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South Dakota Confirms RN Circulator Requirement

Publish Date: September 29, 2015

Last week the South Dakota Department of Health adopted updates to its hospital and ambulatory surgery center rules confirming the use of an RN Circulator in operating rooms, which go into effect on October 11, 2015. The changes to administrative rules Article 44:75 and Article 44:76 now add a definition of circulating nurse and require the use of a circulating nurse in each operating room for the duration of the procedure. 

The definition of a circulating nurse is, “A registered nurse trained, educated or experienced in perioperative nursing who is responsible for coordinating and monitoring the nursing care and safety needs of a patient in the operating or procedure room and who also meets the needs of the operating room team members during surgery.  The circulating nurse works outside the sterile field in which the operation takes place and duties include but are not limited to recording the progress of the operation, accounting for instruments, and handling specimens”. 

Additionally, the rules, which apply to both hospitals and ambulatory surgery centers, state “A Circulating Nurse shall be assigned to each operating/procedure room during a procedure and shall be present for the duration of the surgical procedure unless it becomes necessary for the nurse to leave the operating or procedure room as part of the procedure or the nurse is relieved by another circulating nurse.” 

South Dakota joins over 30 states that address the role of an RN Circulator and becomes the 24th to have what AORN considers a strong requirement. Perioperative nurses who work in South Dakota should ensure their facility policy is updated in order to be in compliance with the new rules.

Changing the Rules 

Regulations are rules imposed by a regulatory body. In this case, the South Dakota Department of Health. Changing regulations is not a quick process. In fact, it can take years to see change. The process to add language to the administrative rules about circulating nurses in South Dakota started a few years ago. AORN Government Affairs worked with a lobbyist, the state legislative coordinator, Sue McNaboe, the South Dakota Department of Health, and other stakeholders to develop language defining a circulating nurse and requiring an RN circulator in all operating rooms. 

Because the language needed to go into the facility rules, the group had to wait until those rules were up for review by the Department of Health.  The Department of Health reviewed the rules and proposed several changes, one of which was adding the circulating nurse language. After a regulatory agency proposes rules, there are public comment periods and public hearings. AORN submitted a letter of support for the circulating nurse language in Article 44:75 and Article 44:76 in November 2014 and again in July 2015 during the public comment period, and the AORN contract lobbyist testified in support of the changes in August 2015 at the public hearing.

While changing regulations can be time consuming, the hard work pays off. As Sue McNaboe, AORN South Dakota legislative coordinator says, “As a perioperative nurse, I am thrilled to see that South Dakota is putting patient safety first. It may have taken a while, but the effort paid off”. 

“AORN Government Affairs employs many strategies to promote laws and regulations to ensure every surgical patient has an RN circulator for the duration of a procedure, but patience, persistence, and the active involvement of AORN members is essential to changing regulations and laws,” says Danielle Glover, MPA, AORN Government Affairs Manager. If you are interested in pursuing language in your state to require an RN circulator for every patient in every operating room, please contact Danielle Glover

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