目的：目前手術煙霧無情及無聲侵襲醫護人員及病人，手術排煙系統即是良好的對策，但臨床現況仍未達到全面使用的狀態。因此於本文獻評論欲進一步探討，執行手術煙霧排除之困境，以利未來改善實有方向及目標。研究對象：本文探討的重點為根據過去研究結果發現，手術護理師對手術煙霧排除執行困境為手術護理師認知、政策、局部排煙系統機器配置、局部排煙系統噪音及費用。結果：因此，在未來計畫的擬定方針中，著手於提升護理人員對手術煙霧認知，並使用混成式教育方法，做進一步的整理並運用於臨床實務。結論：臨床實務方面建議包含制定標準作業流程、擬定局部排煙系統操作查核表、手術室煙霧課程列入手術室護理師每年在職教育積分認證。

Background: Surgical smoke poses a major health risk to medical personnel and patients in the operating room. Although smoke evacuation systems provide an effective countermeasure, they have not yet been widely adopted in clinical practice. This literature review aims to further explore the barriers to implementing surgical smoke evacuation in order to guide future improvement strategies. Methods: Based on previous studies, the main barriers faced by surgical nurses when implementing smoke evacuation include insufficient awareness and knowledge, lack of institutional policies, limited availability or inappropriate configuration of local smoke evacuation systems, disruptive noise from equipment, and associated costs. Results: Future strategies to address these challenges should focus on enhancing nurses’awareness of surgical smoke hazards. The adoption of hybrid educational approaches is recommended to reinforce knowledge and support practical application in clinical settings. Conclusion: This study’s suggestions for clinical practice include formulating standard operating procedures, drafting a local operation checklist for smoke clearance, and incorporating surgical smoke courses into the required annual continuing education credits for operating room nurses.