Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
Implementation of Smoke Evacuation Cautery in the OR: An Evidence-based Practice Improvement Project
Document Type
Poster
Publication Date
11-8-2025
Abstract
BACKGROUND: Electrocautery smoke is produced when a cautery pencil is used in the operating room (OR) setting to stop bleeding and/or incise tissue. Energy generated by these devices raises tissue temperature, causing tissue vaporization, creating surgical smoke. Exposure has negative health consequences for OR personnel. Surgical smoke contains toxic chemicals and by-products and can contain viable malignant cells, viruses, and bacteria.
LOCAL PROBLEM: Implementation occurred in the ORs of an ambulatory surgery center (ASC). The project purpose was to create and implement a smoke evacuation policy, educate OR personnel on surgical smoke hazards, smoke evacuation device use, and acquisition of smoke evacuation equipment. The project aim was to reduce surgical smoke exposure to OR personnel at the ASC as measured by an increase in smoke evacuation cautery (SEC) compliance.
METHODS: The Model for Improvement was utilized to guide the project. Perioperative personnel participated in a pre-test. After education and training, OR circulators completed a competency verification tool, demonstrating competency on smoke evacuation equipment. SEC was utilized in place of standard cautery and compliance was measured.
INTERVENTIONS: OR staff completed pre-test, education sessions, and competency verification tool. Two surgeons utilized SEC in place of standard cautery for all bilateral mastectomy cases. A smoke evacuation policy template was created for the ASC to utilize if Tennessee enacts smoke evacuation legislation.
RESULTS: Surgeon 1 utilized SEC for 85% of bilateral mastectomy cases. Surgeon 2 utilized SEC for 100% of plastics cases. A smoke evacuation policy was created to be utilized if Tennessee passes smoke evacuation legislation. Project utilized as a Quality Assurance Performance Improvement (QAPI) initiative.
CONCLUSIONS: Utilizing SEC reduces exposure to hazardous surgical smoke contents and undeclared viruses and/or malignancies. Over one-third of the U.S. has smoke evacuation mandates enacted or pending. Sustainability and smoke-free ORs will prepare the project site if state laws mandate smoke evacuation in Tennessee.
Recommended Citation
Deprimo, Angela Michelle M. and Talley, Thomas E. Jr., "Implementation of Smoke Evacuation Cautery in the OR: An Evidence-based Practice Improvement Project" (2025). Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP).
https://trace.tennessee.edu/dnp/181