Healthcare Industry Representatives in the OR
October 18, 2016 | Healthcare Risk, Quality, & Safety Guidance
Healthcare industry representatives may help provide nurses, surgeons, and technicians with some of the information they need to keep up with the changing technology of surgical instrumentation and equipment. The Association for periOperative Registered Nurses' (AORN) position statement on the role of industry representatives in the OR states that "by virtue of their education, knowledge, and expertise, health care industry representatives have a valid, but restricted, role in the operative or other invasive procedure setting" (AORN). But when industry representatives are brought into the OR, they may become a hindrance, a safety hazard, or the cause of a lawsuit if they do not understand and adhere to OR protocol or if the hospital fails to delineate its expectations.
Although industry representatives are the focus of this article, many aspects of the discussion apply equally to other OR outsiders, such as visiting surgeons who participate in procedures. (For more information on temporary privileges, see Medical Staff Credentialing. )
A highly publicized incident at a New York City hospital called attention to the need for healthcare organizations to review their policies and procedures for industry representatives in the OR. In 1997, the hospital was fined by New York State for quality-of-care violations related to the death of a woman undergoing a routine hysteroscopic procedure at the hospital's ambulatory care facility (Murphy). Among its findings, the state said the hospital violated accepted standards of medical practice by allowing an unauthorized and unlicensed individual (a medical equipment representative) to participate in the surgical procedure.
The cause of the woman's death, according to the state's report, was fluid overload. Although the industry representative's participation in the procedure was not the cause of her death, questions remain about the extent of his involvement in the procedure. The state's investigative report alleges that the industry representative operated the controls of his company's equipment during the outpatient procedure. The industry representative's firm maintains that he adhered to company policy, which prohibits contact with a patient or medical instrumentation during surgical procedures. In addition, the company states that there was no report of malfunction of its equipment. (*Smart v....