nach oben

Erschienen in:

01.01.2010 | Original Article

Implementation of the Tobacco Tactics Program in the Department of Veterans Affairs

verfasst von: Sonia A. Duffy, PhD, RN, Carrie A. Karvonen-Gutierrez, MPH, Lee A. Ewing, MPH, Patricia M. Smith, PhD, Veterans Integrated Services Network (VISN) 11 Tobacco Tactics Team

Erschienen in: Journal of General Internal Medicine | Sonderheft 1/2010

Einloggen, um Zugang zu erhalten

Abstract

BACKGROUND

Smoking cessation services in the Department of Veterans Affairs (VA) are currently provided via outpatient groups, while inpatient cessation programs have not been widely implemented.

OBJECTIVE

The objective of this paper is to describe the implementation of the Tobacco Tactics program for inpatients in the VA.

METHODS

This is a pre-/post-non-randomized control study initially designed to teach inpatient staff nurses on general medical units in the Ann Arbor and Detroit VAs to deliver the Tobacco Tactics intervention using Indianapolis as a control group. Coupled with cessation medication sign-off, physicians are reminded to give patients brief advice to quit.

RESULTS

Approximately 96% (210/219) of inpatient nurses in the Ann Arbor, MI site and 57% (159/279) in the Detroit, MI site have been trained, with an additional 282 non-targeted personnel spontaneously attending. Nurses’ self-reported administration of cessation services increased from 57% pre-training to 86% post-training (p = 0.0002). Physician advice to quit smoking ranged between 73–85% in both the pre-intervention and post-intervention period in both the experimental and control group. Volunteers made follow-up telephone calls to 85% (n = 230) of participants in the Ann Arbor site. Hospitalized smokers (N = 294) in the intervention group are reporting an increase in receiving and satisfaction with the selected cessation services following implementation of the program, particularly in regards to medications (p < 0.05).

CONCLUSION

A large proportion of inpatient nursing staff can rapidly be trained to deliver tobacco cessation interventions to inpatients resulting in increased provision of services.

Nur mit Berechtigung zugänglich

Haapanen-Niemi N, Miilunpalo S, Vuori I, Pasanen M, Oja P. The impact of smoking, alcohol consumption, and physical activity on use of hospital services. Am J Public Health. 1999;89:691–8.CrossRefPubMed

Office of Quality and Performance. Health Behaviors of Veterans in the VHA: Tobacco Use. 1999 Large Health Survey of Enrollees. Washington, D.C.: Veterans Health Administration; 2001.

Department of Veterans Affairs, Veterans Health Administration, Office of the Assistant Deputy Under Secretary for Health for Policy and Planning. 2005 Survey of Veteran Enrollees’ Health and Reliance Upon VA. Washington DC; 2006.

Rigotti NA, Munafo MR, Stead LF. Smoking cessation interventions for hospitalized smokers: a systematic review. Arch Intern Med. 2008;168:1950–60.CrossRefPubMed

Smith PM, Taylor CB. Implementing an Inpatient Smoking Cessation Program. Mahwah, NJ: Lawrence Erlbaum Associates; 2006.

Simon JA, Solkowitz SN, Carmody TP, Browner WS. Smoking cessation after surgery. A randomized trial. Arch Intern Med. 1997;157:1371–6.CrossRefPubMed

Simon JA, Carmody TP, Hudes ES, Snyder E, Murray J. Intensive smoking cessation counseling versus minimal counseling among hospitalized smokers treated with transdermal nicotine replacement: a randomized trial. Am J Med. 2003;114:555–62.CrossRefPubMed

Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service; 2000.

VA/DoD Clinical Practice Guideline Working Group: Management of Tobacco Use. Washington, DC. Office of Quality and Performance Publication 10Q-CPG/TUC-04: Veterans Health Administration, Department of Veterans Affairs and Health Affairs, Department of Defense; 2004.

10.

Cromwell J, Bartosch WJ, Fiore MC, Hasselblad V, Baker T. Cost-effectiveness of the clinical practice recommendations in the AHCPR guideline for smoking cessation. Agency for Health Care Policy and Research. JAMA. 1997;278:1759–66.CrossRefPubMed

11.

Taylor CB, Curry SJ. Implementation of evidence-based tobacco use cessation guidelines in managed care organizations. Ann Behav Med. 2004;27:13–21.CrossRefPubMed

12.

Rice VH, Stead LF. Nursing interventions for smoking cessation. Cochrane Database Syst Rev. 2008;1:CD001188.PubMed

13.

Duffy SA, Reeves P, Hermann C, Karvonen C, Smith P. In-hospital smoking cessation programs: what do VA patients and staff want and need? Appl Nurs Res. 2008;21:199–206.CrossRefPubMed

14.

Duffy SA, Ronis DL, Valenstein M, et al. A tailored smoking, alcohol, and depression intervention for head and neck cancer patients. Cancer Epidemiol Biomarkers Prev. 2006;15:2203–8.CrossRefPubMed

15.

Department of Veterans Affairs. QUERI implementation guide. Available at: http://www.queri.research.va.gov/implementation/. Accessed July 9, 2009.

16.

Stetler CB, Legro MW, Wallace CM, et al. The role of formative evaluation in implementation research and the QUERI experience. J Gen Intern Med. 2006;21(Suppl 2):S1–8.CrossRefPubMed

17.

Department of Health and Human Services. Dissemination and implementation research in health (R01). Available at: http://grants.nih.gov/grants/guide/pa-files/PAR-06-039.html. Accessed July 9, 2009.

18.

Green LW, Kreuter MW. Health Promotion Planning: An Educational and Ecological Approach (4th ed.). New York, NY: McGraw-Hill; 2005.

19.

Lyon ER. A review of the effects of nicotine on schizophrenia and antipsychotic medications. Psychiatr Serv. 1999;50:1346–50.PubMed

20.

Thomson O’Brien MA, Freemantle N, Oxman AD, Wolf F, Davis DA, Herrin J. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2001;1:CD003030.

21.

U.S. Department of Health and Human Services, Public Health Service. Helping Smokers Quit: A Guide for Clinicians. Available at: http://www.ahrq.gov/clinic/tobacco/clinhlpsmksqt.pdf. Accessed July 9, 2009.

22.

Milner-Fenwick, Inc. Smoking: Getting Ready to Quit (2nd ed.). Available at: www.milner-fenwick.com/products/gn51/index.asp#details. Accessed July 9, 2009.

23.

Smokefree.gov. Available at: http://www.smokefree.gov/expert.html. Accessed July 9, 2009.

24.

An LC, Zhu SH, Nelson DB, et al. Benefits of telephone care over primary care for smoking cessation: a randomized trial. Arch Intern Med. 2006;166:536–42.CrossRefPubMed

25.

Lichtenstein E, Glasgow RE, Lando HA, Ossip-Klein DJ, Boles SM. Telephone counseling for smoking cessation: rationales and meta-analytic review of evidence. Health Educ Res. 1996;11:243–57.CrossRefPubMed

26.

Smith PM, Cameron R, McDonald PW, Kawash B, Madill C, Brown KS. Telephone counseling for population-based smoking cessation. Am J Health Behav. 2004;28:231–41.PubMed

27.

Lawrence K, Heisler M, Resnicow K, Halasyamani L, Mase R, Monroe M. Tools for Being a Helpful Peer Partner (video recording). Supported by the National Heart, Lung, and Blood Institute. Developed by the University of Michigan and St. Joseph Mercy Health System. Ann Arbor: The Regents of the University of Michigan. 2007.

28.

Department of Veterans Affairs, Office of Quality & Performance. Performance Measurement Technical Manual. Available at: http://vaww.oqp.med.va.gov/default.htm (available on VA Intranet only). Accessed July 9, 2009.

29.

Borrelli B, Hecht JP, Papandonatos GD, Emmons KM, Tatewosian LR, Abrams DB. Smoking-cessation counseling in the home. Attitudes, beliefs, and behaviors of home healthcare nurses. Am J Prev Med. 2001;21:272–7.CrossRefPubMed

30.

Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41:327–50.CrossRefPubMed

31.

Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004;328:1519.CrossRefPubMed

32.

Friend K, Levy DT. Smoking treatment interventions and policies to promote their use: a critical review. Nicotine Tob Res. 2001;3:299–310.CrossRefPubMed

33.

Houston Miller N, Smith PM, DeBusk RF, Sobel DS, Taylor CB. Smoking cessation in hospitalized patients. Results of a randomized trial. Arch Intern Med. 1997;157:409–15.CrossRef

34.

Smith PM, Reilly KR, Houston Miller N, DeBusk RF, Taylor CB. Application of a nurse-managed inpatient smoking cessation program. Nicotine Tob Res. 2002;4:211–22.CrossRefPubMed

35.

Taylor CB, Miller NH, Cameron RP, Fagans EW, Das S. Dissemination of an effective inpatient tobacco use cessation program. Nicotine Tob Res. 2005;7:129–37.CrossRefPubMed

36.

Wilson W, Pratt C. The impact of diabetes education and peer support upon weight and glycemic control of elderly persons with noninsulin dependent diabetes mellitus (NIDDM). Am J Public Health. 1987;77:634–35.CrossRefPubMed

37.

Stark JF, Stark J. Performance measurement in congenital heart surgery: benefits and drawbacks. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2003;6:171–83.CrossRefPubMed

38.

Eddy DM. Performance measurement: problems and solutions. Health Aff (Millwood). 1998;17:7–25.CrossRef

39.

Steinberg MB, Schmelzer AC, Richardson DL, Foulds J. The case for treating tobacco dependence as a chronic disease. Ann Intern Med. 2008;148:554–6.PubMed

40.

Sherman SE. A framework for tobacco control: lessons learnt from Veterans Health Administration. BMJ. 2008;336:1016–9.CrossRefPubMed

41.

Ellerbeck EF, Mahnken JD, Cupertino AP, et al. Effect of varying levels of disease management on smoking cessation: a randomized trial. Ann Intern Med. 2009;150:437–46.PubMed

42.

Rigotti NA. The future of tobacco treatment in the health care system. Ann Intern Med. 2009;150:496–7.PubMed

Titel: Implementation of the Tobacco Tactics Program in the Department of Veterans Affairs
verfasst von: Sonia A. Duffy, PhD, RN
Carrie A. Karvonen-Gutierrez, MPH
Lee A. Ewing, MPH
Patricia M. Smith, PhD
Veterans Integrated Services Network (VISN) 11 Tobacco Tactics Team
Publikationsdatum: 01.01.2010
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe Sonderheft 1/2010
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-009-1075-9

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

BACKGROUND

OBJECTIVE

METHODS

RESULTS

CONCLUSION

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Sonderheft 1/2010

Developing and Sustaining Quality Improvement Partnerships in the VA: The Colorectal Cancer Care Collaborative

Integration of Women Veterans into VA Quality Improvement Research Efforts: What Researchers Need to Know

Strategies from a Nationwide Health Information Technology Implementation: The VA CART STORY

What Can the VA Teach Us About Implementing Proven Advances into Routine Clinical Practice?

Organizational Readiness in Specialty Mental Health Care

Practice Changes Associated with the Department of Veterans Affairs′ Family Care Collaborative