Outpatient Surgery Magazine

Special Edition: Staff & Patient Safety - October 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 7 of 43

we're really serious about going smoke-free, should- n't we extend our smoking ban to the OR?" After all, the vapor from smoke plume contains formalde- hyde, ethanol, methane, carbon monoxide, cyanide, known-carcinogen acetaldehyde and 150 other chemicals and toxic substances. For perioperative staff, a day in surgery is essentially the same as smoking more than a pack of unfiltered cigarettes. Of course, we just happened to be perfectly posi- tioned to align our smoke evacuation efforts with a major campus-wide initiative to go smoke-free. Most smoke evacuation initiatives don't line up quite so well. That's OK. The key is timing your efforts and launch dates to have the maximum impact on the maximum number of stakeholders. Buy-in from the get-go Your smoke evacuation program will never go any- where without the full support of executive leader- ship. The earlier in the process that you get top- level leaders onboard, the more effective your efforts will be. Not only did I go right up to our CMO, I also approached our new CEO directly with my vision for smoke-free ORs with a similar pitch: "Hey, we really need to make smoke evacuation a priority right now — especially with everything we're doing to make our campus smoke-free. This would be huge for us." Initially, I got a who-are- you? look from him, but he heard me out. If you want to get smoke-evac efforts over the hump, you really need a point person who isn't afraid to ask for things. What's the worst that could happen? You get told no? Cost will likely be a concern. It certainly was for us in the beginning. But again, you need to be persistent and find a way to show decision-makers — in a way that resonates with them — why an upfront investment is money well-spent. For instance, finding and training good perioperative nurses is difficult and costly. Being able to say your facility truly cares about the safety of its staff and has banned smoke in the OR to prove it will certain- ly help you stand out from other facilities, and recruit and retain the top nurses in your area. If you're still struggling to come up with a com- pelling argument for why your facility needs to go smoke-free right now, try the legal tact. Remind leadership that several states have already banned surgical smoke in the OR and that list is only going to grow in the near future. When that happens in your state, you'll be forced to comply and draft a policy on the state's timeline instead of your own. Resistance is inevitable If you approach a smoke-free initiative with a healthy dose of pragmatism and thick skin, you'll do just fine. You can't give up just because you get told no a bunch of times, or three surgeons yelled you. On the other hand, if you expect the change to be easy, you're in for a rude awakening. Change is never easy — especially large-scale, systemic change that requires a financial investment. Throughout our journey, we encountered resistance on a number of fronts, some expected (cost) and some a bit more surprising (staff). For instance, a surgeon came out of his OR when we were trialing evacuators and said, "Get that device out of my OR and don't ever bring it in here again." There was also the challenge of working with materials management to bring certain smoke evacuator vendors onboard for a trial. I needed to present my research, make my case and stick to a 8 • S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 2 0 POWER IN NUMBERS Members of the Southern Georgia AORN chapter and the Georgia Smoke Coalition gathered to discuss smoke evacuation during the chapter's very first meeting. South Georgia Medical Center

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