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ABSTRACT: BACKGROUND:: Smokers who make a quit attempt during hospitalization have improved long-term abstinence if they receive follow-up support, including via a telephone quitline, a free resource in the United States. Smokers are referred infrequently to this resource by healthcare providers. OBJECTIVE:: The aim of this study was to evaluate the impact of a Web-based educational program (Helping Smokers Quit) on translating the Treating Tobacco Use and Dependence Clinical Practice Guideline: 2008 Update into practice. Using a Web-based survey, frequency of nurses' self-reported referral of smokers to a quitline and performance of the components of a smoking cessation intervention (the 5As: Ask, Advise, Assess, Assist, Arrange) was compared with self-reported performance among nurses who received printed educational materials (control group) at 6 months. METHODS:: Nurses from 30 (n = 15 control and n = 15 intervention) randomly selected and assigned hospitals from California, Indiana, and West Virginia participated. Both groups received a toolkit of materials including a state quitline card and access to the Tobacco Free Nurses Web site; the intervention group had additional access to a project-specific Web page and the opportunity to attend a webinar. Only nurses who completed baseline and 6-month surveys were included in the analysis. Mean improvement of the 5As and refer scores and logistic regressions of consistent (usually or always) referral to a quitline were used to examine differences over time by group. RESULTS:: Pre-post data were collected for 333 nurses (209 intervention, 124 control). Mean improvement was significantly higher in Advise, Assess, Assist, Arrange, and Referral to a Quitline for the Help Smokers Quit group. Nurses in the control group significantly improved in Advise and Referral to a Quitline. Consistent referral was most likely in the intervention group (OR = 1.74, 95% CI [1.11, 2.72]), especially among those who viewed the webinar (OR = 2.34, 95% CI [1.03, 4.23]). DISCUSSION:: After 6 months, nurses in the intervention group had significant improvement in the frequency of interventions and consistency of referral of smokers to the quitline. The improvement of nurses' referral to the quitline among the control group who only received printed materials demonstrates that both are effective strategies in increasing awareness of this resource.
Nursing research 10/2012; · 1.80 Impact Factor
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ABSTRACT: There are 17.3 million nurses worldwide, the largest group of health-care professionals, and they have great potential to address the epidemic of tobacco use and its related morbidity and mortality. However, the evidence indicates that the educational preparation of nurses for tobacco control remains inadequate.
This paper provides an overview of the efficacy of nurses in the delivery of smoking cessation interventions, existing tobacco control content in nursing educational programs, model curricula, teaching resources and strategies for reducing barriers to curricular change.
Despite the efficacy of nursing intervention for tobacco cessation, lack of appropriate knowledge and/or skill presents a major problem for implementation. An important factor fostering this lack of preparation is limited tobacco control content in current nursing educational programs. Barriers to enhancing and building this curricula include lack of preparation of educators, low priority for this content in an already overloaded curricula, negative attitudes, continued smoking by nursing students and/or faculty and lack of tested curricula. The availability of new tobacco control resources, including those specifically tailored for nurses can assist educators in teaching this content and nurses in implementing interventions.
Research and changes in policy are needed to ensure that nursing education includes essential content on tobacco control.
Nurses can be effective in delivering tobacco cessation interventions. Efforts are needed to promote curriculum that ensures that all nursing students and practicing nurses receive tobacco control content and are competent in the delivery of interventions; and to disseminate resources to nursing educators
Drug and Alcohol Review 10/2009; 28(5):507-16. · 1.55 Impact Factor
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ABSTRACT: To describe the frequency of nurses' delivery of tobacco cessation interventions ('Five A's': Ask, Advise, Assess, Assist, Arrange) and to determine the relationship of interventions to nurses' awareness of the Tobacco Free Nurses initiative.
Tobacco cessation interventions can be effectively provided by nurses. The delivery of smoking cessation interventions by healthcare providers is mandated by several organisations in the USA and around the world. Lack of education and resources about tobacco cessation may contribute to the minimal level of interventions. The Tobacco Free Nurses initiative was developed to provide nurses with easy access to web-based resources about tobacco control.
Cross-sectional survey of nurses (n = 3482) working in 35 Magnet-designated hospitals in the USA (21% response rate).
A valid and reliable questionnaire used in previous studies to assess the frequency of the nurse's delivery of smoking cessation interventions ('Five A's') was adapted for use on the web.
The majority of nurses asked (73%) and assisted (73%) with cessation. However, only 24% recommended pharmacotherapy. Only 22% referred to community resources and only 10% recommended use of the quitline. Nurses familiar with TFN (15%) were significantly more likely to report delivery of all aspects of interventions, including assisting with cessation (OR = 1.55, 95% CI 1.27, 1.90) and recommending medications (OR = 1.81, 95% CI 1.45, 2.24).
Nurses' delivery of comprehensive smoking cessation interventions was suboptimal. Awareness of Tobacco Free Nurses was associated with increased interventions. Relevance to clinical practice. Further efforts are needed to ensure that nurses incorporate evidence-based interventions into clinical practice to help smokers quit. These findings support the value of Tobacco Free Nurses in providing nurses with information to support patients' quit attempts.
Journal of Clinical Nursing 08/2009; 18(14):2066-77. · 1.12 Impact Factor
