Eliminating Hazardous Surgical Smoke

Last updated 2024-02-16T19:10:21Z

Surgical smoke is the unwanted by-product of energy-generating devices that are used in almost every surgical procedure. Evidenced-based research proves that surgical smoke plume can contain toxic chemicals such as benzene, formaldehyde, hydrogen cyanide and carbon monoxide, viruses, bacteria, blood and cancer cells that can detrimental to a persons health. As healthcare workers, repeated exposure to toxins can likely cause health issues decades from now.

Origin:

August 2019, Biloxi VA Medical Center

Adoptions:

1 successful, 3 in-progress

Awards and Recognition:

Association of peri-Operative Registered Nurses (AORN) Go Clear Award: Gold Level, Association of peri-Operative Registered Nurses (AORN) Center of Excellence in Surgical Safety: S ... Association of peri-Operative Registered Nurses (AORN) Go Clear Award: Gold Level, Association of peri-Operative Registered Nurses (AORN) Center of Excellence in Surgical Safety: Smoke Evacuation, 1st hospital in the State of Mississippi to receive the AORN Go Clear-Gold Award, iNET Seed Investee

Partners:

Healthcare Environment and Facilities Programs

Overview

The problem

Surgical smoke emitted in the operating room as a by-product of cautery devices creates hazardous air quality that impacts employees and Veterans health. Evidence-based research proves that inhaling surgical smoke for 15 minutes is equivalent to smoking 6 cigarettes. Surgical case time at our facility averages 1-2 hours

The solution

Our facility made the use of smoke evacuation technology mandatory in May 2022. This required purchasing of equipment, and establishing a Station Memorandum. Mandating the use of smoke evacuation devices throughout the facility, which includes operating room, specialty clinics, and any other services that use electrocautery ensures that employees and Veteran ... Our facility made the use of smoke evacuation technology mandatory in May 2022. This required purchasing of equipment, and establishing a Station Memorandum. Mandating the use of smoke evacuation devices throughout the facility, which includes operating room, specialty clinics, and any other services that use electrocautery ensures that employees and Veterans are not subjected to the hazardous dangers of surgical smoke. See more

The results

Incidence of staff call-out decreased by 24% after implementation of the surgical smoke evacuation practice. Additionally, 100% of staff report feeling safer when working in operating rooms where surgical smoke is being evacuated.

Applied for, and received, AORN GoClear Award, as well as designation as Center of Excellence in Surgical Safety: Smoke Evacu ... Incidence of staff call-out decreased by 24% after implementation of the surgical smoke evacuation practice. Additionally, 100% of staff report feeling safer when working in operating rooms where surgical smoke is being evacuated.

Applied for, and received, AORN GoClear Award, as well as designation as Center of Excellence in Surgical Safety: Smoke Evacuation.

Associated news articles for implemented practice

https://news.va.gov/117963/surgical-smoke-improving-safety-in-or/

https://vaww.insider.va.gov/surgery-team-receives-national-recognition/ See more

Metrics

Staff call-outs were decreased by 24% after implementation of surgical smoke evacuation practice. Our facility has been 100% compliant with surgical smoke evacuation since implementation.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

MS: Biloxi VA Medical Center (Biloxi)

Started adoption on 08/2019, ended on 02/2023.

AR: John L. McClellan Memorial Veterans' Hospital (Little Rock, Arkansas)

Started adoption on 09/2023.

NC: Durham VA Medical Center (Durham)

Started adoption on 09/2023.

NV: Ioannis A. Lougaris Veterans' Administration Medical Center (Reno)

Started adoption on 09/2023.

There are no unsuccessful adoptions for this innovation.

Implementation

Departments

Vascular surgery
Neurosurgery
Infection control
Colon and rectal surgery
Cardiovascular surgery
Bariatric surgery
Gynecology
Primary care
Dermatology
Surgery
Anesthesia

Core Resources

Resource type	Resource description
PEOPLE	No additional FTE is required. This practice can be implemented with existing personnel resources at any VHA facility.
PROCESSES	Training, provided by the Association of PeriOperative Registered Nurses' website.
TOOLS	Smoke Evacuator device Smoke evacuation handheld cautery device

Optional Resources

Files

This is an implementation manual to guide users toward a surgical smoke free environment Implementing a Surgical Smoke-Free Environment

Risks and mitigations

Risk	Mitigation
Funding/Resources	This practice cannot be implemented without the purchase of smoke evacuation devices for any procedures that produce surgical smoke. Implementing facilities will need to secure funding for the purchase of the equipment. Mitigation efforts include educating decision-makers on the evidence that supports the implementation of this practice. Our team has developed an implementation guide that includes resource requirements
Time	Educating staff in a timely manner is difficult, but the online education portal is helpful in this matter. The Association of PeriOperative Registered Nurses provides this education portal so that all individuals of the surgical team can complete the educational modules at their convenience. Our team has developed an implementation guide that includes educational support to include pre- and post-tests.
Process	This practice requires a Station Memorandum mandating the use of smoke evacuation in all procedures that produce surgical smoke. Our team has developed an implementation guide that includes templates for Station Memoranda, Standard Operating Procedures, and much more.

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

Email

Email kristy.antonucci@va.gov with questions about this innovation.

About

Origin story

During a search of evidence-based practices that affect the perioperative setting, it was discovered tha tsurgical smoke plume is hazardous to employees and Veterans. Furthermore this issue was, and still is, being presented to legislature for smoke evacuation mandates. Mandates would require the use of smoke evacuation any time surgical smoke is expected. T ... During a search of evidence-based practices that affect the perioperative setting, it was discovered tha tsurgical smoke plume is hazardous to employees and Veterans. Furthermore this issue was, and still is, being presented to legislature for smoke evacuation mandates. Mandates would require the use of smoke evacuation any time surgical smoke is expected. To date, only 11 states require the use of smoke evacuation in the operating room. Prior to implementing this practice, the staff in the Women's Clinic were reluctant to participate in LEEP(loop electrode excision procedure) because of the high volume of surgical smoke emitted during the procedure. This procedure is done on women with suspicion of cervical cancer. Research has shown that the smoke emitted during this procedure can contain cancerous cells. This resulted in staff calling in sick on days these procedures were scheduled. After implementing this practice, the staff in the Women's Clinic now feels safer participating in this procedure, and no longer call in sick on the days these procedures are scheduled.

Original team

Kristy Antonucci

Project team leader

Sheena Strong

Innovation Specialist

Elizabeth Williams

Innovation Specialist

Kristin Mate

System Redesign Coordinator

Search categories

Anesthesiology Dermatology Employee Experience Environmental Programs Service Healthcare Administration High Reliability Moving Forward Nursing Occupational Safety and Health Specialty Care

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