What changes need to occur in procedural areas to become compliant with Joint Commission standards on smoke evacuation? Smoke produced from ablated human tissue is equivalent to smoking cigarettes and contains the same chemicals. It produces an offensive odor, and can cause ocular and upper respiratory irritation. Observational data was obtained from the OR and other procedural areas which produce smoke. Data included effectiveness and noise level of smoke evacuators. Evacuation products were evaluated for applicability for all procedural areas. Current practice for evacuation of smoke included a combination of a centralized smoke evacuation system, free standing units, and standard vacuum. Surgery clinics were using smoke evacuators for laser plume, but not for smoke generated from ESU units, and contained no centralized suction. Barriers identified from assessment: multiple smoke evacuation products and evacuators; increase in number of product and cost; compliance issues; multiple products, venders, and technology; and many levels of smoke evacuation. Products and practice were standardized between procedural areas based on evaluation and needs assessment. Education was developed and delivered on new policy. Gaps were identified and a plan put in place to provide the resources necessary for regulatory compliance. Instituting a new policy based on regulations can only be successful if a planning model is put into place. Identifying stakeholders, resources, and barriers, and basing practice change on evidence is imperative for a successful process improvement.
Terri Link, RN, BSN, MPH
Perioperative Patient Safety Specialist, University of Colorado Hospital