268471 Sustainability of an educational intervention to enhance nurses' tobacco use dependence evidence-based practice

Monday, October 29, 2012 : 5:30 PM - 5:50 PM

Stella Aguinaga Bialous, RN, DrPH , Tobacco Policy International, San Francisco, CA
Linda Sarna, RN, DNSc , School of Nursing, UCLA, Los Angeles, CA
Jenny Kotlerman , Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, CA
Marjorie Wells, PhD, RN, FNP , School of Nursing, UCLA, Los Angeles, CA
Michael Ong, MD, PhD , Medicine, University of California, Los Angeles, Los Angeles, CA
Background: A national tobacco dependence treatment guideline is available since 1996. It provides healthcare professionals with a framework to treat patients who use tobacco, i.e. the 5As: Ask, Advise, Assess, Assist and Arrange. The 2008 guideline update recommends referral to telephone quitlines to support smoking cessation. Guideline adoption has been sub-optimal and nurses and other healthcare professionals' quitline awareness is minimal. The Joint Commission smoking cessation performance measures require follow-up post-discharge. The quitline could provide patients follow-up support in their quit attempts. Methods: Cross-sectional cohort study of hospital-based nurses' (Baseline N=1790, 12 months N=906) from three states assessed the long term (12 months) impact of web-based educational intervention plus nurse-tailored written materials (Helping Smokers Quit, HSQ) on increasing nurses' consistent (always/usually) referral of smokers to a quitline and performance of the 5As compared to nurses who received written information only (control). Nurses were assessed pre- and 12 months post-intervention. Chi-Square analysis was used to assess differences within and between groups. Results: At 12 months, there was a significant increase in nurses' self-reported referral to the quitline in both groups (HSQ p = 0.007 and Control p = 0.002). The HSQ group had a significant increase in consistently implementing the Assess, Assist and Arrange components of the intervention. The Control group had a significant increase in Ask. Conclusions: These results demonstrate that web-based and nurse-tailored educational can lead to an improvement in evidence-based nursing practice related to tobacco dependence intervention, especially in enhancing referrals to the quitline, a free, effective service.

Learning Areas:
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
1) List the steps involved in translating the Tobacco Use Dependence Treatment Guideline into nursing practice 2) Identify the advantages of a nurse-tailored educational program with and without a web-based component 3) Discuss the role of nursesí referral to the quitline in improving support for quit attempts

Keywords: Smoking Cessation, Evidence Based Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the senior consultant in multiple grants focusing on nurses and tobacco dependence and have worked on tobacco control policy for over 2 decades.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.