To examine diathermy smoke evacuation practices, attitudes and awareness of this health risk among perioperative nurses and surgeons

Background Surgical smoke presents a potentially serious occupational health hazard, shown to be as mutagenic as cigarette smoke. Although the long-term effects for healthcare professionals exposed to surgical smoke is... [ view full abstract ]

Background
Surgical smoke presents a potentially serious occupational health hazard, shown to be as mutagenic as cigarette smoke. Although the long-term effects for healthcare professionals exposed to surgical smoke is unproven, there is a need to be proactive and prevent any potential harm.

Aim and objectives
To examine diathermy smoke evacuation practices, attitudes and awareness of this health risk among perioperative nurses and surgeons.

Method
Following ethical approval the study was conducted in five hospitals using a quantitative descriptive approach. A questionnaire adapted using two previously established questionnaires was distributed to a total of 280 perioperative nurses and surgeons with a response rate of 41.8%. Data analysis using SPSS provided descriptive and inferential statistics.

Findings
Perioperative nurses and surgeons’ compliance with smoke evacuation recommendations was not consistent. The private hospital respondents (89%) reported more frequent use of smoke evacuators than the public hospital respondents (53%). However, the recommendations of always using a smoke evacuator for every surgical procedure using diathermy were not adhered to significantly across both hospital sectors. The majority of participants (95%) believed that diathermy smoke was harmful but unless the healthcare professional had experienced health problems from the smoke they reported not being very concerned that diathermy smoke was a risk to their health. Findings indicated that there was a deficit in knowledge, education and training on the importance of diathermy smoke evacuation, the available devices and the effective methods to remove diathermy smoke from the surgical environment.

Conclusions and Implications
It is necessary that a mandatory diathermy smoke education programme incorporating policy development is formulated to include areas of poor compliance and knowledge identified in this study. Perioperative nurses’ assertiveness in overcoming the barriers to drive change in clinical practice will increase as a result. Auditing of the implementation of this programme is recommended. Prioritising the health and safety of employees in the surgical environment is advocated through the provision of routine risk assessments, airborne levels monitoring and occupational health checks in relation to diathermy smoke exposure. Replication of this study is suggested to assess the implementation of diathermy smoke evacuators in all surgical settings.