As non-surgical treatments face increased scrutiny from regulatory authorities, a standardised set of laser safety guidelines is imperative.
The new 2023 Standards for Safe and Quality Care in the Perioperative Environment (SSQCPE), developed by the Australian College of Perioperative Nurses (ACORN), present more compelling reasons for all laser users across Australia to adhere to a uniform standard of laser safety. With non-surgical treatments in the line of sight for review by regulatory authorities, stepping up laser safety standards to ensure patient and staff wellbeing is paramount.
The argument for the cosmetic medicine industry to mandate laser safety training, refresher courses and other relevant policies is grounded in several key aspects of the SSQCPE and they contribute to setting a national benchmark. The SSQCPE provide an argument for mandatory laser safety education regardless of the state or territory in which one is operating.
Currently legislation and regulation concerning this only exists in Queensland, Western Australia and Tasmania and there is an overall sentiment that the other states and territories are exempt from such education.
The SSQCPE draws on the AS/NZS standards (2018) that require that everybody have laser safety education prior to using a laser, and that a refresher course is done regularly. Mandatory initial laser education is also currently supported by both the Australian College of Nursing and the Australasian College of Cosmetic Surgery and Medicine and is built into their post-graduate programs.
Consistency in care and safety
Uniform adherence to these standards ensures that no matter where a patient receives care, they are afforded the same level of safety and expertise. There is no excuse for practitioners working outside of the traditional paradigm of healthcare such as skin and cosmetic clinics to be held to any lesser account than their acute care colleagues.
Adaptation to technological advancements
The field of laser technology is rapidly evolving. By adhering to a standardised set of guidelines, all laser users can stay updated with the latest safety protocols and technological advancements, ensuring the care provided is not only safe but also state of the art.
This area is rapidly evolving and practitioners in skin and cosmetic clinics find themselves faced with more than one laser, intense pulsed light or other energy-based system. This is an additional layer of complexity compared with their perioperative colleagues who generally must be across a single holmium or CO2 laser, but rarely more than two devices in the operating theatres.
Skin and cosmetic clinic staff will also sometimes have to navigate the multitude and utility of older equipment if they are new to an established clinic or inherit the equipment as part of a clinic sale.
Clarity in guidelines and compliance
The meticulous language used in the SSQCPE, with clear distinctions between mandatory requirements and recommendations, allows for straightforward implementation and compliance. This clarity is crucial in minimising misunderstandings and errors in the perioperative environment. Speaking a common language across laser implementation is vital to ensure complex terms and safety standards are well understood by all parties.
Evidence-based practices and comprehensive coverage
The incorporation of evidence summaries from the Joanna Briggs Institute (JBI) and an exhaustive bibliography ensures that the standards are not only practical but also grounded in the best available scientific evidence. This evidence- based approach boosts the credibility and effectiveness of the standards. Additionally, this rigour makes them applicable in environments beyond the perioperative one.
The SSQCPE covers a wide range of specialties and laser applications, ensuring that its guidelines are relevant and applicable across various medical fields. The comprehensive nature of the standards means that they can serve as a one-stop guideline for all laser users in Australia.
Safety of patients and personnel
With detailed criteria focusing on accountability, laser use, personal protective equipment and fire safety, the standards prioritise the safety of both patients and healthcare personnel. Uniform adherence to these standards will significantly reduce the risk of laser-related accidents and injuries. The principles of accountability, laser use, personal protective equipment and fire safety are vital regardless of the context of practice and translate readily into the skin and cosmetic clinic environment.
Laser safety training
The SSQCPE emphasise a rigorous approach to laser safety training for all perioperative personnel involved in laser use. This standard underscores that comprehensive education and ongoing training are not just recommended but mandated for maintaining the safety of both patients and staff in perioperative environments where lasers are used. This includes, but is not limited to, perioperative nurses, surgeons and technicians, ensuring that every team member is equipped with the necessary knowledge and skills to operate lasers safely and effectively.
The standard specifies that Health Service Organisations (HSOs) hold the responsibility for ensuring this training is not only conducted but also kept current, with a requirement for periodic competency verification. The emphasis on training encompasses a broad scope, covering operational aspects of laser use, safety protocols and emergency procedures, including the management of laser-induced injuries and surgical plumes. Moreover, the inclusion of a requirement for a laser safety officer (LSO) in each team highlights the importance of having a dedicated expert to oversee and ensure adherence to these safety standards.
Role of Laser Safety Officer (LSO)
The standardisation of the Laser Safety Officer role across healthcare settings ensures there is always a dedicated professional responsible for overseeing laser safety and compliance with the standards. This role is crucial in maintaining a safe environment.
Promotion of continuous improvement
By following a nationally standardised set of guidelines, healthcare facilities and professionals are part of a culture of continuous improvement. This culture is essential in a medical landscape that is constantly evolving and facing new challenges.
The adoption of the 2023 SSQCPE standards by all laser users in Australia is a commitment to excellence in patient care and safety. Such uniform adherence will ensure the highest standards of laser safety are maintained across the country, benefiting patients and healthcare professionals alike. AMP
Adjunct Associate Professor Elissa O’Keefe RN NP is the owner of Bravura Education and Science Skincare. Bravura Education offers award-winning nationally-accredited laser and IPL courses. Call 1300 001 808 or visit bravura.edu.au
References
1. Association of Perioperative Registered Nurses (AORN). Guidelines for perioperative practice: Laser safety. Denver CO; AORN; 2021. Available from: https://www. aornguidelines.org/guidelines/content?sectionid=245892624&view=book Accessed 16 February 2024.
2. Australian College of Perioperative Nurses (ACORN) (2023). Standards for Safe and Quality Care in the Perioperative Environment (SSQCPE). https://www.acorn.org.au/standards Accessed 16 February 2024.
3. Australian College of Nursing (2024). Graduate Certificate in Cosmetic Nursing. https://www.acn.edu.au/education/postgraduate-course/cosmetic-nursing. Accessed 16 February 2024.
4. Australasian College of Cosmetic Surgery and Medicine (2024). Training Program – Medicine https://www.accsm.org.au/medical-training Accessed 16 February 2024.
5. Australian Commission on Safety and Quality in Health Care (ACSQHC). (2021). National safety and quality health service standards – Clinical governance standard. 2nd ed. Sydney. Available from: www.safetyandquality.gov.au/standards/nsqhs-standards/communicating-safety-standard Accessed 16 February 2024.
6. Bhojani N, Andonian S, Watterson JD, Dushinski JW, Shayegan B, Schuler TD et al. (2020). Canadian Urological Association best practice report: Holmium: YAG laser eye safety. Can Urol Assoc J.;14(12):380–2.
7. International Electrotechnical Commisssion (IEC) (2022). IEC TR 60825-8:2022 Safety of laser products – Part 8: Guidelines for the safe use of lasers on humans. Geneva: IEC.
8. International Organization for Standardization (ISO) (2014). ISO 16571 System for evacuation of plume generated by medical devices. Geneva: ISO.
9. O’Keefe E. (2018). Laser Safety. The Dissector. 46(3):17–8.
10. Standards Australia/Standards New Zealand (AS/NZS) (2018). Australian/New Zealand standard: Safe use of lasers and intense light sources in health care. Sydney. Available from: https://www.standards.org.au/standards-catalogue/sa-snz/other/he-003/as-slash-nzs–4173-colon-2018.
