During the past decade, physicians have begun to perform an increasing number of interventional procedures in various locations outside the traditional OR. Changes in technology and practice have generated the need for a paradigm shift about perioperative practice because these interventional areas have become perioperative centers of care in which patients undergo operative and other invasive procedures. Physicians, nursing staff members, support staff members, and administrators in these interventional areas must consider perioperative practice standards, institutional policies, state practice acts, and regulatory and accreditation requirements when creating policies and procedures. Personnel must be familiar with AORN standards and recommended practices and understand the perioperative practice guidelines related to nurse staffing in invasive procedure areas. Advanced practice nurses and other leaders must use evidence-based research as the basis for policy and procedure changes.