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Feature| Volume 19, ISSUE 5, P508-515, October 2021

Empowering Nurse Executives to Advocate for Surgical Smoke–Free Operating Rooms

Published:November 20, 2020DOI:https://doi.org/10.1016/j.mnl.2020.10.004
      Evacuating surgical smoke in the operating room protects patients and perioperative teams from the hazards associated with inhaling surgical smoke. States have passed bills mandating health care facilities and ambulatory surgery centers adopt policies to evacuate surgical smoke. We use a 5-step process for identifying options to reduce exposure to the harmful toxins found in surgical smoke and recommend executive nurse leaders collaborate with states and professional organizations to pursue smoke evacuation legislation. This strategy empowers executive nurse leaders and perioperative teams to work with professional organizations and state legislators to reduce exposure to the harmful health hazards associated from surgical smoke.
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      References

        • Ulmer B.
        The hazards of surgical smoke.
        AORN J. 2008; 87: 721-734
        • The National Institute for Occupational Safety and Health
        NIOSH Study Finds Healthcare Workers’ Exposure to Surgical Smoke Still Common.
        (Available at:)
        https://www.cdc.gov/niosh/updates/upd-11-03-15.html
        Date: 2015
        Date accessed: September 12, 2020
        • Steege A.L.
        • Boiano J.M.
        • Sweeney M.H.
        Secondhand smoke in the operating room? precautionary practices lacking for surgical smoke.
        Am J Ind Med. 2016; 59: 1020-1031
        • Stephenson D.J.
        • Alcott D.A.
        • Koch M.
        The presence of P22 bacteriophage in electrocautery aerosols.
        in: Proceedings of the National Occupational Research Agenda Symposium. NORA, Salt Lake City, UT2004
        • Ilce A.
        • Yuzden G.E.
        • Yavuz van Giersbergen M.
        The examination of problems experienced by nurses and doctors associated with exposure to surgical smoke and the necessary precautions.
        J Clin Nurs. 2017; 26: 1555-1561
        • Tomita Y.
        • Mihashi S.
        • Nagata K.
        • et al.
        Mutagenicity of smoke condensates induced by CO2-laser irradiation and electrocauterization.
        Mutat Res. 1981; 89: 145-149
        • Hill D.S.
        • O'Neill J.K.
        • Powell R.J.
        • Oliver D.W.
        Surgical smoke - a health hazard in the operating theatre: a study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units.
        J Plast Reconstr Aesthet Surg. 2012; 65: 911-916
        • Ball K.
        Compliance with surgical smoke evacuation guidelines: implications for practice.
        ORNAC J. 2012; 30 (14-16, 18-19, 35-37)
        • American College of Surgeons
        Covid-19: Considerations for Optimum Surgeon Protection Before, During, and After Operation.
        (Available at:)
        • Teitelbaum J.B.
        • Wilensky S.E.
        Essentials of Health Policy and Law.
        3rd ed. Jones and Bartlett Learning, Burlington, MA2017
        • Liu Y.
        • Song Y.
        • Hu X.
        • Yan L.
        • Zhu X.
        Awareness of surgical smoke hazards and enhancement of surgical smoke prevention among the gynecologists.
        J Cancer. 2019; 10: 2788-2799
        • AORN
        Guideline for surgical smoke safety.
        in: Guidelines for Perioperative Practice. AORN, Inc, Denver, CO2020: 1007-1038
        • Krueger S.
        • Disegna S.
        • DiPaola C.
        The effect of surgical smoke evacuation systems on surgical site infections of the spine.
        Clin Microbial Infect Dis. 2018; 3: 2-5
        • Occupational Safety and Health Administration
        OSH Act of 1970.
        (Available at:)
        https://www.osha.gov/laws-regs/oshact/completeoshact
        Date: 2004
        Date accessed: September 11, 2020
        • The Joint Commission
        About the Joint Commission.
        (Available at:)
        • Association of periOperative Registered Nurses
        AORN Go Clear Award Program.
        (Available at:)
        • American Nurses Association
        About ANA.
        (Available at:)
        https://www.nursingworld.org/ana/about-ana/
        Date accessed: September 26, 2020
        • The American Nurses Association
        Healthy Work Environment.
        (Available at:)
        • US Department of Labor
        Occupational Safety and Health Administration. All About OSHA. OSHA 3301-08R.
        (Available at:)
        https://www.osha.gov/Publications/all_about_OSHA.pdf
        Date: 2018
        Date accessed: May 21, 2020
        • American National Standards Institute
        ANSI.
        (Available at:)
        https://www.ansi.org/
        Date accessed: September 26, 2020
        • International Council on Surgical Plume
        About Us.
        (Available at:)
        http://www.plumecouncil.com/about.phtml
        Date accessed: September 24, 2020
        • Holmes S.
        Factors affecting surgical plume evacuation compliance.
        ACORN. 2016; 29: 39-42
      1. Markets and Markets. Smoke Evacuation Systems Market by Product (Smoke Evacuator [Portable & Stationary], Filter, Pencil, Accessories), Application (General Surgery, Laparoscopic, Orthopedic, Aesthetic), End-User (Hospitals, ASC, Surgical Centers) - Global Forecast to 2025.
        (Available at:)
        • Ott D.E.
        Carboxyhemoglobinemia due to peritoneal smoke absorption from laser tissue combustion at laparoscopy.
        J Clin Laser Med Surg. 1998; 16: 309-315
        • Ott D.E.
        Smoke and particulate hazards during laparoscopy procedures.
        Surg Serv Manag. 1997; 3: 11-13
        • da Silva R.D.
        • Sehrt D.
        • Molina W.R.
        • Moss J.
        • Park S.H.
        • Kim F.J.
        Significance of surgical plume obstruction during laparoscopy.
        JSLS. 2014; 18 (e2014.00269)
        • Mathias J.
        Hiding in plain sight: surgical smoke threatens health of OR staff.
        OR Manager. 2015; 31: 104
        • York K.
        • Autry M.
        Surgical smoke: Putting the pieces together to become smoke free.
        AORN J. 2018; 107: 693-700
        • Integrated Benefits Institute
        Poor Health Costs US Employers $530 Billion and 1.4 Billion Work Days of Absence and Impaired Performance According to Integrated Benefits Institute.
        (Available at:)
        • I.C. Medical
        Where Does OSHA Stand on the Issue of Surgical Smoke? 2017.
        (Available at:)
        • Rhode Island General Assembly
        An Act Relating to Health and Safety — Licensing of Health Care Facilities. 2018-H 7082, 2018-S 2238.
        (Available at:)
        https://bit.ly/2OgPbLf
        Date: 2018
        Date accessed: May 11, 2020
        • Colorado General Assembly
        A Bill for an Act Concerning Prevention of Human Exposure to Surgical Smoke During Surgery at Certain Licensed Health Care Facilities. 2019-H19-1041.
        (Available at:)
        • Ball K.
        Smoke break: It’s Time for Facilities to Make Every OR Smoke Free.
        (Medical Design & Outsourcing. Available at:)
        • Association of periOperative Registered Nurses
        Smoke Evacuation News.
        (Available at:)
        • Gee D.
        A New Smoking Gun: Smoke in the OR. 2019. WAVE News.
        (Available at:)
        • Limchantra I.V.
        • Fong Y.
        • Melstrom K.A.
        Surgical smoke exposure in operating room personnel: a review.
        JAMA Surg. 2019; 154: 960-967
        • Stewart A.
        Surgical Smoke Law Robs ASCs of Chance to Self-Regulate, Says Dr. Charles Adams Jr.
        (Beckers ASC Review. Available at:)
        • Michaelis M.
        • Hofmann F.M.
        • Nienhaus A.
        • Eickmann U.
        Surgical smoke-hazard perceptions and protective measures in German operating rooms.
        Int J Environ Res Public Health. 2020; 17: 515
        • Siegel v.
        California Pacific Medical Center, 2002 Cal. App. Unpub. LEXIS 1463 (Court of Appeal of California, First Appellate District, Division Five, May 23, 2002, Filed).
        (Available at:)
        • Oregon Legislative Assembly
        Oregon House Bill 2901.
        (Available at:)
        • Scroggins R. U.S
        Lags on Surgical Smoke Plume Laws.
        (Available at:)
        • Association of periOperative Registered Nurses
        Rhode Island Governor Signs Smoke Evacuation Legislation.
        (Available at:)

      Biography

      Rebecca Vortman, DNP, RN, CNOR, is clinical assistant professor at the University of Illinois Chicago College of Nursing in Springfield, Illinois. She can be reached at [email protected] Janet Thorlton, PhD, MS, RN, is clinical associate professor at the University of Illinois Chicago College of Nursing in Champaign, Illinois.