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Promoting the Freedom to Protect
PRESIDENT’S MESSAGE Promoting the Freedom to Protect CHARLOTTE L. GUGLIELMI RN, BSN, MA, CNOR, AORN PRESIDENT
N
inety-nine years ago, in recognition of the 40th anniversary of the Great Chicago Fire of October 9, 1871, the Fire Marshals Association of North America declared that this anniversary “should henceforth be observed not with festivities, but in a way that would keep the public informed about the importance of fire prevention.”1 In 1920, President Woodrow Wilson proclaimed the first National Fire Prevention Day, and since 1922, Fire Prevention Week has been observed annually during the week in which October 9th occurs.1 I have many vivid childhood memories of events commemorating Fire Prevention Week. I recall the annual school visit from members of the local fire department and hoping the fire drill that was conducted that week would occur during a Latin exam. I also remember many television ads featuring Smokey the Bear and Sparky the Firedog that urged viewers to be mindful of fire safety. No matter what your age or in what decades you went to school, I believe many of you can remember this annual event and perhaps have your own stories about observing Fire Prevention Week. Nurses love to tell stories, but unfortunately, many of us also have a story about witnessing an OR fire. These are the stories we dread telling, but we continue to share them in hopes that our colleagues will learn from our difficult experiences.
The ECRI Institute estimates that “550 and 650 surgical fires occur each year in the United States”2(p312); approximately 20 to 30 of these fires are considered serious, and one to two deaths result.2 Even one death is too many; it is almost universally accepted that OR fires are preventable. In October 2006, AORN President Paula Graling, RN, DNP, CNOR, CNS, used her monthly AORN Journal message to challenge us to focus on this issue. She wrote, Fire Safety Month provides us with a perfect opportunity to remember that vigilant fire prevention efforts in the OR should occur every day. The time to discuss the possibility of fire and appropriate fire safety measures applicable to your specific practice is at the beginning of a procedure when all team members are present. Don’t be complacent and think a surgical fire will never happen; your patients are counting on you to protect them.3(p563) THE POWER TO PROTECT Are you empowered to be a protector? Do you raise key questions about fire risks and patient safety? For example, when you are caring for a patient who is undergoing a facial procedure and who is receiving oxygen by nasal cannula, do you initiate a conversation with the team about the use of electrosurgery? If you are making rounds and you observe that an alcohol-based prep solution has not fully dried, do you stop the line and make sure the solution is
doi: 10.1016/j.aorn.2010.07.006
© AORN, Inc, 2010
September 2010
Vol 92
No 3 ● AORN Journal
251
September 2010
Vol 92
allowed to dry before the patient is draped? If you are an educator, do you teach OR fire risks to the medical students and residents that you orient? If you are responsible for writing guidelines for the delivery of care in your hospital or surgery center, have you created a role-specific tool for staff members that provides a standardized, predictable algorithm for responding to an OR fire? Colleagues, if you answered “yes” to the situations that are applicable to your practice setting, you are demonstrating the freedom to protect. RESOURCES FOR FIRE PREVENTION In late 2009, the Anesthesia Patient Safety Foundation, in conjunction with the ECRI Institute, released new recommendations for the prevention of surgical fires. This document, entitled “New clinical guide to surgical fire prevention,”4 contains updated information and new guidelines that focus on oxygen delivery, use of supplemental oxygen, and implementing a preoperative time out to assess fire risk potential for every patient in every procedure. Next month, AORN expects to release a newly updated version of the Fire Safety Tool Kit. This product, which is available without charge to members, is “dedicated to the victims and survivors of surgical and procedural fires throughout the world.”5 The tool kit, originally produced in 2006, is full of valuable resources and remains an indispensable resource for perioperative educators. The updated version will contain a new policy and procedure, fire safety performance evaluation tool, and educational presentation. The updated information is based on the changes in the recommendations from the ECRI Institute and the National Fire Protection Association. Effective communication is key to preventing errors in the OR. To protect your patients from the risk of OR fires, you must be a communicator. In the time-out phase of the “AORN Comprehensive Surgical Checklist,”6 the circulating nurse has the opportunity to verbalize concerns specific to the patient. This is the perfect time to raise the need for a discussion of the risks of fire safety.
252
AORN Journal
PRESIDENT’S MESSAGE
No 3
PLEDGE TO BE A PROTECTOR Many of you have joined me in committing to a time out for every patient, every time. If you have not already taken the pledge, now is the time to do it by filling out the Commit to Time Out information at http://www.aorn.org/AboutAORN/ PartnersInHealth/NationalTimeOutDay/Commit. Let us also spread our commitment by encouraging our colleagues to do the same. Can we afford to have even one nurse not take the pledge? Our unity on this issue will clearly demonstrate our belief in the freedom to protect. Let us focus our energy at the point of care to protect our patients by increasing awareness about the potential for an OR fire and taking steps to prevent fires from occurring. Let us embrace Fire Prevention Week 2010 as a time to enhance our commitment to our patients. References 1.
About Fire Prevention Week. National Fire Protection Association. http://www.nfpa.org/itemDetail.asp? categoryID⫽1439&itemID⫽34426&URL⫽Safety%20 Information/Fire%20Prevention%20Week%202010/ About%20Fire%20Prevention%20Week. Accessed July 21, 2010. 2. ECRI Institute. A look at October. Fire in the OR! Health Devices. 2009;38(10):312. 3. Graling P. Fighting fire with fire safety. AORN J. 2006; 84(4):561-563. 4. ECRI Institute. New clinical guide to surgical fire prevention. Health Devices. 2009;38(10):314-332. 5. Fire Safety Tool Kit: Dedication to patients and families. AORN, Inc. http://www.aorn.org/PracticeResources/ ToolKits/FireSafetyToolKit/DedicationToPatientsAnd Families/. Accessed July 21, 2010. 6. AORN Comprehensive Surgical Checklist. AORN, Inc. http://www.aorn.org/PracticeResources/ToolKits/ CorrectSiteSurgeryToolKit/Comprehensivechecklist/. Accessed July 21, 2010.
Charlotte L. Guglielmi, RN, BSN, MA, CNOR, is the AORN President and a perioperative nurse specialist at Beth Israel Deaconess Medical Center, Boston, MA. President Guglielmi has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article.
N
inety-nine years ago, in recognition of the 40th anniversary of the Great Chicago Fire of October 9, 1871, the Fire Marshals Association of North America declared that this anniversary “should henceforth be observed not with festivities, but in a way that would keep the public informed about the importance of fire prevention.”1 In 1920, President Woodrow Wilson proclaimed the first National Fire Prevention Day, and since 1922, Fire Prevention Week has been observed annually during the week in which October 9th occurs.1 I have many vivid childhood memories of events commemorating Fire Prevention Week. I recall the annual school visit from members of the local fire department and hoping the fire drill that was conducted that week would occur during a Latin exam. I also remember many television ads featuring Smokey the Bear and Sparky the Firedog that urged viewers to be mindful of fire safety. No matter what your age or in what decades you went to school, I believe many of you can remember this annual event and perhaps have your own stories about observing Fire Prevention Week. Nurses love to tell stories, but unfortunately, many of us also have a story about witnessing an OR fire. These are the stories we dread telling, but we continue to share them in hopes that our colleagues will learn from our difficult experiences.
The ECRI Institute estimates that “550 and 650 surgical fires occur each year in the United States”2(p312); approximately 20 to 30 of these fires are considered serious, and one to two deaths result.2 Even one death is too many; it is almost universally accepted that OR fires are preventable. In October 2006, AORN President Paula Graling, RN, DNP, CNOR, CNS, used her monthly AORN Journal message to challenge us to focus on this issue. She wrote, Fire Safety Month provides us with a perfect opportunity to remember that vigilant fire prevention efforts in the OR should occur every day. The time to discuss the possibility of fire and appropriate fire safety measures applicable to your specific practice is at the beginning of a procedure when all team members are present. Don’t be complacent and think a surgical fire will never happen; your patients are counting on you to protect them.3(p563) THE POWER TO PROTECT Are you empowered to be a protector? Do you raise key questions about fire risks and patient safety? For example, when you are caring for a patient who is undergoing a facial procedure and who is receiving oxygen by nasal cannula, do you initiate a conversation with the team about the use of electrosurgery? If you are making rounds and you observe that an alcohol-based prep solution has not fully dried, do you stop the line and make sure the solution is
doi: 10.1016/j.aorn.2010.07.006
© AORN, Inc, 2010
September 2010
Vol 92
No 3 ● AORN Journal
251
September 2010
Vol 92
allowed to dry before the patient is draped? If you are an educator, do you teach OR fire risks to the medical students and residents that you orient? If you are responsible for writing guidelines for the delivery of care in your hospital or surgery center, have you created a role-specific tool for staff members that provides a standardized, predictable algorithm for responding to an OR fire? Colleagues, if you answered “yes” to the situations that are applicable to your practice setting, you are demonstrating the freedom to protect. RESOURCES FOR FIRE PREVENTION In late 2009, the Anesthesia Patient Safety Foundation, in conjunction with the ECRI Institute, released new recommendations for the prevention of surgical fires. This document, entitled “New clinical guide to surgical fire prevention,”4 contains updated information and new guidelines that focus on oxygen delivery, use of supplemental oxygen, and implementing a preoperative time out to assess fire risk potential for every patient in every procedure. Next month, AORN expects to release a newly updated version of the Fire Safety Tool Kit. This product, which is available without charge to members, is “dedicated to the victims and survivors of surgical and procedural fires throughout the world.”5 The tool kit, originally produced in 2006, is full of valuable resources and remains an indispensable resource for perioperative educators. The updated version will contain a new policy and procedure, fire safety performance evaluation tool, and educational presentation. The updated information is based on the changes in the recommendations from the ECRI Institute and the National Fire Protection Association. Effective communication is key to preventing errors in the OR. To protect your patients from the risk of OR fires, you must be a communicator. In the time-out phase of the “AORN Comprehensive Surgical Checklist,”6 the circulating nurse has the opportunity to verbalize concerns specific to the patient. This is the perfect time to raise the need for a discussion of the risks of fire safety.
252
AORN Journal
PRESIDENT’S MESSAGE
No 3
PLEDGE TO BE A PROTECTOR Many of you have joined me in committing to a time out for every patient, every time. If you have not already taken the pledge, now is the time to do it by filling out the Commit to Time Out information at http://www.aorn.org/AboutAORN/ PartnersInHealth/NationalTimeOutDay/Commit. Let us also spread our commitment by encouraging our colleagues to do the same. Can we afford to have even one nurse not take the pledge? Our unity on this issue will clearly demonstrate our belief in the freedom to protect. Let us focus our energy at the point of care to protect our patients by increasing awareness about the potential for an OR fire and taking steps to prevent fires from occurring. Let us embrace Fire Prevention Week 2010 as a time to enhance our commitment to our patients. References 1.
About Fire Prevention Week. National Fire Protection Association. http://www.nfpa.org/itemDetail.asp? categoryID⫽1439&itemID⫽34426&URL⫽Safety%20 Information/Fire%20Prevention%20Week%202010/ About%20Fire%20Prevention%20Week. Accessed July 21, 2010. 2. ECRI Institute. A look at October. Fire in the OR! Health Devices. 2009;38(10):312. 3. Graling P. Fighting fire with fire safety. AORN J. 2006; 84(4):561-563. 4. ECRI Institute. New clinical guide to surgical fire prevention. Health Devices. 2009;38(10):314-332. 5. Fire Safety Tool Kit: Dedication to patients and families. AORN, Inc. http://www.aorn.org/PracticeResources/ ToolKits/FireSafetyToolKit/DedicationToPatientsAnd Families/. Accessed July 21, 2010. 6. AORN Comprehensive Surgical Checklist. AORN, Inc. http://www.aorn.org/PracticeResources/ToolKits/ CorrectSiteSurgeryToolKit/Comprehensivechecklist/. Accessed July 21, 2010.
Charlotte L. Guglielmi, RN, BSN, MA, CNOR, is the AORN President and a perioperative nurse specialist at Beth Israel Deaconess Medical Center, Boston, MA. President Guglielmi has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article.