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Quit for Surgery
Rationale
Smoking continues to be a major cause of morbidity and mortality in Autralia. Evidence-based guidelines are unequivocal in recommending that smoking cessation advice be provided routinely in a range of health care settings. Preadmission clinics provide such an opportunity with additional benefits of quitting before surgery, including reduced complications and improved analgesic and anaesthic outcomes. Evidence suggests smoking care should be multicomponent, come from a range of health professionals and include Nicotine Replacement Therapy (NRT) and post discharge follow up. Despite the existence of such guidelines, such care is not routinely provided.
A trial conducted by Hunter New England Population Health (HNEPH) at the Hunter Elective Admissions Pre Procedure Service (HEAPPS) demonstrated improved cessation rates and delivery of cessation care after utilising a multi-component smoking cessation intervention. This involved using computer delivered behavioural cessation counselling, computer generated tailored self help material, brief cessation counselling by nursing and anaesthetist staff prior to admission, pre and post operative Nicotine Replacement Therapy provision, and post discharge telephone counselling. What remains to be demonstrated is that such a service can be provided to patients as part of routine service delivery.
Aims and objectives
As a partnership between HNEPH and the John Hunter Hospital, the aim of the project is to ensure smoking patients of HEAPPS at the John Hunter Hospital receive best practice smoking cessation care.
The objective of the project is to faciliate and monitor the adoption of the smoking cessation intervention, previously trialed by HNEPH into routine clinical practices of the pre-surgical clinic at the John Hunter Hospital.
Overview of service
Patients will receive best pratice computer prompted smoking cessation care. Modification to the touchscreen computer program will allow for counselling directed at the needs of pregant women, patients being admitted for surgery within 24 hours of attending the pre-admission clinic and for patients to choose not to continue with the program after a brief motivational section. Development and generation of a regular feedback report of care provision for key stakeholders will allow monitoring of adequate service provision. Assistance will be provided to develop administrative procedures, staff skills and maintenance procedures to ensure the clinic can provide the service. The effectiveness of the adoption strategy for maintaining smoking cessation care for patients attending the preadmission clinic will be evaluated. A pre post design is proposed where measures of care provision at the end of the trial will be compared with care provided over a six month period after the completion of the adoption support activities.
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