The Detrimental Effects of Surgical Smoke: Promoting Safety in an Operating Room Team-A Mixed Methods Approach

Abstract

Background: Electrosurgical or electrocautery technology is one of the most widely used in the world, yet no federal agency has mandated the use of electrosurgical filter devices for the protection of surgical teams. Currently, there are 500,000 operating room workers in the U.S.Objective: To identify and appraise perceived barriers and benefits that impact implementation of a hospital-approved electrosurgical filter device that reduces the exposure of surgical smoke by a surgical team. Utilize that data to implement a filter device and collect feedback. Methods:The study is a quality improvement project that involved mixed methods. Because there were no patients involved, an institutional review board approval was deemed unnecessary. The operating room staff in an acute care hospital completed a nine-question survey to determine the pre-intervention perceptions of the staff. There were 53 pre-surveys handed out and 42 of them were returned-a 79% response rate. After the implementation of the device, focus groups were organized to collect feedback. Findings:The main barrier expressed by the operating room staff was perceived cost of a system that would be effective in surgical smoke removal. The main perceived benefit from the use of an electrocautery filter device was the decrease in surgical smoke. Conclusion:Four out of the 11 in the surgeon group expressed overall satisfaction with the filter device. Seven of the 20 (35%) who provided feedback said they were satisfied and that same percentage expressed looking forward to future use of the filter device. Thirty percent (30%) of respondents voiced reports of no smell, and 25% said they felt the filter device was useful in reducing surgical smoke.