Key result
Implementation of standard operating procedures for smoking cessation advice increased counselling by physicians from 6.7% to 38.7%, but had no significant effect on nurses.
Why the study?
Does the implementation of standard operating procedures improve the frequency of smoking cessation counselling provided to smoking patients admitted to cardiology wards?
Does the implementation of standard operating procedures improve the frequency of smoking cessation counselling provided to smoking patients admitted to cardiology wards?
Implementing standard operating procedures for smoking cessation on cardiology wards significantly increases counselling by physicians but not nurses, highlighting a need to address staff motivation.
Answers are grounded in this paper and cite their sources.
SOPs may increase physician counselling on cardiology wards; leaves open nurse engagement and effects on patient cessation.
BACKGROUND: Smoking is a major cardiovascular risk factor, and smoking cessation is imperative for patients hospitalized with a cardiovascular event. This study aimed to evaluate a systems-based approach to helping hospitalized smokers quit and to identify implementation barriers. DESIGN: Prospective intervention study followed by qualitative analysis of staff interviews. METHODS: The prospective intervention study assessed the effects of implementing standard operating procedures (SOPs) for the provision of counselling and pharmacotherapy to smokers admitted to cardiology wards on counselling frequency. In addition, a qualitative analysis of staff interviews was undertaken to examine determinants of physician and nurse behaviour; this sought to understand barriers in terms of motivation, capability, and/or opportunity. RESULTS: A total of 150 smoking patients were included in the study (75 before and 75 after SOP implementation). Before the implementation of SOPs, the proportion of patients reporting to have received cessation counselling from physicians and nurses was 6.7% and 1.3%, respectively. Following SOP implementation, these proportions increased to 38.7% (p < 0.001) and 2.7% (p = 0.56), respectively. Qualitative analysis revealed that lack of motivation, e.g. role incongruence, appeared to be a major barrier. CONCLUSIONS: Introduction of a set of standard operating procedures for smoking cessation advice was effective with physicians but not nurses. Analysis of barriers to implementation highlighted lack of motivation rather than capability or opportunity as a major factor that would need to be addressed.
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Raupach et al. (2012) studied smoking patients admitted to cardiology wards (n=150). standard operating procedures (SOPs) for smoking cessation advice vs. before SOP implementation was evaluated on proportion of patients reporting to have received cessation counselling from physicians (p=< 0.001). Implementation of standard operating procedures for smoking cessation advice increased counselling by physicians from 6.7% to 38.7%, but had no significant effect on nurses.
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