Surgical Smoke Evacuation Guidelines: Compliance Among Perioperative Nurses

AORN J. 2010 Aug;92(2):e1-23. doi: 10.1016/j.aorn.2009.10.026.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Air Pollutants, Occupational / standards*
  • Air Pollution, Indoor / prevention & control*
  • Attitude of Health Personnel
  • Data Collection
  • Diffusion of Innovation
  • Electrosurgery / adverse effects
  • Electrosurgery / nursing
  • Electrosurgery / standards*
  • Guideline Adherence*
  • Humans
  • Internet
  • Middle Aged
  • Operating Rooms / standards
  • Organizational Culture
  • Perioperative Nursing / standards
  • Safety Management / standards
  • Smoke / adverse effects
  • Smoke / prevention & control*
  • Ventilation / standards*


  • Air Pollutants, Occupational
  • Smoke