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issue just wasn't among many staff members' top priorities.
A little more than a year ago, smoke evacuators were being used in
less than one-third of cases. Terri Foster, BSN, RN, CNOR, the surgi-
cal services educator at Allegiance Health in Jackson, Mich., knew it
was going to take more than just orders from above to encourage the
use of smoke evacuation technology. Ms. Foster and her colleagues
used troubleshooting and trialing, facts and humor, documentation
and monitoring to clear the air. For their efforts to protect their staff
from harmful surgical plume, we proudly award the team at
Allegiance Health the OR Excellence Award for Staff Safety.
Finding out what works
The facility already owned smoke evacuation equipment, and staff had
been encouraged to use it. It was time to figure out why they didn't.
"The initial barriers included the bulkiness of the tool and the loudness
of the machine in operation," says Ms. Foster. "The biggest thing sur-
geons wanted was something that wasn't going to be in the way. Noise
was the other consistent objection."
On the plus side, they had a wider range of options to trial this time
around. As it turned out, the trials didn't just eliminate the factors that
didn't work for the OR teams. They also illuminated what did work.
"We found an accessory that connects between the electrocautery
machine and the smoke evacuator device, which triggers the evacua-
tion to turn on when the cautery pencil is in use and to shut off when
it's not in use," she says.
This automatic activation makes the smoke evacuator abundantly
more usable, and safety equipment that is easily and conveniently
usable is more likely to motivate staff to comply with safety practices.
It's a truism, incidentally, that Ms. Foster's facility has also put to serv-
ice in other efforts. Where there's smoke, there's a fire hazard, particu-
