Warren Memorial Hospital Receives National Recognition for “Going Clear”

Thanks to the efforts of Warren Memorial Hospital’s Surgical Services, the hospital has earned a gold Go Clear Award from the Association of periOperative Registered Nurses (AORN) for their efforts in reducing surgical smoke. WMH became just the third surgical facility in the Commonwealth and 54th organization in the country to earn this distinction.

Surgical smoke, also known as cautery smoke and surgical plume, is created by tools including lasers, electrosurgical units and ultrasonic devices, used to cut tissue and control bleeding. While these tools have improved the speed and effectiveness of surgery, the smoke they produce can be a malodorous and visual nuisance to the surgical team. More importantly, studies have shown that surgical smoke contains toxic chemicals – up to 150 different hazardous materials – not filtered out by a mask.

Warren Memorial Hospital surgical nurse Kristina Wolf, BSN, RN, CNOR, has worked in the OR for more than 17 years. She knew surgical smoke was a concern, but was not aware of its full impact until she began looking for an interesting research topic for her master’s degree in nursing.

With the support of hospital leadership, Kristina immersed herself in research and learned about the Go Clear Award Program of the Association of periOperative Registered Nurses (AORN), which recognizes facilities that have committed to implementing practices to increase surgical patient and staff safety by eliminating surgical smoke.

The intensive 10-step process involved performing a gap analysis, developing an action plan, creating extensive educational materials, writing competency tests and implementing new policies and procedures for the entire department.

As part of the action plan, Kristina worked closely with general surgeon and Vice President of Medical Affairs Robert Meltvedt, MD, and other surgeons to evaluate the effectiveness and efficiency of smoke evacuation systems currently on the market. These are essentially a high-flow vacuum that attaches to the surgical instrument and captures aerosols and gases at the surgical site, dramatically reducing the amount of smoke released into the air. “Thanks to our surgeons and the entire surgical team, we have been able to incorporate the use of an evacuation system into all of our surgical procedures,” Kristina explains.

Kristina also oversaw the development of an extensive education process. “This was a true team effort over several months,” she explains. “Our OR team was amazing, everyone was committed to completing the series of 10 courses.”

“The work that Kristina and the entire team did is extremely beneficial to OR staff and surgeons,” says Dr. Meltvedt. “It’s just becoming clear what the total impact of long-term exposure to surgical smoke may be. Proactively mitigating those effects is definitely the right course of action,” he adds, noting that the potential risk to patients is negligible since their exposure is brief.

WMH became just the third surgical facility in the Commonwealth and 54th organization in the country to earn AORN’s highest recognition – a gold Go Clear Award!

“This was no small undertaking,” says Ronnie Duckworth, RN, director of Surgical Services, “and we are extremely proud of the work done by everyone on the team to ensure the safety of our staff, physicians and patients.”

Kristina’s work isn’t stopping here. “The risks of surgical smoke are generally acknowledged throughout the profession, but only an estimated 50% of healthcare workers in the U.S. understand its full impact,” she says, adding that smoke evacuation units are not currently mandated through state licensing boards or national accreditation organizations. “I have already started working with our Valley Health sister hospitals to share best practices and create a healthier environment for all!”