Guantanamo Bay Surgical Team Earns National Recognition for Eliminating Surgical Smoke

Story by Emily McCamy

U.S. Navy Medicine Readiness and Training Command Guantanamo Bay

GUANTANAMO BAY, Cuba – U.S. Naval Hospital Guantanamo Bay earned national recognition from the Association of periOperative Registered Nurses (AORN) after eliminating surgical smoke from its operating room – one of only 14 military treatment facilities to achieve the “Go Clear” Award.

The award recognizes medical teams that implement advanced smoke evacuation technology and demonstrate commitment to surgical safety through staff education and rigorous compliance with AORN’s evidence-based standards.

The initiative – spearheaded by Cmdr. Jennifer Francis, a perioperative nurse, and Hospital Corpsman 2nd Class Shakirah Peterson-Wall, a surgical technician – protects surgical staff from the harmful effects of inhaling smoke generated during surgical cauterized procedures.

“This initiative started with the question, ‘How many MTFs are smoke free?’” Francis said. “A colleague from U.S. Naval Hospital Okinawa reached out and opened the conversation. We started making calls to other Navy MTFs to talk about the process and realized we had the tools to achieve the smoke-free standard; we just needed a few extra supplies and training.”

Francis collaborated with Peterson-Wall, who leads training for the surgical department, to turn the concept into action.

“Cmdr. Francis was very passionate about this initiative – I executed it,” said Peterson-Wall. “Surgical smoke contains carcinogens and is the by-product of using energy-generating devices. Prolonged exposure can lead to throat and lung cancers, and in some cases, HPV has been found in the throats of staff. That’s not a risk I’m willing to take.”

Together, they contacted AORN to understand the certification process. The team ordered carbon filters for the suction machines and smoke evacuation tubing for cautery devices. After training staff on the health risks of surgical smoke, they launched a 12-week audit to ensure 100% compliance during all procedures that involved cautery.

“At the end of 12 weeks, we submitted our data to AORN, and they awarded us the Smoke Free Certification,” said Peterson-Wall. “We eliminated 99.9% of surgical smoke produced during surgery. We can’t do our best if we aren’t at our best.”

Francis emphasized the importance of leadership support in sustaining the effort. “This is a deckplate initiative and I’m grateful our director of surgical services, Lt. Cmdr. Shaw Rowe, advocated for this change. We’re a small command, but we did it.”

The initiative reflects a broader trend toward surgical smoke elimination. To date, 18 states require smoke evacuation during cauterized procedures.

“This practice has to be part of your battle rhythm,” Francis said. “It’s our responsibility to ensure safety – not just for the patient, but for the entire operating room team.”

The hospital was formally recognized at the AORN Global Surgical Conference & Expo in Boston on April 6, 2025, alongside U.S. Navy Medicine Readiness and Training Command Okinawa. Cmdr. Jim Zmijski, a perioperative nurse assigned to U.S. Navy Medicine Readiness and Training Command Guantanamo Bay, was present to represent the command.

“This award is a testament to the innovation and leadership of our surgical team,” Francis said. “We armed ourselves with the facts, trained our people, and made safety the standard.”