5 Key Takeaways from a Successful Smoke-Free Transition

In 2019, North Kansas City Hospital became one of a handful of hospitals in the country that decided to make their operating rooms smoke-free by fitting every OR suite with CONMED’s smoke-evacuating electrosurgical pencils.1 At first, surgeon use of these pencils was not mandated, but after the onset of the COVID-19 pandemic, the facility has now gone completely smoke-free.

Denice Morrison, RN, MSN, NPD-BC, CNOR was one of the nurse champions driving the smoke-free initiative at this facility. During a recent interview with CONMED Sr. Marketing Manager Alex Bada, she shared some tips and tricks from her experience. Here are 5 key takeaways*:

1. The Dangers of Surgical Smoke Are Not Universally Understood
Even though professional organizations like AORN and companies like CONMED have been raising awareness of the dangers of surgical smoke for years, that doesn’t mean that everyone has gotten the message. Despite being a leader and accomplished professional, it wasn’t until 2019 that Denice learned about those dangers by attending a CE course. “I had heard about it before through AORN,” Denice said, “but the speaker really opened my eyes to the hazards.” As she went through the smoke-free transition and began educating her co-workers, she had many colleagues tell her they had no idea how hazardous surgical smoke was. Educating healthcare professionals on the dangers of surgical smoke is still one of the best ways to drive change at organizations that have not gone smoke-free. As Denice says:

“Put the thought in their head that you’re breathing something hazardous, and you should be concerned about that, and you should have a voice in that.”

2. Lead with Education & Make It Personal
Like many things in life, some people are unwilling to change or take action until not doing so directly affects them personally, and surgical smoke is no different. The first thing Denice did was get her fellow nurses on board and use their support to convince nursing leadership and hospital administration that action was needed. Next step: convincing the surgeons. Denice printed out copies of surgical smoke literature and articles about surgeons needing lung transplants from inhaling surgical smoke and left them in the physician lounges, while also using surgeon champions to help convince other surgeons. Educating the staff also helped embolden nurses to speak up and demand change. As Denice says:

“We really got the staff on board so they were hearing it from the literature in the lounge and the staff in the room saying, ‘You may only be breathing this smoke during your cases, but I’m breathing this all day long, so it is critical and important to me. You know I’m married and have kids…it’s personal…I want to have a safe work environment, I want you to have a safe work environment and we should also be concerned about patients too…this is a safety issue” purchasing and surgeons (especially advocates) involved in the process as early as possible. “Don’t surprise them in a case and say, ‘we’re evaluating this today,” Denice says, “talk to them about the risks and benefits.”

Make it personal: Once organizations like the American College of Surgeons and AORN came out and said that the COVID-19 virus could potentially be contained in surgical smoke, the last surgeon hold-outs agreed to go smoke-free.

3. Get Purchasing and Surgeons Involved Early
Communication is key. Denice recommends getting benefits beforehand and see if they are willing to try it.”

North Kansas City Hospital also did not immediately mandate using smoke evacuation pencils in all cases: “At first we gave them a choice and said we strongly recommend using these products, but you don’t have to,” said Denice. This gave surgeons time to adjust and adapt to the new pencils. After 6-8 months, North Kansas City Hospital did mandate the use of CONMED’s smoke evacuation pencils and went completely smoke-free.

4. Use Honesty to Acknowledge Barriers and Overcome Them
Any good sales rep can talk about the benefits and advantages of a product, but the reality is that going smoke-free does add costs to the facility and can be a challenge for surgeons not used to a smoke-free pencil. Instead of spinning or downplaying those drawbacks, Denice recommends addressing them honestly up-front. “Be honest about the challenges they are facing and work with the individual surgeons to overcome them.” Denice said that small changes like changing the tip or using the telescoping handpiece helped overcome the barriers for surgeons who struggled visualizing the surgical site with these smoke evacuating pencils.

5. Utilize CONMED’s Clear The Air and AORN’s Go Clear Programs
Not every facility will have a champion as dedicated as Denice, but utilizing CONMED’s Clear the Air program and AORN’s Go Clear programs are invaluable tools that can help make the transition easier. Denice said that CONMED’s audit tool, “was very helpful and made it easier for the staff to fill out the audit.” As Alex pointed out, these programs are not mutually exclusive: they complement each other and can be used together.

Denice Morrison, RN, MSN, NPD-BC, CNOR
*Some of Denice’s comments have been edited for clarity and/or context




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