Surgical smoke presents a serious health hazard, but perioperative nurses' compliance with smoke evacuation recommendations is not consistent. I investigated key indicators for compliance with electrosurgical smoke evacuation recommendations based on nurses' individual innovativeness characteristics, perceptions of the attributes of smoke evacuation recommendations, and organizational innovativeness characteristics. The study findings provide implications for improving nurses' compliance with smoke evacuation recommendations. Individual innovativeness characteristics, including nurses' knowledge and training, were most strongly linked to smoke evacuation compliance. The key indicators that promote surgical smoke evacuation can provide direction to guide the content of education programs and help identify the personnel and settings that are most in need of this information. Barriers to compliance included lack of equipment, physician resistance, noise, and staff member complacency. Vendor demonstrations on the ease of smoke evacuation device use can show nurses that smoke evacuation is compatible with nursing practice. Facility leaders should provide smoke evacuation policies that are easy to understand and should enforce these policies.

More than 500,000 health care workers are exposed to surgical smoke every year. Toxic gases create an offensive odor, small particulate matter causes respiratory complications, and pathogens may be transmitted in the surgical smoke to the surgical team. Previous research notes that perioperative nurses do not consistently follow smoke evacuation recommendations. The purpose of this study was to determine key indicators that are associated with compliance with smoke evacuation recommendations. Data from a web-based survey completed by 777 nurse members of AORN were analyzed to examine the relationship between the key indicators and compliance with smoke evacuation recommendations. Major findings were that specific key indicators influencing compliance include increased knowledge and training, positive perceptions about the complexity of the recommendations, and increased specialization, interconnectedness, and leadership support in larger facilities. Education programs can be developed that directly address these key predictors so that a surgical environment free from surgical smoke is promoted.

The professional literature predicts worldwide perioperative nursing shortages. Compounding this is the absence of perioperative curricula in most nursing programs, which reduces new graduate interest in and awareness of employment opportunities in the OR environment. Educators at a university and a large hospital system formed an innovative partnership to create a pilot undergraduate nursing course to better prepare nurses for the surgical setting. The course was offered in a condensed-semester format and included online activities, simulation experiences, classroom discussions, and clinical experiences in a small group setting. Two of the four nursing students in the course were hired directly into the perioperative setting after graduation, decreasing hospital costs related to recruitment and orientation. The success of the course led to its integration into the undergraduate curriculum, thus providing a valuable elective option for junior and senior nursing students, as well as achieving a new model for perioperative nursing education.

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The beneficial role of gastrointestinal endoscopy for the prevention, diagnosis, and treatment of many digestive diseases and cancer is well established. Like many sophisticated medical devices, the endoscope is a complex, reusable instrument that requires reprocessing before being used on subsequent patients. The most commonly used methods for reprocessing endoscopes result in high-level disinfection. To date, all published episodes of pathogen transmission related to gastrointestinal endoscopy have been associated with failure to follow established cleaning and disinfection/sterilization guidelines or use of defective equipment. Despite the strong published data regarding the safety of endoscope reprocessing, concern over the potential for pathogen transmission during endoscopy has raised questions about the best methods for disinfection or sterilization of these devices between patient uses.