Improving Smoking Cessation Education and Referral in the Ambulatory Surgical Setting
Repository Posting Date2018-06-05T19:08:31Z
Author DetailsClare Moran, DNP, RN, FNP, firstname.lastname@example.org; Paul D'Amico, PhD, RN, ANP
Lead Author Sigma AffliationKappa Gamma
TypeDNP Capstone Project
Level of EvidenceOther
CINAHL HeadingsSmoking Cessation; Smoking Cessation Programs; Smoking Cessation--Education; Ambulatory Surgery; Smoking Cessation Programs--Methods; Quality Improvement
Introduction Smoking is the leading cause of preventable death in the U.S. yet studies show that nurses lack the knowledge and skills to screen and counsel smokers. This study focuses on improving smoking cessation interventions in the ambulatory surgical setting where pre-operative cessation can decrease post-operative complications and improve health.
Aims This study sought to determine if implementation of an evidence-based protocol using the 5A’s method facilitates provider assessment and documentation of smoking cessation, education, intervention, and referral in smokers in the ambulatory surgical setting.
Methods A quality improvement project was conducted using a convenience sample of all nurses working in pre-surgical testing and ambulatory surgery. A three-month retrospective chart review evaluated current documentation rates of smoking history, readiness to quit, counseling, and referral in current smokers presenting to both units. Twelve nurse practitioners and fourteen registered nurses were educated on the 5A’s model. Following the in-service, a three-month prospective chart review was conducted. Chi square analyses were conducted to determine the rates of change.
Results/Findings Following the in-service, all areas of documentation increased. Prospective analysis revealed referrals were given to 76.3% of patients ready to quit, an increase of 73% from the retrospective data. These results were significant with p=.035 on a Fisher’s exact test.
Conclusions Education on the 5A’s method can increase nurses’ assessment and documentation of smokers’ education, intervention, and counseling. Nurses can reach smokers in a variety of settings and the ambulatory setting provides a unique opportunity for pragmatic counseling and referral.