A guide to zero harm in the OR — 5 notes

Operating rooms are intense environments that present risks for both patients and clinical staff. Surgical smoke contains 150 chemicals, with smoke particles able to travel 40 miles per hour — and that's just one of the potential harms present in the OR. 

During an April 20 webinar hosted by Becker's and sponsored by Stryker Surgical Technologies, panelists discussed solutions available to eliminate risks in the OR, as well as strategies to support a successful implementation. 

The speakers were: 

  • Stephanie Eaton, medical education specialist at Stryker Surgical Technologies 
  • Amy Boone, BSN, RN, clinical director of perioperative services at University Hospitals of Cleveland 
  • Dena Salamon, MSN, RN, director of operating rooms at Cleveland Clinics main campus 

Key takeaways from the discussion: 

1. Reaching zero harm in the OR is a journey because there are multiple risks that need to be addressed, Ms. Eaton said. In addition to surgical smoke, Stryker's portfolio of solutions allows health systems to eliminate airborne contaminants, splashes and spills, and cut the risk of retained sponges. Since implementing Stryker's SurgiCount+ platform, Mayo Clinic has had zero such cases. "Before … they were having a retained surgical sponge every 13 days," Ms. Eaton said. "Policies and procedures helped by reducing that number to one every 64 days, but that didn't eliminate the problem. After implementing, they retained zero sponges." 

2. Pinpoint where the most risk is coming from in your OR when deciding where to start on the path to zero harm, Ms. Boone said. "You really have to focus on where you're not hitting the mark," she said, adding that UH started with addressing the more obvious risks, such as retained sponges, before moving on to smoke. 

3. Emphasizing the harms posed can help overcome cost concerns regarding the implementation of new technologies. "The cost of not implementing this strategy is that we could potentially negatively impact our patients and staff in the long-term, and that could very seriously put the organization at risk for liability," Ms. Boone said of how she approached supply management to advocate for zero-harm platforms.

"When you're going up against finance, adding something to a routine that we already do, it could be a challenge when adding cost, [but] when you add safe patient care and patient safety into the terminology, people start listening," Ms. Salamon said. 

4. Monitoring compliance can inform where policies are needed surrounding the use of zero-harm platforms. "Where we find that there is pushback, resistance or non-compliance, we have addressed that by having a policy," Ms. Boone said. Surgeons often ask for the policy involving a new technology, she added. "As soon as you can provide that, it's a little easier to swallow." 

5. Starting with a small roll-out can foster team buy-in. "It's hard to go all in all at once," Ms. Salamon said of her experience at Cleveland Clinic. "Small rollouts are good at first because not everybody likes change. Even though it's a positive change that's going to provide safe patient care, people just don't like change," she said, adding that building in time for educating on how to use the platforms and leading a slow roll out has been effective. 

To watch the full webinar, click here. 

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