Paper
Monday, November 14, 2005
Evaluating Effectiveness of an Inpatient Nurse-Directed Smoking Cessation Program in a Small Community Hospital
Cheryl E. Gies, RN, BSN, MSN, Department of Nursing, Blanchard Valley Regional Health Center, Findlay, OH, USA, Debra D. Buchman, PhD, RN, CNS, School of Nursing, Medical College of Ohio, Toledo, OH, USA, Janet H. Robinson, PhD, RN, Lourdes College, Sylvania, OH, USA, and Dianne M. Smolen, PhD, RNBC, CNS, Acute and Long Term Care Department, Medical College of Ohio School of Nursing, Toledo, OH, USA.
| Learning Objective #1: Evaluate the post-discharge effects of a nurse-directed smoking cessation intervention on a sample of hospitalized adults |
| Learning Objective #2: Discuss the important role nurses can take to promote smoking cessation among their patients |
The impact of smoking on health is well known and there is strong evidence that individuals have positive outcomes when tobacco cessation interventions are implemented by nurses in clinical settings. The purpose of this research study was to evaluate the effectiveness of a structured, nurse-directed smoking cessation intervention for hospitalized adult smokers. The study used a quasi-experimental, prospective, longitudinal design with Pender's Revised Health Promotion Model as the conceptual framework. The sample included 68 hospitalized adults who were assigned to a control or intervention group. The control group received smoking cessation literature (standard of care). The intervention group received the smoking cessation literature and the nursing intervention. In addition, participants in the intervention group were randomized to subgroups for follow-up by the nurse after discharge. The first subgroup received one phone call and the second subgroup received four phone calls. Smoking status for all participants was assessed at baseline and at twelve weeks by self-report and carbon monoxide monitoring. Fifty-five participants completed the study. Smokers receiving the nurse-directed intervention were more likely to be tobacco abstinent at three months (n=17, 55%) than smokers in the control group who received standard care (n=5, 21%). There was no statistically significant difference in tobacco abstinence between the one follow-up call group and the four follow-up call group. However, for the participants who changed from non-smoking at one week to smoking at twelve weeks, the additional phone calls appeared to delay the relapse. Comparing participants who were smoking at twelve weeks to participants who were not smoking at twelve weeks, regardless of intervention, smokers were significantly more likely to live with another smoker. Implications for practice and future research include testing family-focused interventions and evaluation of a low intensity, sustained relapse prevention program over a longer period of time.