D uring the COVID-19 pandemic, many hospitals were forced to put nonessential surgeries on hold, restrict visitors and other nonessential personnel, and create new processes to screen and control entry into the hospital and, in particular, clinical spaces. In all these, there was one category of visitor that required special consideration-medical device representatives who provide product-related education and support.COVID-19 restrictions within hospitals raised important questions about whether and in which cases medical device representatives are "essential" and to what extent hospitals and nurses have become dependent on their services. The pandemic prompted important questions about the benefits and risks of having medical device representatives in clinical spaces, which include issues related to trust and informed consent, infection risk, efficiency of surgeries, confidentiality and privacy, and commercial influence (Grundy et al., 2018). The pandemic also raised questions about whether and to what extent perioperative teams are dependent on medical device representatives and what this might mean for safe, quality, ethical, and cost-effective care.
INDUSTRY REPRESENTATIVES AS EDUCATORSIndustry representatives are present in hospitals on a daily basis, in operating rooms, cardiac catheterization laboratories, and patient care units and are often available remotely 24/7 (Grundy et al., 2018). Surgeons, nurses, and administrators generally consider their expertise to be essential to product use given the increasing variety and complexity of medical technologies, the rapid introduction of new products, and the funding pressures faced by hospitals.Activities of industry representatives include being on call and/or physically present to provide technical guidance or troubleshooting issues with implants; guiding nursing staff through the selection of instruments and helping to pace surgical procedures efficiently; advising on tailoring equipment settings to individual patients; providing in-house training to staff on the use of new products such as glucometers or intravenous pumps; and fulfilling, curating, or sponsoring ongoing education needs related to wound care, surgical