Acute and Critical Care Nurses' Confidence in Implementing Tobacco Cessation Interventions

Saturday, 16 November 2013

Sarah Jane Craig, MSN, RN, CCNS, CCRN
Acute Care, University of Virginia School of Nursing, Charlottesville, VA
Larry Lassiter, MSN, RN, CNL
School of Nursing, Georgia Health Sciences University, Augusta, GA
Janie Heath, PhD, APRN-BC, ANP, ACNP
School of Nursing, University of Virginia, Charlottesville, VA

Learning Objective 1: 1) Identify factors that influence the acute and critical care nurses' confidence in their ability to implement tobacco cessation interventions.

Learning Objective 2: 2) Discuss he US Public Helath Service 5 A’s framework as a tool to assist health care providers to intervene in tobacco dependent clients.

Background In acute care settings it is the responsibility of the nurse to assess the client’s tobacco dependence and provide tobacco cessation teaching prior to discharge from the hospital. The specific aim of this research was to identify factors related to confidence in implementing tobacco cessation interventions in acute care.

Methods A descriptive design was utilized for a 15-item survey at the Nursing Leadership for Tobacco Control exhibit at the American Association of Critical Care Nurses National Teaching Institute (NTI) in Orlando, Florida.  Descriptive statistics were conducted to ascertain the self-reported confidence of acute and critical care nurses to implement interventions in tobacco dependent clients.  A convenience sample of nurses at NTI self-reported confidence and intention to implement tobacco cessation interventions.

Results Surveys were completed by 436 nurses at NTI out of 8,000 nurses.  Pertinent results 75% reported an education level of BSN or higher and 23.9% reported an AND, 65% of responders were certified, 32% were employed by Magnet facilities, and 28% worked at facilities with at least one Beacon Unit.  Ninety-three percent reported an average, above average, or high intention to integrate tobacco cessation interventions into daily nursing practice.  Nurses were most confident in asking about tobacco use (87.6%), advising tobacco cessation (91.4%), and assessing readiness to quit (84%).  Nurses were least confident in assisting clients to quit (78%) and arranging follow-up to quit (65%).  

Conclusion Acute and critical care nurses are confident in assessing for tobacco use, readiness to quit, and advising clients to quit.  Further skill development is required for assisting and arranging follow-up interventions to help clients quit tobacco products.  Acute and critical care settings must continue to strive to create environments which foster professional nursing development through certification, higher education, and benchmarks of nursing excellence such as Beacon units, and Magnet institutions.