Patient Safety
The Association of periOperative Registered Nurses (AORN), Denver, has partnered with electrosurgical device manufacturer Megadyne, Draper, Utah, to give association members and other key medical professionals an OR safety toolkit.
The toolkit takes a comprehensive, collaborative approach to emergency preparedness in the OR and in medical facilities overall.
With the electrosurgical pencil being the number one ignition source and cause of fires in ORs, Megadyne sought to pass along knowledge on how surgical fire dangers can be reduced or eliminated, says Melissa Fischer, R.N., a clinical specialist for Megadyne.
“Each of us will likely be a patient someday, or one of our family members will, and not only do we want people to be safe, but we also want nurses and surgeons to feel comfortable with electrosurgical products,” Fischer says.
Megadyne also sponsors several lectures and offers them free to users of its electrosurgery equipment.
Lectures on electrosurgical patient safety, laparoscopic electrosurgical safety and surgical fire prevention each provide one continuing education credit hour.
A course on electrosurgery science and safety costs $10 for non-Megadyne customers and provides two continuing education credits.
Tools of prevention
Fires occur in the OR when three factors unite: a fuel source such as sheets, drapes or chemicals; oxygen; and a heat or emission source such as lasers, cauterizing devices or electrosurgical pencils.
These devices, used in 85 percent to 90 percent of all surgical procedures, contribute to about 100 OR fires annually, 20 of them involving serious injury or death, Fischer says.
Toolkit contents empower OR staff to be more responsive and aware of equipment and supplies that can react and cause fires, she says.
This knowledge might lead to a reduction of clutter—the accumulation of too many supplies in the OR—and promote better organization.
Victoria Steelman, R.N., an advanced practice nurse in perioperative nursing at the University of Iowa Healthcare, Iowa City, supports the cooperative safety initiative.
“Fire safety in operating rooms is a critical component of an overall program of safety,” she says. “This toolkit is intended to make it easier for busy managers to develop their policies, educational programs and an emergency preparedness plan.”
Toolkits contain fire policy, procedure guides, methods for exercising emergency plans and information that stresses the importance of materials managers alerting staff when new equipment or flammable materials are purchased so that evacuation plans are adjusted accordingly.
They also contain fire safety posters and several DVDs that include a fire demonstration by the not-for-profit health services research agency ECRI, candid interviews with families of OR burn victims and footage at Christiana Care Health System in Wilmington, Del., where surgical teams assess fire risk prior to each procedure based on the type of surgery and the equipment being used.
“It’s really a tool for a manager to take into a facility and use as an in-service training tool for staff,” Brian Tepp, marketing manager for AORN, says.
The toolkit’s scope and distribution would have been reduced substantially without Megadyne’s support, Tepp says. Nearly 15,000 kits have been mailed to AORN managers and educators, and all 40,000 members have access to the free toolkit online at www.aorn.org.
Another 10,000 nonmembers, including risk and operations managers, finance, chief nursing officers and other directors and educators, have been invited for a limited time to view the toolkit online.
An invaluable part of the kit is a temporary license for SmartDraw, a software program that allows users to design floor plans, develop an exit plan, identify burn rates for walls and show the location of fire alarms and extinguishers, oxygen lines, shutoff valves and other elements identified in the toolkit as vital elements for emergency plans, he says.
“It shouldn’t be a nurse sitting in a room measuring the floor, dropping in the floor plan,” Tepp says. “He or she needs to involve the facilities department, the local fire department and take into consideration any surrounding factors that may impact that evacuation plan.
“They may need to know what’s going on above and below them that may be potential fire hazards. Engineering departments should be involved. It’s a collaborative approach.”
Nancy Torner is a freelance writer based in Roseville, Minn.
Fire safety, schematic software program
AORN’s ToolKit includes a free download of SmartDraw®, a program that allows users to design unit-specific schematics to identify fire zones, firewalls and burn ratings, evacuation routes, fire extinguisher and alarm locations, and more.
Source: AORN, 2006
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