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Surgical smoke has not been clearly defined in the literature and often is identified using surrogate terms (eg, plume). In January 2020, a literature search was performed and a principle‐based concept analysis involving four general principles (epistemological, pragmatic, linguistic, and logical) was used to define surgical smoke and identify implications for perioperative personnel, patients, researchers, and policymakers. Surgical smoke is a visible plume of aerosolized combustion byproducts produced by heat‐generating surgical instruments. It consists of water vapor and gaseous substances; can carry toxic chemicals, bacteria, viruses, and tumors; can obscure the surgical field; and can be inhaled. Surgical smoke has a distinctive noxious odor and can cause physical symptoms such as watery eyes and throat irritation. Perioperative leaders should promote protection from occupational harm by educating their staff members on the use of smoke evacuators to mitigate the effects of surgical smoke on perioperative patients and personnel.

Hemorrhaging during operative and other invasive procedures can result in devastating outcomes for surgical patients. An effective plan of action in the form of a massive transfusion protocol (MTP), along with teamwork and clear communication among OR personnel, is critical during a hemorrhagic crisis to improve patient outcomes. However, perioperative personnel may be unprepared to manage a hemorrhagic crisis because they lack experiential knowledge of these uncommon, high-risk scenarios. Perioperative leaders at a 500-bed acute-care hospital in the Midwest developed an educational activity involving a video-recorded simulated MTP scenario, learning modules, and debriefing sessions to educate more than 150 employees. Perioperative personnel received preeducation and watched the video-recorded MTP simulation together, and then participated in team debriefings after watching the video. Based on team debriefings and evaluation feedback, most staff members believed that the activity improved team communication.

Energy‐generating surgical devices (eg, electrosurgical units, lasers) produce surgical smoke that can cause negative health effects in exposed individuals. In 2019, a review of nursing documentation at an urban teaching hospital revealed that personnel were properly evacuating surgical smoke during less than 0.5% of applicable procedures. To address the noncompliance and reduce exposure to surgical smoke, an interdisciplinary team initiated a quality improvement project to implement a surgical smoke evacuation policy for all smoke‐generating procedures. The project included creation and implementation of a smoke evacuation policy, staff member education on the hazards of surgical smoke and proper evacuation device use, and acquisition of the proper smoke evacuation equipment. After instituting the policy in June 2020, results of a three‐month chart audit showed that there was nursing documentation confirming personnel used energy‐generating devices and the corresponding surgical smoke evacuation devices during 664 of 2,224 procedures, for a compliance rate of 30%.

Objectives The objective was to describe and illustrate what is known about the needs of novice nursing faculty as they transition into the faculty role. The worldwide nursing shortage is partly due to the lack of faculty, and one reason for that lack is the reported difficulty of transitioning into the faculty role. Methods An integrative review of the literature was conducted. Results Results demonstrated that new faculty are either intentionally supported in their new environment, with successful development of their skills and career, or they are unintentionally unsupported, which leaves them languishing and reduces intent to stay. Conclusions Despite gaps in the literature and a low level of strength of evidence, the review offers implications for managing and maintaining relationships with novice faculty to facilitate their ultimate success. Institutions should aim to have in place identified elements that ensure novice faculty are intentionally supported rather than unintentionally unsupported.

As a perioperative nurse in an ambulatory surgery center, what nonpharmacologic strategies can I use to minimize preoperative anxiety in my patients?-JBS, AURORA, COLO.

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