Date of Award

4-17-2025

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences

Department

Nursing

Major Advisor

Amanda Noorani

Second Advisor

Chris Webb

Abstract

Abstract

Background: Surgical smoke is a byproduct produced during surgical procedures when high-energy producing devices are used to vaporize tissue. This smoke poses health risk to anyone present in the operating room.

Purpose: The purpose of this quality improvement (QI) project was to educate and minimize the exposure of both staff and patients to the hazardous toxic fumes and vapors produced by energy-generating electrocautery devices.

Methods: The intervention based on the Kim Ball Smoke Evacuation Compliance Model was implemented in a large military hospital with 20 operating rooms and three labor and delivery suites. Implementation included formal education strategies, equipment updates, and compliance monitoring tools. Data collection included staff education tracking, direct observation of eligible surgical procedures using the AORN audit tool, and suction Bovie pencil implementation. Descriptive statistics were conducted to evaluate the project outcomes.

Results: Over 50% of staff completed the education. Compliance for all five AORN audit elements improved or was sustained during post-implementation. Suction Bovie usage increased 113.5% from pre- to post-implementation.

Discussion: This quality improvement initiative showed that using a suction Bovie pencil, along with educating staff about the dangers of surgical smoke, helped to create a smoke-free environment in the operating room.

Conclusion: Utilizing a suction Bovie pencil had a positive impact on helping to create a smoke-free atmosphere in the operating room. Future direction for this project is to educate all surgical new-hires and provide bi-annual training for permanent staff to continue their knowledge and awareness of surgical plume.

Key Terms: Association of Perioperative Registered Nurses, bioaerosols, diathermy plume, operating room, suction Bovie Pencil, surgical plume, surgical smoke

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