McDaniel Anna M, Stratton Renee M, Britain Maria
Indiana University Schools of Nursing, USA.
Annu Rev Nurs Res. 2009;27:345-63. doi: 10.1891/0739-6686.27.345.
Nurses have been at the forefront of initiatives to improve patient outcomes through systems change. Nursing research addressing systems approaches to treatment of tobacco dependence has demonstrated increased implementation of evidence-based practice guidelines. Existing health system research conducted by nurse scientists has focused on four strategies: tobacco use identification systems, education and training of nursing staff to deliver tobacco intervention, dedicated staff for tobacco dependence treatment in both acute and primary care settings, and institutional policies to support tobacco intervention. Nursing involvement in multidisciplinary health services research focusing on tobacco treatment has lagged behind advances in clinical nursing research of individual-focused smoking cessation interventions. Health information technology shows promise as part of an integrated approach to systems changes to support tobacco intervention, particularly in light of the current national emphasis on adoption and meaningful use of electronic health records. Future directions for translational research present unprecedented opportunity for nurse scientists to respond to the call for policy and systems changes to support tobacco treatment.
护士一直处于通过系统变革改善患者治疗效果倡议的前沿。针对烟草依赖治疗系统方法的护理研究表明，循证实践指南的实施有所增加。护士科学家开展的现有卫生系统研究集中在四种策略上：烟草使用识别系统、对护理人员进行烟草干预培训、在急症和初级保健机构设立专门的烟草依赖治疗人员，以及支持烟草干预的机构政策。在以烟草治疗为重点的多学科卫生服务研究中，护理方面的参与落后于以个人为重点的戒烟干预临床护理研究的进展。卫生信息技术有望成为支持烟草干预的系统变革综合方法的一部分，特别是鉴于当前国家对采用和有效使用电子健康记录的重视。转化研究的未来方向为护士科学家响应支持烟草治疗的政策和系统变革呼声提供了前所未有的机会。
