Simerson Darlie, Hackbarth Diana
Chicago, IL.
Chicago, IL.
J Emerg Nurs. 2018 May;44(3):242-248. doi: 10.1016/j.jen.2017.08.004. Epub 2017 Aug 30.
Smoking is the single most avoidable risk factor for many health problems such as cardiovascular disease and pulmonary dysfunction. Emergency departments provide care for many patients who smoke. Patients who smoke and are discharged to home from emergency departments do not customarily receive smoking-cessation information. This project explored the feasibility and acceptability of a brief smoking-cessation intervention as part of emergency nursing practice.
This practice improvement project was conducted in a large midwestern emergency department. A review of data from 12 months before the project revealed a 17.6% prevalence of smoking among patients discharged from the emergency department with no patient having received smoking-cessation information, confirming the need for intervention. A survey of emergency nurse attitudes and learning needs indicated that nurses believed offering advice to quit was appropriate but that they had limited smoking-cessation training. A total of 83 nurses received training on an "Ask, Advise, Refer" protocol.
Evaluation after training indicated that emergency nurses gained knowledge about brief smoking-cessation intervention methods, and 75.7% (n=74) felt adequately trained. During the 12-week intervention, data were collected on 7,465 emergency visits. Nurses advised all smokers to quit using the protocol, and 6.3% of patients accepted smoking-cessation referrals.
Emergency nurses felt comfortable performing the smoking-cessation intervention, suggesting that training was effective. Data indicated that patients were consistently advised to quit smoking. Results suggest that brief smoking-cessation interventions are feasible and acceptable in emergency settings. The training and protocol could be used in other emergency departments, and lessons learned can guide future efforts by emergency nurses to help patients quit smoking.
吸烟是许多健康问题（如心血管疾病和肺功能障碍）中唯一最可避免的风险因素。急诊科为许多吸烟患者提供护理。从急诊科出院回家的吸烟患者通常不会收到戒烟信息。本项目探讨了作为急诊护理实践一部分的简短戒烟干预措施的可行性和可接受性。
本实践改进项目在中西部的一家大型急诊科进行。对项目开展前12个月的数据回顾显示，从急诊科出院的患者中吸烟率为17.6%，且没有患者收到戒烟信息，这证实了进行干预的必要性。对急诊护士态度和学习需求的调查表明，护士们认为提供戒烟建议是合适的，但他们接受的戒烟培训有限。共有83名护士接受了“询问、建议、转诊”方案的培训。
培训后的评估表明，急诊护士获得了关于简短戒烟干预方法的知识，75.7%（n = 74）的护士觉得自己得到了充分的培训。在为期12周的干预期间，收集了7465次急诊就诊的数据。护士们按照方案建议所有吸烟者戒烟，6.3%的患者接受了戒烟转诊。
急诊护士对进行戒烟干预感到得心应手，这表明培训是有效的。数据表明，患者始终得到了戒烟建议。结果表明，简短戒烟干预在急诊环境中是可行的且可接受的。该培训和方案可用于其他急诊科，所吸取的经验教训可为急诊护士今后帮助患者戒烟的工作提供指导。
