Provision of smoking care in NSW hospitals: opportunities for further enhancement

Freund, Megan; Campbell, Elizabeth; Paul, Christine; Wiggers, John; Knight, Jenny; Mitchell, Elayne

doi:10.1071/nb07102

Cited by 9 publications

(16 citation statements)

References 46 publications

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Section: Discussionsupporting

confidence: 86%

“…These results may reflect a diagnostic/curative approach rather than a primary prevention approach to the assessment and provision of nicotine dependence treatment, consistent with other research. [34][35][36] The data suggests a low rate (6%) of recorded smoking status on discharge summaries. Discharge summaries are forwarded to treating GPs, community mental health teams and drug and alcohol services, and summarise the therapeutic events and planned interventions.…”

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

An audit of the prevalence of recorded nicotine dependence treatment in an Australian psychiatric hospital

Wye¹,

Bowman²,

Wiggers³

et al. 2010

Australian and New Zealand Journal of Public Health

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Objectives: To investigate the prevalence of recorded smoking status, nicotine dependence assessment, and nicotine dependence treatment provision; and to examine the patient characteristics associated with the recording of smoking status. Method: A retrospective systematic medical record audit was conducted of all psychiatric inpatient discharges over a six‐month period (1 September 2005 to 28 February 2006), at a large Australian psychiatric hospital, with approximately 2,000 patient discharges per year. A one‐page audit tool identifying patient characteristics and prevalence of recorded nicotine dependence treatment, and requiring ICD‐10‐AM diagnoses coding was used. Results: From 1,012 identified discharges, 1,000 medical records were available for audit (99%). Documentation of smoking status most frequently occurred on the admission form (28.8%) and diagnoses summary (41.6%). Documentation of nicotine dependence was not found in any record, and recording of any nicotine dependence treatment was negligible (0‐0.5%). The rate of recorded smoking status on discharge summaries was 6%. Patients with a diagnosis of alcohol, cannabis, sedative use disorders or asthma were twice as likely to have their smoking status recorded compared to those who did not have these diagnoses. Conclusions: Mental health services, by failing to diagnose and document treatment for nicotine dependence, do not conform to current clinical practice guidelines, despite nicotine dependence being the most commonly diagnosed psychiatric disorder. Implications: Considerable system change and staff support is required to provide an environment where a primary prevention approach such as smoking care can be sustained.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 92%

An audit of the prevalence of recorded nicotine dependence treatment in an Australian psychiatric hospital

Wye¹,

Bowman²,

Wiggers³

et al. 2010

Australian and New Zealand Journal of Public Health

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“…2009). In general health settings, adding nicotine dependence treatment to existing computerized systems increases hospital provision of evidence‐based tobacco treatment (Freund et al. 2008, Koplan et al.…”

Section: Discussionmentioning

confidence: 99%

“…2008). The addition of systems to monitor the provision of nicotine dependence treatment, and provide feedback to staff regarding their performance has also been suggested to improve adoption of clinical guidelines (Freund et al. 2008) and represent important avenues for further research to explore within the context of psychiatric care provision.…”

Section: Discussionmentioning

confidence: 99%

Providing nicotine dependence treatment to psychiatric inpatients: the views of Australian nurse managers

Wye¹,

Bowman²,

Wiggers

et al. 2010

Journal of Psychiatric and Mental Health Nursing

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The prevalence of smoking in psychiatric settings remains high. This study aims to describe the views of nurse managers in psychiatric inpatient settings regarding the provision of nicotine dependence treatment, and whether there were associations between such views and the provision of nicotine dependence treatment. A cross-sectional survey was mailed to all public psychiatric inpatient units in New South Wales, Australia, for completion by nurse managers. Of the identified 131 service units, 123 completed questionnaires were returned (94%). Patient-related factors were considered to have a high level of influence on the provision of nicotine dependence treatment: patients requesting assistance to quit (58%), patients being receptive to interventions (52%), and patient health improving with quitting (45%). Units where the respondent reported that nicotine dependence treatment was as important as other roles were more likely to provide nicotine dependence treatment compared to units whose respondents did not hold this view (OR = 0.257, d.f. = 1, P < 0.01). While the results indicate strong support for the provision of nicotine dependence treatment, this support appears qualified by perceived patient readiness to quit, suggesting care is provided selectively rather than systematically. Positioning smoking as an addiction requiring treatment within a traditional curative approach may lead to a health service more conducive to the routine provision of nicotine dependence treatment.

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“…Despite the well-documented benefits of addressing tobacco use in hospitals and providing follow-up support, adherence to clinical practice guidelines by health providers is less than optimal,17 18 with low levels of smoking cessation support provided if any 17 19. High-intensity hospital-based behavioural interventions which contain a post-discharge component of at least 1 month follow-up have been found to increase cessation rates by 37% at 6–12 months when compared with usual care 13.…”

Section: Introductionmentioning

confidence: 99%

Development of an online smoking cessation program for use in hospital and following discharge: smoke-free recovery

McCrabb¹,

Balogh

Baker³

et al. 2017

BMJ Innov

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BackgroundTobacco smoking can have negative health outcomes on recovery from surgery. Although it is recommended best practice to provide patients with advice to quit and follow-up support, provision of post-discharge support is rare. Developing an online smoking cessation program may help address this gap.ObjectivesThis paper describes the development and pretesting of an online smoking cessation program (smoke-free recovery, SFR) tailored to the orthopaedic trauma population for use while in hospital and post-discharge.MethodsDrawing on the DoTTI framework for developing an online program, the following steps were followed for program development: (1) design and development; (2) testing early iteration; (3) testing for effectiveness and (4) integration and implementation. This article describes the first two stages of SFR program development.ResultsSFR is a 10-module online smoking cessation program tailored for patients with orthopaedic trauma. Of the participants who completed testing early iterations, none reported any difficulties orientating themselves to the program or understanding program content. The main themes were that it was ‘helpful’, provision of ‘help to quit’ was low and SFR increased thoughts of ‘staying quit post-discharge’.ConclusionsThis study found that a theory and evidence-based approach as the basis for an online smoking cessation program for patients with orthopaedic trauma was acceptable to users. A randomised controlled trial will be conducted to examine whether the online smoking cessation program is effective in increasing smoking cessation and how it can be integrated and implemented into hospital practice (stages three and four of the DoTTI framework).

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Provision of smoking care in NSW hospitals: opportunities for further enhancement

Cited by 9 publications

References 46 publications

An audit of the prevalence of recorded nicotine dependence treatment in an Australian psychiatric hospital

An audit of the prevalence of recorded nicotine dependence treatment in an Australian psychiatric hospital

Providing nicotine dependence treatment to psychiatric inpatients: the views of Australian nurse managers

Development of an online smoking cessation program for use in hospital and following discharge: smoke-free recovery

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