Aorn Guidelines — For Perioperative Practice

| | Key Updates in 2025 | Key Updates in 2026 | | :--- | :--- | :--- | | Transmission-Based Precautions | New risk-based strategies for contact, droplet, and airborne precautions, shaped by COVID-19 research. | Refined guidance building on the 2025 framework to ensure teams can quickly apply the right precautions. | | Enhanced Recovery After Surgery (ERAS) | A brand new guideline providing implementation interventions for pre-, intra-, and postoperative patient optimization. | Not the primary focus of the 2026 edition. | | Surgical Attire | Expanded guidance on lanyards, cell phones, and cleaning personal items to reduce contamination. | Not the primary focus of the 2026 edition. | | Sharps Safety | Updated to include organizational programs, engineered safety devices, and best practices for safe handling and disposal. | Not the primary focus of the 2026 edition. | | Sterile Technique | New recommendation for a perioperative Air Quality Management Program to reduce airborne contamination. | Not the primary focus of the 2026 edition. | | Autologous Tissue Management | - | Revised to clearly outline steps for preserving tissue viability and reducing infection risk during reimplantation. | | Care and Cleaning of Surgical Instruments | - | Major updates : Enhanced PPE for decontamination staff, borescope inspections for lumened instruments, and cleaning verification protocols. | | Safe Use of Surgical Energy Devices | - | Major updates : New title reflecting broader technology, 67 recommendations (12 new), guidance on return electrodes, and IED management. | | Pneumatic Tourniquet Safety | - | Revised to address risks from improper selection and monitoring, helping teams evaluate and protect patients. | | Local-Only Anesthesia Care | - | Updated to include new steps for protecting patients from rare systemic or allergic reactions. | | Medication Safety | Critical updates focusing on organizational oversight, technology, compounding, and hazardous drug handling. | Not the primary focus of the 2026 edition. |

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Strategies for implementing

The air in Operating Room 4 had a specific weight. Not just the pressure of the HEPA filters or the chill of 62 degrees Fahrenheit, but the gravity of what was about to happen. Sarah, the circulating nurse for the past nineteen years, could feel it in her bones. A 17-year-old gymnast, a burst aneurysm, a neurosurgeon with trembling hands and a god complex.

Across the table, Jamie, a new graduate nurse with eager eyes and a tablet smudged with fingerprints, was scrolling through the pre-op checklist. "Count’s clear from Preadmission Testing," Jamie chirped. "Patient ID verified, consent signed. All good." aorn guidelines for perioperative practice

The 2025 edition marked a milestone with the introduction of a brand-new guideline and further revisions to six others.

Clinicians may be accustomed to outdated techniques or legacy habits, requiring robust change-management strategies. | | Key Updates in 2025 | Key

Adherence to established national standards shields facilities during malpractice litigation.

Operating rooms contain high-risk equipment and hazardous materials. AORN outlines safety measures for managing the physical environment: | Not the primary focus of the 2026 edition

: Each guideline undergoes a comprehensive systematic review of research. Recommendations are then rated based on the quality and strength of that underlying evidence.