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Archive , No. 

Your Roadmap to Recovery

Guidelines are a tremendous asset, but your facility must forge its own path forward with elective surgeries in the COVID-19 era.

Jared Bilski


Vangie Dennis, RN, MSN, CNOR, CMLSO
AND WE'RE BACK As facilities begin reopening their doors for elective procedures, staff will have to adjust to new PPE requirements that will include widespread use of N95 masks.

On April 17, the Trump administration issued a three-step plan for reopening the American economy as parts of the nation begin to emerge from the coronavirus outbreak. The plan's first phase green lighted elective surgeries performed in outpatient facilities where COVID-19 cases are decreasing, truly welcome news for idle surgical teams. Since the announcement, nearly half of U.S. states have been given the go-ahead to resume elective surgeries. The staggered reopening of outpatient facilities amid these uncertain times has left many surgical administrators with more questions than answers.

To help guide your ramp-up to resuming surgeries, the Association of periOperative Registered Nurses (AORN) teamed up with the American College of Surgeons (ACS), the American Society of Anesthesiologists (ASA) and the American Hospital Association (AHA) to create a roadmap that guides the readiness, prioritization and scheduling of elective surgeries to ensure maximum patient safety ( Use the roadmap to answer these key questions before reopening your ORs:

  • Are we ready to reopen? There should be a sustained reduction in the rate of new COVID-19 cases in your community for at least 14 days, according to the roadmap. But even if your state's governor has deemed it safe to resume elective cases, expect a lag between when you decide to reopen and when your facility will be ready to start performing surgery.

"It might take a full week to reset for surgery," says Julie Maiden, the director at Surgical Eye Center in Greensboro, N.C. First, she says, perform a deep terminal cleaning with EPA-approved cleaning solutions. Then, make sure every staff member is aware of the physicians' and anesthesiologists' guidelines for appropriate patient selection.

Ms. Maiden also recommends addressing the many logistical issues involved in reopening ORs after a significant hiatus, including ensuring every piece of equipment is in good working order, and checking expiration dates on medication vials and supplies.

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