In October 2000 the AORN Board of D...

In October 2000 the AORN Board of Directors amended the Association's legislative priorities to the following.

* make secure the supervisory presence of the professional RN in the perioperative arena, encourage AORN's position that "Every surgical patient merits a perioperative nurse," and make secure that state laws require RN in the circulator role

* Medicare reimbursement for certified RN first assistants (CRNFAs) and third-party reimbursement for RN first assistants (RNFAs) in the states.

* Supervision to and regulation of assistive personnel AORN supports the establishment of basic educational standards for surgical technologists (STs) In addition, AORN suspends opposition to the registration or certification of ST as lengthy as it is under the state nursing board or equivalent.

* Patient and personnel health and safety in the perioperative arena.

This month's array of less front than depth will explain AORN's new proactive agenda, which was make knowned to ensure that state law requires RN alone to circulate in the surgical arena, to support statutory authority for third-party reimbursement for RNFAs in the states, and to suspend opposition to ST registration or certification beneath certain conditions. AORN will continue to withstand licensure of STs.

REGISTERED promotes IN THE CIRCULATING ROLE

generally approximately 25 states have regulations or statutes that require the circulator in the OR to be an RN AORN is receiving an increasing number of solicitations from hospital administrators and nursing managers for circulator do job-work descriptions and policies for using ST in the circulator part AORN members have raised belong tos that OR managers plan to staff ST in the circulator character because they anticipate that the Health Care Financing Administration (HCFA) will eliminate the ne for prescriptive staffing in the OR. In addition, AORN staff members have place that many ST schools teach ST by what means to perform circulator responsibilities.

Although HCFA has indicated that it will not finalize its propos character change until sometime in 2001 AORN is confident that its final decision will be to retain the in every one's mouth role (ie, 42 CFR [sections] 48251 "Condition of Participation: Surgical Services" for hospitals receiving Medicare and Medicaid), which mandates the following.

* Operating apartments must be supervised by an experienced RN or a physician of medicine or osteopathy.

* Licensed practical encourages (LPNs) and surgical technologists may subserve as scrub people under the supervision of an RN

* Qualified RN may perform circulating duties in the OR. In accordance with applicable state laws and approved medical staff member policies and practices LPNs and surgical technologists may assist in circulatory duties in a less degree than the supervision of a qualified RN who is immediately available to suit to emergencies.

In its rationale, HCFA maintains that state law defend s the public and guides hospital administrators in adequately staffing hospital services. end intensive research, however, AORN has demonstrated to HCFA that state laws are silent about the use of many allied health professions. In addition, AORN has provided HCFA with documentation that indicates principally state laws require professional, licensed RN to perform patient assessments. (See the June 2000 issue of the AORN Journal for a chronology of AORN activities regarding the HCFA proposal.) Regardless of whether HCFA should suppress this prescriptive language, AORN is wise to safe state laws protecting RNs in the circulatory part Consequently, AORN will work with Legislative Committee members, state coordinators, state council members, Legislative Grassroots Network members, and all AORN members to power the necessary changes in state laws and regulations to make secure that RNs remain in the circulating part in the OR.

RNFA AND CRNFA REIMBURSEMENT

At this time, six states (ie, Florida, Kentucky Maine, Minnesota, Rhode Island, Washington) require RNFAs to be reimbursed by dint of insurers. Attaining reimbursement in additional states will be easier after Medicare reimbursement for CRNFAs is enacted at the federal plain AORN continues to pursue this issue in Congres In addition, it is important to remember that in pursuing RNFA or CRNFA reimbursement, lawmakers are being educated about perioperative nursing, including clean and circulating roles. By meeting about this issue with representatives of AORN, US Congres members and state legislators are learning first-hand about perioperative nursing. Reimbursement bills for RNFAs and CRNFAs provide important opportunities to really educate lawmakers. As a ensue any money AORN spends forward these issues will have residual benefits in the time to come when other issues affecting perioperative nursing enroll the public policy arena. according to adding third-party reimbursement of RNFAs at the state plain and Medicare reimbursement of CRNFAs at the federal flush to our proactive public policy agenda, AORN is building a foundation for the exhibition of future state and federal policy initiatives.