Empowering Safety: A Massachusetts General Hospital Team Is Pushing for Smoke-Free ORs

In one of several presentations on the dangers of surgical smoke at the Association of periOperative Registered Nurses’s (AORN’s) International Surgical Conference & Expo 2024, held from March 9 to 12, 2024, in Nashville, Tennesse, a poster titled “Becoming Smoke-Free in the OR—An Academic Medical Center Clinical Improvement Project” was presented by Emily Browne, BSN, RN; Kimberly Fougere, ABSN, RN; Shelley Almeida, BSN, RN, CNOR. All 3 presenters are from the Massachusetts General Hospital in Boston, Massachusetts (MGH).

Surgery with smoke

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“It all started a few years ago; we had some of our other coworkers come to AORN and see…the risks, the hazards of surgical smoke and plumes inhalation in the OR, and from there (our project) snowballed. The general surgery team leader spoke with those who had come to the AORN [conference]. They started their research into smoke evacuation.”

Emily Browne, BSN, RN; Kimberly Fougere, ABSN, RN; Shelley Almeida, BSN, RN, CNOR, with Tori Whitacre Martonicz, senior editor of Infection Control Today. All 3 presenters are from the Massachusetts General Hospital in Boston, Massachusetts (MGH).

They spoke with different companies and products, and now they have a smoke evacuation committee made up of people from various parts of the hospital, including leadership staff. “We are near 100% using smoke evacuation [with our surgeries],” Browne said.

The authors noted the implications for perioperative nursing and others in the OR. At MGH, the "Smoke-Free in the OR project" significantly impacted surgical and nursing practices. This initiative brought about several key changes. First, it increased the staff's understanding of the hazards posed by surgical smoke plumes in the OR environment.

Additionally, the project resulted in the standardization of supply distribution to include smoke evacuation devices in all relevant procedures. Policies and guidelines were also created, reflecting the mandatory use of these devices in every case, ensuring consistent implementation.

Furthermore, the project empowered staff to advocate for the necessity of Smoke Evacuation devices, fostering a culture of safety and awareness. Despite failing to reach the goal of full implementation within the initial 6-month timeframe, substantial progress has been made. The team is confident in achieving the 100% smoke-free standard by 2024.

Overall, this project supports the creation of an environment that prioritizes safety. It aims to reduce the risk of harm from surgical smoke exposure for all OR team members. Moreover, the initiative aligns with government agency regulations and actively supports adopting surgical smoke evacuation legislation in Massachusetts.

The poster also mentions how perioperative nurses and others in the operating room can get smoke evacuation in your facilities, as required by law in your state. As an advocate for patient and staff safety, it is crucial to champion using smoke evacuation devices in all surgical cases. This involves taking proactive steps to investigate, trial, and obtain the necessary tools for your OR's specific needs.

Updating institutional policies to mandate smoke evacuation devices can further solidify their implementation and ensure consistency across procedures.

Furthermore, engaging with legislators to support bills related to surgical smoke evacuation in front of the House and Senate is vital. By advocating at both the institutional and legislative levels, perioperative nurses can work towards creating safer environments for surgical teams and patients alike.

The conference ran from Saturday, March 9, to Tuesday, March 12, 2024. For all ICT’s coverage, go here.