|
Smoking referral pathway for cardiology patients quitting in hospital 2008 – 2009
Authors:
Jane Skinner, Marian Phebey and Sharon Williams
Presenters:
Sharon Williams
Specialist Stop Smoking Adviser, Newcastle and North Tyneside
Stop Smoking Service, North Tyneside Primary Care Trust, UK
Marian Phebey
Cardiology Ward Sister, Newcastle Hospitals Foundation Trust, Newcastle upon Tyne, UK
Abstract
Smoking is a major factor in the development of a number of illnesses, including cardiovascular disease, and has been associated with delayed wound healing, increased length of hospital stay and repeated readmissions. Smoking is also associated with health inequalities.
Newcastle Hospitals Foundation Trust was keen to provide an effective and sustainable service to support patients who wished to quit smoking. There were concerns that existing pathways for smokers being discharged from hospital were fragmented and did not provide optimal support.
Recognising the importance that patients with cardiovascular disease quit smoking, the cardiology ward at the Royal Victoria Infirmary piloted a new referral pathway.
A multidisciplinary group agreed a pathway for motivated smokers. NRT was prescribed during admission and appointments were made before discharge for follow up in community clinics. Written documentation and prescribing information was developed and NRT products were readily available on the ward. Implementation of the pathway was underpinned by appropriate staff training and a staff nurse was a ‘local champion’ supporting patients to have proactive management.
During the pilot, referral rates to community clinics increased by up to 80% and the CO validated quit rates at 4 weeks were 48 – 52%.
This performance has been sustained and the pathway is now being considered for roll out across the Trust.
Source of funding: None during pilot.
Funding for full production of prescribing guide accepted from Johnson and Johnson to assist roll out during 2010.
Declaration of interest: none
About the presenters
Marian has been a nurse in the NHS for several years, a ward sister since 1974 and has worked in various speciality areas including cardiology, respiratory medicine and oncology since the mid 1980s. Her current role as ward sister on a 29-bedded cardiology unit in an inner city hospital is wide and varied. The ward accepts patients from many areas across the North East who require specialist cardiology interventions and monitoring. Marian disseminates her expertise across the Trust by supporting the in house basic CPR training programmes to ensure all staff have adequate training and skills to respond and act appropriately to emergency situations.
Sharon has been nursing since the mid 1980s with time out and a return to community nursing in the mid 1990s. Sharon went on to qualify as a specialist public health nurse and moved from health visiting to the stop smoking service in January 2008. Her current role in the PCT is as specialist stop smoking adviser to Newcastle Hospitals Foundation Trust, North Tyneside General Hospital and St Nicholas’ Hospital which is a position covering three acute Trusts with additional links into two primary care Trusts. Part of the current role aims to directly link primary and secondary care by facilitating partnership working across both Trust and professional boundaries and to develop robust referral pathways and staff training packages.
References
1. BMA Tobacco Control Resource Centre (2006) Smoking and Surgery: A Review for
Surgeons and Anaesthesiologists. BMA: Tobacco Control Resource Centre
2. DH (2008) NHS Stop Smoking Services: Service and Monitoring Guidance 2008/09.
DH: London
3. HDA (2003) (Transferred to NICE 2005) Standard for Training in Smoking Cessation Treatments.
NICE: London
4. Joint Formulary Committee March 2008 ed 55. British National Formulary.
BMA and Royal Pharmaceutical Society: London
5. Lancaster, T., Silagy, C. and Fowler, G. (2008) Training Health Professionals in Smoking
Cessation (Review), Cochrane Database of Systemic Reviews. John Wiley and Sons, Ltd.
6. NHS Information Centre for Health and Social Care (2006) Statistics on Smoking in England,
The Information Centre, Lifestyle Statistics.
7. NICE (2008) Identifying and Supporting People most at risk of dying prematurely PH 15.
NICE: London
8. NICE (2006) Brief Interventions and Referral for Smoking Cessation in Primary Care
and Other Settings PH01. NICE: London
9. Ornish, D., Brown, S.E., Scherwitz, L.W.,Billings, J.H., Armstrong, W.T., Ports, T.A., McLanahan,
S.M., Kirkeeide, R.L., Brand, R.J., Gould, K.L. (1990) Can Lifestyle Changes Reverse
coronary Heart Disease? The Lifestyle Heart Trial, Lancet, July 21, 336(8708), pp 129 – 33
10. Rigotti, N.A., Munafo, M.R. and Stead, L.F. (2008) Interventions for Smoking Cessation in
Hospitalised Patients. Cochrane Database of Systemic Reviews, Issue 2, CD001837 Pub 2
|
