| introduction | programme | venue | speakers | delegate list | booking | supporters | sponsors
<
Innovations in smoking in pregnancy
Mary O’Connor, Midwife Specialist, Nobles Hospital, Isle of Man
Abstract
New stop smoking in pregnancy service commenced in the Isle of Man 2006, incorporating the best of the NHS and World wide best practice. Service based upon the seven pillars of clinical governance and twelve essential elements. Action plan created and service implemented only when all elements had been achieved.
All women referred to service receive an inhalator and gum/lozenge at first appointment as standard and asked to replace a few cigarettes each day with the NRT.Over a three to four week period they have increased their self belief in their ability to go for a full quit, other forms of NRT are then dispensed directly to the women(they do not receive a prescription or a voucher).An emergency supply of NRT is given to all women on the programme at 37 weeks in gestation for post natal use in an attempt to reduce relapse rates.
CO readings are taken at each appointment using the micromedical baby CO as a motivational tool. Initially as part of the service urinary cotinine samples were taken for analysis, however that has now been discontinued as we found that if we encouraged the woman to disclose the amount she truly smoked in the first few weeks then the difference was marginal in the disclosure rates and we were able to treat her successfully without the need for expensive laboratory testing.
CO levels are recorded for all pregnant women at their first antenatal booking appointment.
Monitoring of data: pre conception,at booking, three months, at delivery, four weeks post natal and at three months post natal.
New electronic database created for pregnant smokers monitoring not only their smoking/medical/obstetric history but a complete demographic template and obstetric outcome.
Automated text messaging/ emailing for appointments as well as for motivational support for all women particularly in the first four weeks.
Community visits and workplace visits offered, partners and family members and friends also treated into the post natal period.
Relaxation, dietary, dental support provided.
Social marketing- e.g. refuse collection trucks wrapped in advertising for the service - 'take it to the people'
Validated quit rates 52%.
All benefited from the cut down to quit and the emergency supply of NRT.
Emphasis of service on the woman and not the FETUS.
There to help and support and not to judge.
Successful shift in identity from smoker to non smoker
Biography
Mary O'Connor, Midwifery Lead/Specialist Tobacco Dependency in Pregnancy. ADM, RM, RMN,RN
Qualified as a nurse at Hammersmith Hospital in London and as a midwife at Queen Charlottes and Chelsea Hospital for Women in 1992 where I worked as a staff midwife until my move to the Isle of Man in 1996.
In 2004 successfully influenced the Isle of Man Government to introduce new legislation, which would improve the lives of young disadvantaged families.
In November 2004 won the following national awards:
British Journal of Midwifery, Annual Midwifery Best Practice Awards. 'Midwife of the Year for Innovation'
NHS Estates, Building Better Healthcare Awards 'Outstanding Sustainability project of the Year'
Green Apple Award for 'Individual Contribution to Environmental Best Practice'
Several publications regarding sustainable development in healthcare and advices healthcare and related organisations on environmental best practice and women's health
In 2006 recognised by the Sustainable Development Department of the United Nations for contribution to Europe and Women's Health.
In 2006 appointed by the Isle of Man Government to coordinate and implement a new innovative service for pregnant smokers.
Mary O'Connor
Nobles Hospital
Strang
Isle of Man
IM4 4RJ
| |
| 
