

terminology is only distributed through AORN and

AORN Syntegrity licensed vendors. For questions

about PNDS 3 implementation into the electronic

health record and electronic perioperative record

solutions, please contact the AORN Syntegrity

team via e-mail at syntegrity@aorn.org. AORN

Syntegrity is a registered trademark of AORN,

Inc, Denver, CO. YouTube is a registered trade-

mark of Google, Inc, Mountain View, CA.

References1. National Guideline Clearinghouse. Agency for Healthcare

Research and Quality. http://www.guideline.gov. Accessed

January 21, 2014.

2. Sofaer S, Schumann MJ. Fostering Successful Patient and

Family Engagement: Nursing’s Critical Role. Silver

Spring, MD: Nursing Alliance for Quality Care; 2013.

http://www.naqc.org/WhitePaper-PatientEngagement.

Accessed January 21, 2014.

3. Hemingway M, Ferguson J. Boston bombings: response to

disaster. AORN J. 2013;99(2):277-288.

4. National Research Council. The Future of Nursing: Leading

Change, Advancing Health. Washington, DC: National

Academies Press; 2011.

Victoria M. Steelman, PhD, RN, CNOR, FAAN,

is the AORN president and an assistant pro-

fessor at The University of Iowa College of

Nursing, Iowa City. Dr Steelman has no de-

clared affiliation that could be perceived as

posing a potential conflict of interest in the

publication of this article.

AORN Journal j 451