Implementing AORN Recommended Practices for Product Selection

CONTINUING EDUCATION 

Implementing AORN 

Recommended Practices 

for Product Selection 

JULIE A. CONRARDY, MSN, RN, CNOR, CNS-BC 

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indicates that continuing education contact hours are 

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Purpose/Goal 

To educate perioperative nurses about how to implement the 

AORN “Recommended practices for product selection in 

perioperative practice settings.” 

Objectives 

1. Discuss AORN’s practice recommendations for product 

selection and evaluation. 

2. Identify the benefits of implementing a multidisciplinary 

product selection and evaluation team. 

3. Discuss methods for implementing AORN’s practice 

recommendations for product selection. 

Accreditation 

AORN is accredited as a provider of continuing nursing 

education by the American Nurses Credentialing Center’s 

Commission on Accreditation. 

2.7 

www.aorn.org/CE 

Approvals 

This program meets criteria for CNOR and CRNFA 

recertification, as well as other continuing education 

requirements. 

AORN is provider-approved by the California Board of 

Registered Nursing, Provider Number CEP 13019. Check with 

your state board of nursing for acceptance of this activity for 

relicensure. 

Conflict of Interest Disclosures 

LCDR Conrardy has no declared affiliation that could be 

perceived as posing a potential conflict of interest in the 

publication of this article. 

The behavioral objectives for this program were created 

by Kimberly Retzlaff, editor/team lead, with consultation 

from Rebecca Holm, MSN, RN, CNOR, clinical editor, 

and Susan Bakewell, MS, RN-BC, director, Perioperative 

Education. Ms Retzlaff, Ms Holm, and Ms Bakewell have 

no declared affiliations that could be perceived as posing 

potential conflicts of interest in the publication of this 

article. 

Sponsorship or Commercial Support 

No sponsorship or commercial support was received for 

this article. 

Disclaimer 

AORN recognizes these activities as continuing education for 

registered nurses. This recognition does not imply that AORN 

or the American Nurses Credentialing Center approves or 

endorses products mentioned in the activity. 

doi: 10.1016/j.aorn.2012.04.001 

788 j AORN Journal June 2012 Vol 95 No 6 Published by Elsevier, Inc., on behalf of AORN, Inc.

RECOMMENDED PRACTICES 

ABSTRACT 

Implementing AORN 

Recommended Practices 

for Product Selection 

JULIE A. CONRARDY, MSN, RN, CNOR, CNS-BC 2.7 

This article focuses on the revised AORN “Recommended practices for product 

selection in perioperative practice settings.” Hospitals and ambulatory surgery 

facilities should have protocols in place for product evaluation that includes 

a multidisciplinary team approach. The process for product evaluation and selection 

includes gathering information; establishing consistent requirements for product 

evaluation; performing a financial impact analysis; investigating a plan to standardize 

products; conducting an environmental impact analysis; determining 

whether to purchase single-use, reposable, or reusable products or reprocess singleuse 

devices; developing an evaluation process based on objective criteria; and 

developing and implementing a comprehensive plan to introduce and use new 

products. Use of an evaluation tool that is based on objective criteria is one way to 

obtain valuable input during product evaluations. Because of varied roles and 

experiences, the perioperative RN is an integral member of the product selection 

committee. AORN J 95 (June 2012) 789-800. Published by Elsevier, Inc., on behalf 

of AORN, Inc. doi: 10.1016/j.aorn.2012.04.001 

Key words: AORN recommended practices, product selection, product evaluation, 

multidisciplinary team, environmental impact. 

Product selection is not as simple as acquiring 

a new product, trying it out in the perioperative 

setting, asking one provider’s 

opinion, and then determining whether a facility 

will use it. The purpose of the AORN “Recommended 

practices for product selection in perioperative 

practice settings” is to “provide guidelines for 

evaluating and purchasing medical devices and 


other products used in perioperative settings.” 1(p191) 

There are six recommendations that will assist perioperative 

nurses in selecting appropriate products 

for use in the perioperative arena. The following 

article is by no means a “how-to” guide, but 

rather a discussion of the recommended practices 

that is intended to assist readers in following the 

steps from the beginning to the end of the product 

doi: 10.1016/j.aorn.2012.04.001 

Published by Elsevier, Inc., on behalf of AORN, Inc. June 2012 Vol 95 No 6 AORN Journal j 789

June 2012 Vol 95 No 6 CONRARDY 

selection process and implementing a multidisciplinary 

team approach to product selection. 

WHAT’S NEW? 

The newly updated recommended practices (RP) 

document was first published electronically in 

January 2010 in AORN’s Perioperative Standards 

and Recommended Practices. The most significant 

changes from the previous version, which was first 

published in 2004, are more detailed descriptions 

of the requirements for establishing a multidisciplinary 

team that represents the facility and the 

requirement that perioperative RNs demonstrate 

competency related to product evaluation and 

selection. 

Multidisciplinary teams are not static, but rather 

ever changing. The composition of the committee 

changes based on the products being evaluated. 

Perioperative nurses are essential participants for 

product evaluations because they are in the unique 

position to provide end-user input as well as 

patient feedback on many products. Perioperative 

nurses are natural leaders and should understand 

the importance of showing and maintaining 

competency related to product and equipment 

Educational Resources 

n The Role of the Perioperative Nurse in Product Evaluation and 

Selection. http://www.aorn.org/Education/Specialty_Education/ 

Product_Evaluation_and_Selection_Course.aspx. 

n Perioperative Management Resources: Evaluation of New 

Technology. Denver, CO: AORN, Inc; 2005. http://www.aorn 

bookstore.org//product/product.asp?sku¼MAN376. 

n Product selection. In: Policy and Procedures Templates [CD- 

ROM]. 2nd ed. Denver, CO: AORN, Inc; 2010. http://www 

.aorn.org/Books_and_Publications/AORN_Publications/Policy_ 

and_Procedure_Templates.aspx. 

n AORN position statement on environmental responsibility. 

http://www.aorn.org/Clinical_Practice/Position_Statements/ 

Position_Statements.aspx. 

Web site access verified February 16, 2012. 

790 j AORN Journal 

usage to help promote patient safety. Establishing 

a consistent method for product evaluation will 

streamline the process and help eliminate wasted 

time and effort. 

The RP also highlights the need for contractual 

agreements, financial analysis, product requirements, 

environmental impact, an evaluation 

process, and an implementation process if products 

are selected. Additionally, the revised RP provides 

guidance on measuring quality assurance and process 

improvement, as well as establishing and 

maintaining user competency and continued 

training and education on selected products. 

RATIONALE 

The perioperative practice setting, be it a large 

hospital or a busy ambulatory facility, is the 

optimal location for assessing new products. 

“Innovations in procedures and technology are 

drivers of perioperative practice, and nurses in 

particular must find ways to incorporate new 

products into the perioperative setting.” 2(p334) The 

varied expertise of perioperative RNsdas leaders, 

educators, infection prevention professionals, 

researchers, and patient advocates, to name a 

fewdplaces them in 

a unique position to effectively 

integrate and evaluate 

products based on standards 

of safety and quality of 

patient care. 2 

Perioperative RNs 

develop an extensive 

working knowledge of 

surgical procedures, 

processes, and outcomes for 

each procedure in which 

they are involved, and they 

can become well versed in 

the complete and complex 

perioperative experiences 

of patients from beginning to 

end. This puts them in an 

ideal position to offer critical

RP IMPLEMENTATION GUIDE: PRODUCT SELECTION www.aornjournal.org 

and timely feedback based on evidence-based 

practice and provider experience with 

many products. 

In today’s economically challenging environment, 

facility administrators and other personnel 

are looking for ways to “trim the fat” from budgets 

across the board. Some are quick to say that there 

is no price too high to put on patient safety, and 

they are correct; however, perioperative RNs have 

a fiscal responsibility as well and must participate 

in the process for evaluating and selecting the 

best quality products that will ensure both costeffectiveness 

and patient safety. “All health care 

organizations should have processes to evaluate 

purchases of new products.” 3(p782) If product evaluation 

and selection are made through a thorough 

systematic approach, then outcomes will contribute 

to safe patient care, consumer satisfaction, and cost 

containment. 

DISCUSSION 

Product selection is often complex, but with an 

established process in place, it can be simplified. In 

this section, each recommendation from the RP 

document will be discussed briefly, with emphasis 

on the perioperative RN’s role, potential barriers to 

implementation, and strategies for overcoming 

these barriers to ultimately establish successful 

implementation. 

Recommendation I 

Health care facilities should have an established 

mechanism for product selection in place, but 

because the surgical arena is never a static environment, 

there is always a need for process improvement. 

A multidisciplinary team should be 

established to guide process improvement and 

product selection. 

A multidisciplinary team is “a group composed 

of members with varied but complementary experience, 

qualifications, and skills that contribute 

to the achievement of the organization’s specific 

objectives.” 4 Depending on the size of the facility, 

the team should be all encompassing, with particular 

regard to the end users of the products. It is 

important to include the end users in the product 

evaluation process so they have an equal say in the 

suitability of the products being considered. If 

there is no consideration given to the end users 

or they are unwilling to participate in product 

evaluations, a product could be purchased that may 

not meet their needs or the needs of the patients. 

This could lead to products being wasted or 

underused, which can become a financial burden 

on the facility. 

The perioperative RN is an integral component 

of the evaluation and selection process. The role 

of the perioperative RN is constantly evolving 

and is indeed dynamic, and perioperative RNs are 

well versed in the preoperative, intraoperative, 

and postoperative phases of the surgical experience. 

The varied and dynamic role, as well as 

the need to work with many different ancillary 

services in a given day, makes the perioperative 

RN an ideal participant on the product selection 

team. 

The perioperative RN must be willing to advocate 

for safe, effective, efficient, and environmentally 

friendly products and equipment for the 

product evaluation to be a worthwhile process. 1 

Advocacy is demonstrated by volunteering and 

following up regarding the desire to participate 

in product evaluations. This responsibility rests 

on the RN’s shoulders, but the following factors 

may prevent perioperative RNs from being a part of 

the multidisciplinary team: 

n unavailability because of workload; 

n lack of interest or knowledge in the process; 

n timing of the review and evaluation process (eg, 

if the review is scheduled for a day when the 

nurse is not working or during the day when the 

nurse works nights); or 

n the need to conduct multiple reviews simultaneously, 

which may create confusion. 

These potential pitfalls can be overcome by the end 

users asking the individuals on the multidisciplinary 

AORN Journal j 791


Figure 1. The product review process requires full commitment from the RN to see it through to completion. 

team questions about the products, the process, and 

any concerns that they might have. It is important 

for nurses to inform their facility leaders if they are 

interested in participating in the product evaluation 

process and providing them with as much advanced 

notice as possible to assist the leaders in covering 

the workload. 

At my facility, the process is not cumbersome 

but does require full commitment on the 

RN’s part to see the process through to completion 

(Figure 1). Product selection is not just the 

process of suggesting that a new product be added 

to the ordering system at a facility, but includes 

asking facility leaders about the existing product 

evaluation policy, how to start the process of 

presenting a product or piece of equipment for 

evaluation, and how the nurse can participate on 

the team. 

Recommendation II 

After the perioperative RN becomes a member of 

the multidisciplinary committee, he or she will 

work with the team to develop a process to guide 

product selection. The product selection process 

includes gathering information; establishing consistent 

requirements for each product under evaluation; 

performing a financial impact analysis; 

investigating a plan to standardize products across 

the facility; conducting an environmental impact 

analysis; determining whether to purchase single- 


use, reposable, or reusable products; determining 

whether to reprocess single-use devices; developing 

an evaluation process based on objective 

criteria; and developing and implementing 

a comprehensive plan to introduce and use 

new products. 

Information gathering. The first step is to 

gather information about products and equipment. 

Information gathering can be fairly easy when 

a specific product or piece of equipment is being 

evaluated. The perioperative RN is frequently the 

catalyst for this process. This first step usually 

occurs when someone asks the nurse a question 

about a particular product or information is found 

in a brochure. This question or discovery then 

triggers the process of researching the item. This 

research can be accomplished by searching the 

Internet or contacting a vendor, or through 

hands-on evaluation at a vendor show or in 

another facility. 

Consistent requirements. The committee 

members should identify consistent requirements 

for each new technology or product that is under 

review. This part of the process can be daunting 

because team members who have different requirements 

have to evaluate and develop criteria 

together. However, this step is essential because it 

helps to eliminate products and equipment that do 

not meet the needs of the facility, patients, and 

staff members.


The process of creating consistent requirements 

is certainly more cumbersome when evaluating 

a product like gloves because there are so many 

choices available, and different team members 

request different criteria. For example, the perioperative 

nurse would evaluate all-purpose gloves 

for a good fit and nonpermeable material for 

protection during cleaning, whereas an infection 

prevention professional would want the gloves to fit 

well, especially in the fingers for providers who are 

involved in more precise, intricate work like 

placing IV lines. 

The perioperative RN is an excellent resource 

for identifying new products specific to surgical 

patient care but must 

keep in mind factors 

such as compatibility 

with current equipment, 

patient and staff 

member safety, environmental 

impact, and 

cost-effectiveness. Perioperative RNs are familiar 

with many different equipment systems already 

in place at their facilities and have access to 

companies and their representatives who can 

readily provide information on the compatibility, 

cost, and safety of many products. The Internet 

is also a great resource for comparing product 

costs and finding information on environmental 

impact. Team members also can poll other 

facilities in the area for information on the 

products they use. This information may be 

readily available from providers who work in 

multiple facilities in any given city. These 

providers can provide information on products 

based on their experiences. 

Financial impact. The associated cost of 

acquiring a new product is always a concern. 

Hospitals and ambulatory facilities do not have 

unlimited budgets, so it is essential to consider the 

cost associated with introducing a new item to the 

supply system. It is essential that a representative 

from the finance department be involved in the 

multidisciplinary team from the beginning of the 

product evaluation process to assist with the 

financial analysis. This assistance is beneficial to 

the other team members who may not know how to 

complete the analysis. The perioperative nurse can 

assist by acquiring vendor quotes on the associated 

costs for new products and equipment, which is 

essential for the financial department to have for 

a cost analysis. 

Standardization. When looking to procure 

new technology or products, the product selection 

team should consider standardization, which 

can reduce costs and may improve inventory 

control and use of storage space. 5-8 When referring 

to product evaluation, 

standardization can 

loosely be defined as 

a procurement agreement 

within a geographical 

region or 

between various 

groups within a facility pertaining to a certain 

product or product line. In the example of surgical 

gloves, there are many companies that provide this 

product. However, if there is a particular brand that 

a facility provides for surgeons, there may be other 

facilities within the same network that stock the 

brand. This opens up the opportunity to standardize 

acquisition of the same brand at all of the local 

network facilities. When proposing a product 

evaluation for multi-brand products (eg, gloves, 

cleaning supplies, dressings, tape), a standardization 

effort can work to the facility’s benefit. This 

principle also applies to purchasing a product 

within the facility. If the gloves are used by the 

OR personnel and not the radiology department 

personnel, there is a potential to benefit the facility 

if staff members in both departments agree to use 

thesamegloves. 

One potential challenge with gaining new 

products that have been standardized in a facility 

is what to do with the old products that are still 

in the supply rotation. This challenge may be 

A facility in the same network may stock a particular 

brand, which opens up the opportunity to 

standardize at all of the local network facilities. 



overcome by developing a phasing-in plan. A 

well-developed phasing-in plan establishes a timeline 

guide for incorporating the new product into 

the supply system at the facility. Perioperative 

nurses can assist in this process by providing an 

accurate account of supplies that are still on hand 

in their work centers and helping to identify the 

amount of time needed to deplete the excess 

supplies while introducing the new standardized 

products. Adhering to the phasing-in plan ensures 

fiscal responsibility and gives consideration to 

decreasing the environmental impact by not 

wasting good supplies and adding to the 

waste stream. 

Environmental impact. To help assess the 

environmental impact, the product selection team 

should answer the following questions: 

n Can the product be recycled? 

n Is the product made of recycled materials? 

n What method is used for disposal? 

The answers can guide the team in making sound 

decisions for which products would be the most 

beneficial for a product evaluation. 

Consumers are very conscious of environmental 

concerns associated with the health care industry 

and the impact of waste. Various regulatory agencies 

(eg, state and county agencies) can assist teams 

in determining whether products are recyclable. 

These agencies frequently provide or assist in developing 

programs for managing recyclable items, 

such as plastic bottles. 

Single-use, reposable, and reusable 

products. Product selection teams must take 

into account whether they want to evaluate and 

possibly purchase single-use, reposable, or reusable 

items, all while considering efficiency, cost, the 

environment, and patient and personnel safety. 

Reusing, repairing, and refurbishing products can 

lead to a large reduction in the annual amount of 

waste generated at a health care organization. 9,10 

Products that have a short shelf life or will be used 

only infrequently may be less desirable products for 


evaluation because they may be outdated before 

they are used. 

Reprocessing single-use devices. Potential 

cost savings created by reprocessing single-use 

devices can be a determining factor during product 

evaluation. Of course, all criteria for reprocessing 

must be addressed before the evaluation process 

can begin. Questions that the team should ask 

include the following: 

n Is the product on the list of approved reprocessed 

items from the US Food and Drug 

Administration (FDA)? 

n Is reprocessing cost-effective for the facility? 

Challenges to reusing products can vary from 

gaining provider or staff member buy-in to 

finding a qualified, FDA-approved processing 

company for reprocessing single-use items. A 

facility in which I worked in the past chose to 

pilot test reprocessed arthroscopic shavers. Some 

providers were not happy with the outcomes, 

and they stated that the reprocessing changed 

the dimensions of the original product so it did 

not work as well as a brand-new shaver. Ultimately, 

we chose not to reuse these products 

at the facility, even though the company was 

FDA-approved, because of staff member preferences. 

An example of a single-use product that 

was reprocessed and reused successfully at my 

former facility was sequential compression 

device sleeves. 

Evaluation process. It is important to use 

a consistent evaluation process to help ensure 

an objective review and analysis. 5,6,11 The 

evaluation process allows each team member to 

provide input based on his or her department’s 

requirements and needs. Involving team members 

from multidisciplinary departments with varying 

needs helps ensure the most appropriate products 

are selected to meet varying needs, 12 and 

involving personnel from multiple clinical areas 

helps garner direct feedback from those whose 

practice will be affected by the product. 5,13


Part of the evaluation process includes establishing 

and implementing the use of an evaluation 

tool. A product evaluation tool (Figure 2) should 

be simple to follow and easy to complete and 

should include product-specific criteria, including 

safety, performance, quality, efficiency, and ease 

of use, to name a few. 1 Having a well-defined 

multidisciplinary team will help ensure all of the 

technical questions about cost, usability, and safety 

are answered before the evaluation tool is developed. 

This assists the team members in creating an 

effective, streamlined tool based on objective 

criteria. As clinical experts and end users of the 

products, perioperative RNs have valuable input 

regarding what questions to ask when evaluating 

a product. 

Overall documentation of the selection and 

evaluation process must occur because it can 

provide additional information to justify procuring 

the equipment or products or for negating the 

purchase as well. 1 

Documentation must 

remain objective and 

factual and not contain 

any opinions that may 

mar the data about 

specific products. This 

is a reason for the 

requirement of having 

an evaluation tool that is strictly objective 

in nature. 

Finding the right people to evaluate products 

objectively can be a potential challenge; some 

providers may not have the time to fill out evaluations, 

others may have a vested interest in particular 

products, and some providers are willing 

to use whatever product is provided as long as it 

does the specified job. These challenges can be 

overcome by establishing a plan ahead of time for 

how to deal with each. For example, if the evaluators 

do not have time to complete the evaluation 

form, the perioperative RN can assist by 

asking the questions out loud during the evaluation 

and recording the answers. Providing a space 

Challenges in introducing new products can 

occur when only one person is trained on the 

product and does not share the information. 

This knowledge hoarding can be decreased 

by establishing a set number of trainers. 

for evaluators to disclose any vested interest in 

products being evaluated can protect the facility 

and the team from legal action. Finally, if evaluators 

do not have strong feelings about a particular 

product, it can be annotated on the comment 

section. Doing this provides documentation to 

support the decision in the event that issues arise 

later on, such as the original evaluator is discontented 

with the evaluated product. 

Introduction of new products. Another 

consideration that should be investigated during 

a product evaluation is how much education 

will be needed for end users of the product. It 

is essential that all end users be trained properly 

on all new products and equipment. Many vendors 

provide educational offerings related to their products. 

The education provided by the manufacturer 

allows the perioperative team to be well 

informed on the particulars of certain products 

and equipment. It is 

important to remem- 

ber that education 

must be a continual 

process and not 

a one-time offering 

because of the 

dynamic and complex 

processes that occur 

in the perioperative arena. If the education 

becomes static and does not evolve with the 

technology, practitioners may develop shortcuts 

over time. The downside of using shortcuts 

ranges from malfunctioning equipment to 

situations in which patient or staff member safety 

is at risk. 

Challenges in introducing new products can 

occur when only one person is trained on the 

product and the person does not share the information. 

This knowledge hoarding can be decreased 

when the multidisciplinary team members establish 

a set number of trainers. Designating more than 

one perioperative RN as a trainer eliminates the 

problem and allows for multiple people to maintain 



Figure 2. A product evaluation tool should be simple to follow and easy to complete and should include productspecific 

criteria (eg, safety, ease of use, environmental impact). 

competency in the department. These trainers 

should provide education to new perioperative 

RNs. 

The Final Four 

The final four recommendations in each AORN RP 

document discuss education/competency, documentation, 

policies and procedures, and quality 

assurance/performance improvement. These four 

topics are integral to the implementation of 

AORN practice recommendations. Personnel 

should receive initial and ongoing education and 


competency validation as applicable to their roles. 

Implementing new and updated recommended 

practices affords an excellent opportunity to create 

or update competency materials and validation 

tools. AORN’s perioperative competencies team 

has developed the AORN Perioperative Job 

Descriptions and Competency Evaluation Tools 14 

to assist perioperative personnel in developing 

competency evaluation tools and position 

descriptions. 

Documentation of nursing care should include 

patient assessment, plan of care, nursing diagnosis,


and identification of desired outcomes and interventions, 

as well as an evaluation of the patient’s 

response to care. Implementing new or updated 

recommended practices may warrant a review or 

revision of the relevant documentation being used 

in the facility. 

Policies and procedures should be developed, 

reviewed periodically, revised as necessary, and 

readily available in the practice setting. New or 

updated recommended practices may present an 

opportunity for collaborative efforts among nurses 

and personnel from other departments within the 

facility to develop organization-wide policies 

and procedures that support the recommended 

practices. The AORN Policy and Procedure 

Templates, 2nd edition, 15 provides a collection 

of 15 sample policies and customizable templates 

based on AORN’s Perioperative Standards and 

Recommended Practices. Regular quality improvement 

projects are necessary to improve 

patient safety and to ensure safe, quality care. For 

details on the final four practice recommendations 

that are specific to the RP document discussed in 

this article, please refer to the full text of the 

RP document. 

HOSPITAL PATIENT SCENARIO 

Nurse A has just finished first assisting on an 

inguinal hernia repair procedure and the surgeon 

asks whether she is aware of a new, top-of-the-line 

wound closure product that was just approved by 

the FDA. The surgeon quotes the benefits of the 

product for both the staff members and patients, 

saying, “It is stated that you need no dressing and 

that patients are thrilled with the results of minimal 

scarring.” He mentions that it would have been 

great to have for the procedure they just finished 

and may also be beneficial for the emergency 

department (ED) personnel for surface wound 

closures. Nurse A tells the surgeon she has not 

heard of the particular item but says it sounds 

interesting and that she will talk with the OR 

supervisor and see what they can do to possibly 

acquire the item. 

Before Nurse A speaks with her supervisor, she 

conducts a search online to see what information 

she can find on the product. Nurse A finds information 

on the specific product and learns that there 

are also some other products similar to it. Nurse A 

alerts her supervisor of her discussion with the 

surgeon and asks whether they can look at pilot 

testing the wound closure product. The supervisor 

thinks the item warrants a review. Because the 

surgeon also indicated that the ED personnel also 

might benefit from the product, Nurse A, acting as 

a catalyst, establishes contact with a nurse in the 

ED and inquires whether the ED staff members 

would be interested in pilot testing the product or 

one similar to it. 

Next, Nurse A gathers some information on 

the product she discussed with the surgeon as well 

as the products she discovered in her original 

search. She looks for information on environmental 

impact, patient and staff member safety, and compatibility 

with current facility processes. She also 

establishes contact with the vendor to ask for 

data she might need on safety, costs, and environmental 

impact. 

Nurse A checks the schedule for the next 

multidisciplinary product evaluation meeting at the 

facility and provides information to the committee 

chair for a product evaluation proposal for the 

wound closure products. Her supervisor asks Nurse 

A if she would like to represent the OR in the 

evaluation because of her knowledge about the new 

item and her knowledge about possible opportunities 

for use. 

This situation provided a great opportunity for 

Nurse A. She acted as the catalyst for starting the 

process of a product evaluation of the wound 

closure product by engaging in a simple conversation 

with members of her surgical team and 

further including the ED personnel in the process. 

She then passed on the information and request 

to her supervisor. Her goal as a participant and 

representative of the OR in the evaluation process 

should be to remain involved in the process from 

start to finish. Because of her initial legwork on 



a product search, she had a head start in the process 

and could provide quick answers and references 

to the rest of the team. Nurse A was familiar with 

her facility’s processes and followed her chain of 

command to find out how to go about getting the 

wound closure product into the facility. 

AMBULATORY SURGERY PATIENT 

SCENARIO 

Nurse C is the nurse manager of a six-room, freestanding 

ambulatory surgery center. She read an 

article in her professional journal regarding the 

increasing prevalence of multidrug-resistant, 

gram-negative organisms (MDR-GNOs). Shortly 

thereafter, a patient who was an MDR-GNO carrier 

came to the surgery center for a medial meniscectomy. 

Although the surgery center had a multidrugresistance 

policy in place, Nurse C was not sure 

whether it covered these newer organisms. Given 

the limited antibiotic treatment options for these 

aggressive organisms and that surgical patients are 

particularly at risk for acquiring them, Nurse C 

began researching improved prevention methods, 

focusing particularly on patient skin preparation 

products. 

During the research process, Nurse C attended 

a session at the AORN Congress on preventing the 

spread of MDR-GNOs. After the session, Nurse C 

went to the Exhibit Hall and focused on visiting 

exhibitors who supplied patient skin prep solutions. 

She spoke with vendors from companies 

Resources for Implementation 

n AORN Nurse Consult Line. (800) 755-2676 or (303) 755-6300, 

option 3. 

n ORNurseLink. http://www.aorn.org/ORNurseLink. 

n Perioperative Job Descriptions and Competency Evaluation 

Tools [CD-ROM]. http://www.aorn.org/Books_and_Publicatio 

ns/AORN_Publications/Perioperative_Job_Descriptions_and_ 

Competency_Evaluations_Tools.aspx. 

Web site access verified February 16, 2012. 


representing three different prep solution products 

and obtained product literature and contact information 

from each. 

After returning to her facility, Nurse C spoke 

with the facility administrator and medical director 

about performing a comparison evaluation of several 

new skin prep solution products. After gaining their 

support, Nurse C obtained information regarding the 

quantity of skin prep solution that currently was 

being used in the surgery center. She then contacted 

three companies and set up a time for each of them to 

present their products to a team of key stakeholders 

(ie, facility administrator, supply manager, medical 

director). She also asked the vendors to present 

information regarding the cost of using their products 

based on information she had provided to them 

regarding current skin prep use at the surgery center, 

as well as statistics regarding success at treating 

MDR-GNOs and costs based on use. 

After hearing the presentations, Nurse C set up a 

three-month trial (ie, one month for each product). 

She developed a form for the team members to use 

to objectively evaluate each product. The circulating 

nurse would be responsible for completing 

the form in cooperation with the surgeon at the end 

of each procedure. 

Each vendor gave an inservice program to 

facility surgical team members the week before the 

trial of the vendor’s product. The vendors provided 

the skin prep solutions at discounted rates during 

the trial. At the end of the three months, Nurse C 

collated the evaluation 

results and presented them to 

the key stakeholders. Based 

on the results of the trial (ie, 

an improved product that 

applies easily, dries rapidly, 

and is effective against both 

gram-positive and gramnegative 

organisms) and 

evaluation of product cost, 

the stakeholders unanimously 

decided on one 

product.


Nurse C applied current information from her 

professional organization to address a patient 

outcome issue of concern for her surgery center. 

She researched the subject and went a step further 

by attending an education session on the 

subject and taking advantage of the opportunity 

to speak directly to vendors. Nurse C was familiar 

with her facility’s processes and followed 

her chain of command to perform a comparison 

evaluation of a new product that resulted in cost 

savings for the surgery center with a goal of improved 

patient outcomes by preventing the spread 

of MDR-GNOs. 

CONCLUSION 

The key to implementing a successful evaluation 

in any facility is obtaining multidisciplinary 

participation. Successful evaluation leads to 

effective selection and procurement of medical 

devices and equipment, which are necessary 

elements in a facility’s clinical service delivery 

program. Providing the most appropriate equipment 

and consumable items for clinical use 

depends on having a clear process that is understood 

throughout the facility or system. 16 

This may be facilitated by having clear policies 

and procedures in place. It is important to keep 

the policies and procedures as general in nature as 

possible so they can be easily adapted to different 

practice areas where product evaluations may take 

place (eg, OR, clinic, ED, physician’s office). 

Instituting streamlined, easy-to-follow policies and 

procedures will also help to ensure consistency in 

the evaluation process and that all equipment and 

products are reviewed and evaluated the same 

way. Providing step-by-step tasksdno more than 

10, or less than one page for simplicitydenables 

all evaluators and trainers to communicate clearly 

and helps ensure compliance. If policies and 

procedures become too lengthy or confusing, 

providers and perioperative nurses may not have 

the time or inclination to pay close attention to all 

the fine print and may choose not to participate. 

Keeping the process streamlined and easy to 

follow will help ensure a positive experience for 

all those involved. 

The acquisition process should encompass 

a multidisciplinary approach, and the team must 

consider patient and employee safety, environmental 

impact, efficiency, and cost-effectiveness. 

A finance department representative and end users 

of products and equipment should be invited to be 

members of the committee, and they are often the 

ones with proposals as well. Developing and implementing 

a concise and systematic evaluation 

process will help ensure that the best product for 

the facility is selected and ultimately used. 

Editor’s note: The views expressed by LCDR 

Conrardy in this article are hers alone and do not 

necessarily reflect the official policy or position of 

the Department of Navy, Department of Defense, or 

the US Government. 

References 

1. Recommended practices for product selection in perioperative 

practice settings In: Perioperative Standards 

and Recommendation Practices. Denver, CO: AORN, 

Inc; 2012:191-200. 

2. Halvorson CK, Chinnes LF. Collaborative leadership in 

product evaluation. AORN J. 2007;85(2):334-352. 

3. Burlingame B. Comparative evaluation for purchasing 

new products or equipment [Clinical Issues]. AORN J. 

2010;91(6):779-786. 

4. Multidisciplinary team. Business dictionary. http://www 

.businessdictionary.com/definition/multidisciplinary-team 

.html. Accessed February 16, 2012. 

5. Barlow RD. Infusing value analysis in contracting strategies: 

it’s not just a pricing or product evaluation and selection 

game. Healthc Purchasing News. 2008;32(10):62. 

6. Halvorson CK, Chinnes LF. Collaborative leadership in 

product evaluation. AORN J. 2007;85(2):334-352. 

7. Greene J. Value analysis team guides OR purchasing. OR 

Manager. 2006;22(11):19, 21. 

8. Hupp D. A strategy for review of new products. OR 

Manager. 2005;21(11):23-24. 

9. Serb C. Think green. Hosp Health Netw. 2008;82(8): 

22-26, 35. 

10. Birk S. An issue that can’t be contained. Mater Manag 

Health Care. 2008;17(5):42-44. 

11. Akridge J. Softer, stronger fabrics enhance gowns 

and drapes. Healthc Purchasing News. 2009;33(4): 

14-19. 

12. Flynn AB, Knishinsky R. A matter of reprocessing. 

Mater Manag Health Care. 2005;14(10):32-35. 

13. McGain F, Clark M, Williams T, Wardlaw T. Recycling 

plastics from the operating suite. Anaesth Intensive Care. 

2008;36(6):913-914. 



14. Perioperative Job Descriptions and Competency 

Evaluation Tools [CD-ROM]. Denver, CO: AORN, Inc; 

2012. 

15. Policy and Procedure Templates. 2nd ed [CD-ROM]. 

Denver, CO: AORN, Inc; 2010. 

16. Guidelines for the introduction of a new medical device. 

The Royal Children’s Hospital Melbourne. http://www 

.rch.org.au/cpa/products.cfm?doc_id¼11335. Accessed 

February 16, 2012. 

Julie A. Conrardy, MSN, RN, CNOR, CNS-BC, 

LCDR, USN, is the department head, Main Operating 

Room at the Naval Hospital, Rota, Spain. 

LCDR Conrardy has no declared affiliation that 

could be perceived as posing a potential conflict 

of interest in the publication of this article. 

This RP Implementation Guide is intended to be an adjunct to the complete recommended practices document upon 

which it is based and is not intended to be a replacement for that document. Individuals who are developing and 

updating organizational policies and procedures should review and reference the full recommended practices 

document. 

800 j AORN Journal

EXAMINATION 

CONTINUING EDUCATION PROGRAM 

Implementing AORN Recommended 

Practices for Product Selection 

PURPOSE/GOAL 

To educate perioperative nurses about how to implement the AORN “Recommended 

practices for product selection in perioperative practice settings.” 

OBJECTIVES 

1. Discuss AORN’s practice recommendations for product selection and evaluation. 

2. Identify the benefits of implementing a multidisciplinary product selection and 

evaluation team. 

3. Discuss methods for implementing AORN’s practice recommendations for 

product selection. 

The Examination and Learner Evaluation are printed here for your convenience. 

To receive continuing education credit, you must complete the Examination 

and Learner Evaluation online at http://www.aorn.org/CE. 

QUESTIONS 

1. The most significant changes from the previous 

version of the “Recommended practices for product 

selection in perioperative practice settings” are 

1. more detailed descriptions of the requirements 

for establishing a multidisciplinary 

team. 

2. the requirement that perioperative RNs 

demonstrate competency related to product 

evaluation and selection. 

3. the need to keep the product team members 

consistent regardless of the product being 

evaluated. 

4. the need to have a method for product evaluation 

that changes depending on the product 

being evaluated. 

a. 1 and 2 b. 3 and 4 

c. 1, 2, and 4 d. 1, 2, 3, and 4 

2.7 


2. The product selection team should include end 

users of the products to 

1. give them equal say in the suitability of the 

products being considered. 

2. prevent them from having to use a product 

that may not meet their needs or the needs of 

patients. 

3. avoid the potential of wasting or under-using 

products, which can become a financial 

burden on the facility. 

4. minimize the number of people on the 

product evaluation team. 

a. 1 and 2 b. 3 and 4 

c. 1, 2, and 3 d. 1, 2, 3, and 4 

3. Methods for gathering information to evaluate 

a new product to be used in the OR include 

1. conducting a hands-on evaluation at a vendor 

show or in another facility. 


June 2012 Vol 95 No 6 CE EXAMINATION 

2. contacting the vendor to ask questions. 

3. doing an online search. 

4. polling patients to find out which products 

they would prefer. 

a. 1 and 3 b. 2 and 4 

c. 1, 2, and 3 d. 1, 2, 3, and 4 

4. The process of creating consistent requirements 

for each new product under review can be difficult 

because team members may have different 

criteria for product acceptability. 

a. true b. false 

5. Factors that perioperative nurses should keep in 

mind when identifying new products for surgical 

patient care include 

1. compatibility with current equipment. 

2. patient and staff member safety. 

3. environmental impact. 

4. cost-effectiveness. 

a. 1 and 3 b. 2 and 4 

c. 1, 2, and 3 d. 1, 2, 3, and 4 

6. The multidisciplinary product selection team 

should include a representative from the finance 

department. 

a. true b. false 

7. In determining whether to use single-use, reposable, 

or reusable items, the product selection team 

must consider 

1. cost. 

2. efficiency. 

3. frequency of use. 

4. patient and personnel safety. 

5. shelf life. 

6. the environment. 

a. 1, 3, and 5 b. 2, 4, and 6 

c. 1, 2, 5, and 6 d. 1,2,3,4,5,and6 

8. In determining whether to reprocess single-use 

devices, the product selection committee should 

consider whether 


1. reprocessing the device is cost-effective. 

2. the device works as well as a brand-new 

item. 

3. the device is on the US Food and Drug 

Administration list of approved reprocessed 

items. 

4. administrators will enforce usage to avoid 

having to get staff member buy-in. 

a. 1 and 2 b. 3 and 4 

c. 1, 2, and 3 d. 1, 2, 3, and 4 

9. An effective product evaluation tool should 

1. address performance, efficiency, and ease of 

use. 

2. be simple to follow and easy to complete. 

3. include generic criteria so it can be used for 

every product or device. 

4. address safety and quality. 

a. 1 and 3 b. 2 and 4 

c. 1, 2, and 4 d. 1, 2, 3, and 4 

10. To overcome the challenges in finding the right 

people to evaluate products objectively, the perioperative 

RN can 

1. assume that providers will use whatever 

product is provided as long as it does the 

specified job. 

2. ask the questions out loud during the evaluation 

and record the answers if the evaluators 

do not have time to complete the evaluation 

form. 

3. provide a space for evaluators to disclose any 

vested interest in products being evaluated to 

protect the facility and the team from legal 

action. 

4. annotate in the comment section if evaluators 

do not have strong feelings about a particular 

product. 

a. 1 and 2 b. 3 and 4 

c. 2, 3, and 4 d. 1, 2, 3, and 4

LEARNER EVALUATION 

CONTINUING EDUCATION PROGRAM 

Implementing AORN Recommended 

Practices for Product Selection 

This evaluation is used to determine the extent 

to which this continuing education program 

met your learning needs. Rate the items as 

described below. 

OBJECTIVES 

To what extent were the following objectives of this 

continuing education program achieved? 

1. Discuss AORN’s practice recommendations for 

product selection and evaluation. 

Low 1. 2. 3. 4. 5. High 

2. Identify the benefits of implementing a multidisciplinary 

product selection and evaluation team. 

Low 1. 2. 3. 4. 5. High 

3. Discuss methods for implementing AORN’s practice 

recommendations for product selection. 

Low 1. 2. 3. 4. 5. High 

CONTENT 

4. To what extent did this article increase your 

knowledge of the subject matter? 

Low 1. 2. 3. 4. 5. High 

5. To what extent were your individual objectives met? 

Low 1. 2. 3. 4. 5. High 

6. Will you be able to use the information from this 

article in your work setting? 1. Yes 2. No 

7. Will you change your practice as a result of reading 

this article? (If yes, answer question #7A. If no, 

answer question #7B.) 

2.7 


7A. How will you change your practice? (Select all 

that apply) 

1. I will provide education to my team regarding 

why change is needed. 

2. I will work with management to change/ 

implement a policy and procedure. 

3. I will plan an informational meeting with 

physicians to seek their input and acceptance 

of the need for change. 

4. I will implement change and evaluate the 

effect of the change at regular intervals 

until the change is incorporated as best 

practice. 

5. Other: _______________________________ 

7B. If you will not change your practice as a result 

of reading this article, why? (Select all that 

apply) 

1. The content of the article is not relevant to 

my practice. 

2. I do not have enough time to teach others 

about the purpose of the needed change. 

3. I do not have management support to make 

a change. 

4. Other: _______________________________ 

8. Our accrediting body requires that we verify 

the time you needed to complete the 2.7 continuing 

education contact hour (162-minute) 

program: ________________________________

Implementing AORN Recommended Practices for Product Selection

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