5 Tips to Achieve Recognitions for RSI Prevention and Smoke Safety

Seven years ago, a shared goal to move the needle on persistent and deadly patient safety hazards led nurses and industry leaders to brainstorm a process to help OR teams achieve widespread team buy-in and comfort with adjunct technology.

These conversations led to AORN’s first safety recognition program for surgical smoke evacuation through the Go Clear^TM Award. Since 2016, hundreds of facilities have achieved the recognition. Seeing this success, AORN launched a similar recognition model in 2022, the Center of Excellence in Surgical Safety, to tackle another deadly and hard-to-prevent hazard: unintentionally retained surgical items (RSIs).

We wondered how and why nurse leaders have implemented AORN’s smoke evacuation and RSI prevention education programs. So, we asked two Center of Excellence recipients what sparked their journey.

At a rural hospital with 2 ORs—Periop staff wanted to understand why adjunct technology to prevent RSI was so important to account for surgical items used in the 2 ORs that Shrene Clements, BSN, RN, CSRN, leads at PeaceHealth General Medical Center in Sedro Woolley, WA. Clements gave her OR teams the goal of achieving AORN’s Center of Excellence in Surgical Safety: RSI Prevention recognition in three months, which they did.  

At an academic medical center with 47 ORs—A lack of knowledge and consistent use of smoke evacuation technology among more than 300 periop professionals working at Memorial Hermann-Texas Medical Center in Houston, TX, led Jamie Nelson, MBA, BSN, RN, CPHQ, CSSGB, and Deborah Marie Ebert, MSN, RN, NEA-BC, CNOR, CCRN-K, CPAN, CAPA, (along with clinical educators) to launch the Center of Excellence in Surgical Safety: Smoke Evacuation education program and successfully achieve AORN’s Go Clear Award.

Despite working in very different periop environments, the leaders shared similar tips for success:

Tip #1: Recognize It Takes More Than Technology

It takes awareness of the dangers these hazards present and confidence with correct use of the technology to prevent staff and patient harm.

For example, despite smoke evacuation technology being installed in every OR in 2018, surgeon compliance with usage was not a big focus, according to Nelson. “Some surgeons adopted the smoke-free equipment and others did not, and that had been the status quo ever since.”

Tip #2: Make it a Competition

Setting clear intentions with your learners about the project goal is essential.

Clements tracked each team member’s progress with the program on a white board displayed for all to see. To help them achieve program milestones, she checked in with staff weekly to reinforce making time for the program modules, and also gave them a preview of the education ahead of each module.

Tip#3: Build Technology Confidence and Competence

Help team members get comfortable with using the equipment including surgeons, nurses and other periop team members.

Ebert said staff and surgeon acceptance and buy-in was accelerated when vendor partners brought in smoke-free pencils and cautery tips and allowed the staff and practitioners time to look at, touch, and ask questions about them. Nelson suggested allowing time for this experience with technology to settle in and garner feedback, saying, “the more familiar everyone became with the smoke-free pencils the more questions they had.”

Tip #4: Get Buy-In from Every Team Member

Make sure everyone working in the OR is part of the learning process. This includes RNs, surgical technologists, and mid-level practitioners. “Involving every role is an essential piece to achieving long-term compliance,” Clements stressed.

To capture all team members’ attention, Nelson and Ebert purposefully spread the message about achieving smoke evacuation recognition status. Nelson also suggested communicating through different medias and venues. “Ensure every role that is a part of the process is invited to participate and provide feedback.”

Tip #5: Work Through Barriers

There will be push-back, so maximize stakeholder buy-in by acting on as many stakeholder questions, concerns, and challenges as possible, Nelson advised. And, recognize when certain procedures may require more time to adapt to new technologies, she adds. For example, pediatric surgeons at her medical center are working through the logistics of using smoke-free pencils on very small neonates.

Learn more about AORN Center of Excellence in Surgical Safety programs, including Smoke Evacuation (Go Clear Award) and RSI Prevention at AORN Global Surgical Conference and Expo 2023. Join our Center of Excellence team at booth #211 to:

• Learn more about how you can begin these programs.
• Discover how you can help enact smoke legislation in your state.
• Demo the education module’s virtual escape room.

Both programs are complimentary and open to anyone.

AORN’s Center of Excellence in Surgical Safety will continue introducing additional topics aimed at helping you and your staff implement consistent safety standards in your OR.