AORN Position Statement on
Orientation of the Surgical Technologist to the Perioperative Setting
PREAMBLE
AORN recognizes that facilities come in every size and configuration, and one orientation program will not adequately address every need. There are certain basic components of orientation for the surgical technologist, however, that must be met consistently to ensure optimal patient outcomes.
AORN defines a novice surgical technologist as an entry-level practitioner who has recently graduated from an accredited surgical technology program and who has been employed for one year or less. Experienced surgical technologists with previous OR experience who have been away from the OR for extended periods will be considered novices.
AORN defines an experienced surgical technologist as a technologist with recent OR experience. This technologist should have at least two years of experience in a facility of similar size and patient acuity as the hiring facility. A skills assessment form should be completed to accurately assess competency levels in all specialties.
AORN defines the orientation coordinator as a nurse educator, designated perioperative registered nurse, clinical nurse specialist, and/or nurse manager who is a registered professional nurse.
POSITION STATEMENT
The orientation of the surgical technologist should be completed under the direction of a perioperative registered nurse and individualized to meet the needs of the orientee as well as the facility. The orientee's baseline knowledge and preferred learning method, and the ability of the facility to accommodate the learning experience, need to be assessed in advance. Orientation timelines and the impact on the budget will vary depending on the capacity of the facility.
Teamwork is an essential element in a successful orientation program. Depending on size and resources, facilities should incorporate an experienced surgical technologist, or a group of surgical technologists (eg, an advisory committee), to work with the orientation coordinator to design and implement both the orientation program and the preceptor development program.
The scope of orientation should include the following topics based on the Perioperative Nursing Data Set.1
Domain 1: Safety. In collaboration with the perioperative registered nurse in the circulating role, the surgical technologist will function as a member of the team to maintain an environment that facilitates a safe patient outcome.
- Count policy (O2)
- Culture of safety (O2-O9)
- Electrosurgical safety in the scrub role (O4)
- Laser safety in the scrub role (O6)
- Safe handling of medication in the scrub role (O9)
- Positioning (O5)
- Radiation safety (O7)
- Smoke evacuation (O6)
- Safe handling of specimens in the scrub role (O2)
- Time-out procedure (O2)
- Tourniquets (O2)
Domain 2: Physiologic response. In collaboration with the perioperative registered nurse in the circulating role, the surgical technologist will function as a member of the team to ensure that the patient's physiologic responses to surgery are as expected.
- Basic life support/code response (O14, O15)
- Latex allergy (O3)
- Equipment/instrumentation/supplies
- Minimally invasive (ie, endoscopic) equipment (O2)
- Powered equipment (O10)
- Basic instrumentation (O10)
- Basic OR equipment (eg, tables, lights, electrosurgical unit, suction) (O5, O2)
- Malignant hyperthermia (O12)
- Prevention of infection
- Infection control (O10)
- Surgical attire (O10)
- Wound management (O10)
- Instrument processing (ie, care and handling) (O10)
- Sterilization/disinfection (O10)
- Skin preps (O10)
- Scrubbing, gowning, and gloving (O10)
Domain 3-B: Behavioral response. The surgical technologist has knowledge regarding ethical care and the rights of the patient and his or her family members. (O26)
- Advance directives (O31)
- Age-specific policies (O21, O24)
- Cultural/population-specific policies (O28)
- Compliance with the Health Insurance Portability and Accountability Act (O25)
- Patient privacy policies (O25)
Domain 4: Health system concerns. The surgical technologist has knowledge regarding the health system environment.
- Career advancement
- Certification
- Code of conduct
- Committee participation
- Communication
- Continuing education
- Critical thinking
- Disaster planning
- Employee rights
- Employee safety
- Environmental responsibility (eg, hazardous waste, recycling)
- Fire safety
- Legal issues
- Organizational structure
- Performance improvement projects
- Professional associations
- Regulatory issues
- Scope of practice
- Team roles
- Terminology
- Vendor policies
Additionally, the orientation process should include orientation to off shifts, weekends, and call situations. This should be accomplished using the preceptor system (ie, having an experienced surgical technologist or perioperative registered nurse serve as an immediate resource for the orientee).
A basic orientation for a novice surgical technologist should include every clinical specialty within the technologist's defined practice area and should be measured by successful competency assessment. The recommended exposure to a clinical specialty is at least 40 hours.
Entry into practice for a surgical technologist should be graduation from an accredited surgical technology program.
Completion of an individualized orientation program for both the novice and experienced surgical technologist should be measured by successful competency assessment. The recommended time frame for orientation of a novice surgical technologist should require at least six months. The recommended time frame for orientation of an experienced surgical technologist should take a minimum of at least three months.
Reference
1. S Beyea, ed, Perioperative Nursing Data Set: The Perioperative Nursing Vocabulary, second ed (Denver: AORN, Inc, 2000).
Original approved by the House of Delegates, Washington, DC, March 2006
Sunset review: March 2011