From Guideline to Practice: A Nursing Intervention to Help Smokers Quit

从指南到实践：帮助吸烟者戒烟的护理干预

• 批准号: 7406570
• 负责人: Linda P Sarna
• 金额: $ 45万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2010-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7406570
• 关键词: Guideline; Practice; Nursing; Intervention; Help

DESCRIPTION (provided by applicant): Tobacco use is the leading cause of preventable death and illness in the US. Despite its availability, the Guideline for evidence-based smoking cessation interventions is underutilized by healthcare professionals. The purpose of this proposal is to translate the Guideline into nursing practice by using an innovative web- based intervention, Helping Smokers Quit (HSQ). The HSQ includes a validated web-based educational program tailored for nurses working in acute care hospitals, a toolkit of printed materials, including the HSQ Pocket Guide for Nurses, web-resources in a special tab on the Tobacco Free Nurses website www.tobaccofreenurses.org, and technical support to the Directors of Nursing (DN). The control group (HSQ- m) will only receive the toolkit. The primary aims are to: 1) Evaluate the effectiveness of the HSQ in improving self-reported nursing performance on smoking cessation interventions with hospitalized patients 6-months after the intervention as compared to the HSQ-m group; 2) Determine the adoption and maintenance of changes in a) nurse performance on cessation interventions 12-months after the intervention; and b) hospital practices 24-months after the intervention in the HSQ as compared to the HSQ-m group; and 3) Determine the variables (nurse- and hospital-level) on the effectiveness of the HSQ and HSQ-m in nursing performance at 6- and 12- months after the intervention. Also, we will: 4) Examine improvement in hospital performance in smoking cessation (based on ratings by the Joint Commission, JC) on interventions offered to patients with the target diagnoses (heart attack, heart failure, and pneumonia), at 12- and 24-months post-intervention in the HSQ as compared to the HSQ-m group; and 5) Evaluate implementation (utilization and satisfaction) of the HSQ and HSQ-m. Six hundred (n = 300 HSQ and n = 300 HSQ-m) nurses from two states with high smoking prevalence (West Virginia, WV, Indiana, IN) and one with low prevalence (California, CA) are the focus of this program. Using an intervention-control, two-group, pre-post design, based upon the RE-AIM model, the HSQ will be delivered to nurses in 15 JC accredited hospitals in WV, IN, and CA (5 in each state). Nurses in 15 other hospitals (5 per state) will serve as controls (HSQ-m). We will partner with nurse experts and tobacco control consultants who will provide community support. The RX for Change(c) curriculum will be delivered via webcast. Data on self-reported nursing performance in smoking cessation will be collected via the web using a valid and reliable questionnaire. Publicly available data from the JC will be used to monitor changes in hospital performance. Interviews with the DNs 24-months after the intervention will identify maintenance of changes in hospitals. Regression models will evaluate effectiveness of the HSQ, adoption/ maintenance of changes in nursing performance; multiple linear regression will examine correlates of nurse performance. Content analysis will be used to evaluate interview responses. This project will provide information about translation of the Guideline to clinical practice and the link between a training program and changes in hospital performance. Statement Despite the availability of proven ways to help patients help stop smoking, the leading cause of preventable death and illness in the US, these interventions are not a routine part of nursing care. The purpose of this application is to translate smoking cessation interventions into clinical nursing practice using a web-based program in three states. Two of these states have smoking prevalence >25%, twice the 12% goal set by Healthy People 2010, and the rate in one state is the second lowest in the country. This project has potential to decrease smoking and improve health outcomes of Americans.

描述（由申请人提供）：烟草使用是美国可预防死亡和疾病的主要原因。尽管有可用的可用性，但医疗保健专业人员将基于证据的戒烟干预措施的指南不足。该建议的目的是通过使用基于网络的干预措施将指南转化为护理实践，帮助吸烟者退出（HSQ）。 HSQ包括一项经过验证的基于Web的教育计划，专为在急诊医院工作的护士身份量身定制，印刷材料的工具包，包括HSQ Pocket Guide for Nurses for Nurses，Web-Resources在烟草免费护士网站上的特殊标签中，网站www.tobaccofreenurses.org，以及向护理（DN）的技术支持（DN）。对照组（HSQ-M）仅接收工具包。主要目的是：1）评估HSQ在干预后6个月后与HSQ-M组相比，对住院患者进行戒烟干预的自我报告护理表现的有效性； 2）确定干预后12个月的戒烟干预措施的护士绩效的采用和维护； b）与HSQ-M组相比，HSQ干预后24个月的医院练习； 3）确定干预后6个月和12个月的HSQ和HSQ-M对HSQ和HSQ-M在护理绩效方面的有效性的变量（护士和医院级别）。另外，我们将：4）检查与HSQ-M组相比，HSQ在HSQ的12岁和24个月的干预后，检查了针对目标诊断（心脏病发作，心力衰竭和肺炎）的干预措施（基于联合委员会的评级）（基于联合委员会的评级）（基于JC的评级）； 5）评估HSQ和HSQ-M的实施（利用和满意度）。该计划的重点是六百个（n = 300 HSQ和n = 300 HSQ-M）的护士（西弗吉尼亚州，西弗吉尼亚州，印第安纳州西部，印第安纳州），一名患病率较低（加利福尼亚州，加利福尼亚州）是该计划的重点。使用基于Re-Aim模型的干预控制，两组前的验证前设计，HSQ将在WV，IN和CA的15个JC认可的医院和CA（每个州的5个）中交付给护士。其他15家医院的护士（每个州5个）将用作控制（HSQ-M）。我们将与护士专家和烟草控制顾问合作，他们将提供社区支持。更改的RX（C）课程将通过Webcast提供。关于戒烟中自我报告的护理表现的数据将通过Web使用有效可靠的问卷收集。来自JC的公开数据将用于监视医院绩效的变化。干预后24个月对DNS的访谈将确定医院变化的维护。回归模型将评估HSQ的有效性，采用/维护护理绩效的变化；多个线性回归将检查护士表现的相关性。内容分析将用于评估面试响应。该项目将提供有关将指南转换为临床实践以及培训计划与医院绩效变化之间的联系的信息。尽管有可靠的方法可以帮助患者帮助停止吸烟，但在美国可预防的死亡和疾病的主要原因，这些干预措施并不是护理护理的常规部分。该应用程序的目的是将戒烟干预措施转化为使用三个州的基于Web的程序的临床护理实践。其中两个州的吸烟率> 25％，这是《健康人2010年》设定的12％目标，而在一个州中的比率是该国第二低的目标。该项目有可能减少吸烟并改善美国人的健康状况。