Presentation on theme: "Do You Have 30 Seconds to Save a Life? Tobacco Cessation PHI."— Presentation transcript:
Do You Have 30 Seconds to Save a Life? Tobacco Cessation PHI
► This is a self-study module developed by members of the Research and Quality Councils to provide staff the best evidence on tobacco cessation. ► At the end of this module, the participant will be able to: Describe the importance of tobacco cessation interventions Discuss the 5 A intervention process for quitting Describe the role of the PinnacleHealth tobacco cessation counselor Identify three resources available within PinnacleHealth System or the community to assist patients with tobacco cessation.
Crime Scene Evidence ► Annually 430,000 people die from tobacco-related diseases ► Healthy People 2010’s goal is for 85% of healthcare providers to routinely advise about cessation ► Nurses can focus efforts in 2 directions: the 26% of the population that use tobacco & also in primary prevention
How can this crime be prevented? ► Motivate high-risk groups ► Minimal efforts improve long-term quit rates by 5-10% ► Consistent, persistent approach ► Multiple, personalized interventions
How can nurses prevent the crime? ► Nurse-led tobacco cessation interventions increase success by 50% ► “If the 2.2 million nurses in the US each helped 1 person/yr quit, nurses would triple the US quit rate (Tobacco free nurses, 2002)
A crime-free society takes time ► Cessation requires many attempts ► The process is different for each person ► Quitting occurs in stages and nurses need to intervene at each stage
Tampered Evidence (myths) ► Smokers don’t want to quit. Fact: Seventy to eighty percent of smokers do want to quit but are unable to do so without assistance. ► ► Nurses don’t have enough time to provide smoking cessation advice. Fact: A brief smoking intervention (< 3 minutes) can increase quit rates. ► ► Nurses who smoke can’t be helpful to patients using tobacco. Fact: No one understands the difficulty of quitting more than a person who has recently attempted quitting.
Short-Term Risks of Tobacco Use ► Smokers shortness of breath exacerbation of asthma harm to pregnancy impotence, infertility ► Smokeless tobacco users mouth and gum disease
Long-term Risks of Tobacco Use ► Smokers Heart attack COPD Stroke Cervical cancer Pancreatic cancer Bladder Cancer Lung cancer Oral, pharyngeal, esophageal cancer ► Smokeless Tobacco Users Oral, pharyngeal, esophageal cancer
Environmental Risks of Tobacco Use ► Lung cancer and heart disease from second hand smoke ► Low birth weight ► SIDS ► Asthma ► Middle ear infections ► Respiratory infections
Rewards/Benefits of Quitting ► After 20 minutes... Blood pressure and heart rate drop to normal Body temperature of extremities increases to normal ► After 8-12 hours... Blood oxygen level increases to normal Carbon monoxode levels drop to normal ► After 24-48 hours... Chance of heart attack is decreased Nerve endings start regrowing Smell and taste is enhanced
Rewards/Benefits of Quitting ► After 2-3 weeks... Circulation improves Walking becomes easier Lung function increases up to 30% ► After 1-12 months... Coughing, sinus congestion, fatigue, SOB decrease Cilia regrow in lungs, reducing risk of infection Body’s overall energy increases Risk of coronary heart disease is decreased by half
Rewards/Benefits of Quitting ► After 5 years... Lung cancer death rate decreases by half Stroke risk similar to non-smoker Risk of mouth, throat and esophageal cancers is decreased by half ► After 10-15 years... Lung cancer death rate similar to non-smoker Pre-cancerous cells are replaced Risk of cancer to other organs decreases Risk of coronary disease is equivalent to a non-smoker
Barriers to Quitting ► Previous unsuccessful quit attempts ► Enjoys smoking and has smoked for a long time ► Living with other smokers or smoking friends ► Stress reliever ► Fear of weight gain ► Fear of failure ► Withdrawal symptoms
► Advise your patient to quit using tobacco products. “It is important for you to quit smoking now and we can help you” ► Personalizing the message can increase its impact. ► Reinforce that it can take up to seven attempts to successfully stay quit.
► Assess readiness to quit. “Are you interested in quitting with our help?” “Are you ready to quit in the next few weeks?”
► Assist patient to quit. Contact Tobacco Cessation Counselor if patient is ready to quit at 221-6263. Provide “Preparing to Quit Using Tobacco” on patient education intranet site: http://home.pinnaclehealth.org/PatientEd/Tobacco PreparingToQuit.pdf http://home.pinnaclehealth.org/PatientEd/Tobacco PreparingToQuit.pdf
Tobacco Cessation Counselor Role ► Assists patients in developing an individualized plan to quit. ► Consult generated when smoking checked on Admission Assessment BUT: counselor is part time and not able to see all pts. ► Counselor will follow up with phone consults first. Call if pt ready to quit and in need of a “plan”.
Methods to Help Quitting ► Pharmacotherapy ► Self-help materials ► Individual counseling and group therapy ► Alternative therapies Use of multiple methods can increase the chance of successfully quitting.
Pharmacotherapy ► Nicotine Replacement Therapy can be used for short-term therapy reduce withdrawal symptoms in patients. ► This should only be used with patients that still have nicotine in their systems. ► It takes an average of 3 days for nicotine to clear from the smoker’s body.
Nicotine Replacement Therapy ► Available in various forms – gum, transdermal patches, intranasal spray and lozenge ► Advise patient to consult with physician before use of these products ► Advise patients to read product instructions prior to use
Pharmacotherapy ► Bupropion SR (Zyban or Wellbutrin) has been found to decrease the urge for smoking.
Individual Counseling and Group Therapy ► Both forms of counseling have been shown to be effective ► PinnacleHealth offers Tobacco Cessation Classes for a fee. Information is found on the Learning Institute intranet site. Click on “Community Education” ► Areas of potential information include Health Screening, Support Groups, Wellness Services, Women’s Programs. ► http://www.pinnaclehealth.org/body.cfm?id=94&action=list http://www.pinnaclehealth.org/body.cfm?id=94&action=list
Alternative Therapies ► Hypnosis, acupuncture, acupressure and electroacupressure have been utilized but not shown to have conclusive benefit ► These can be adjunctive therapy with the other therapies
Self-Help Materials ► Written materials ► Audio/video tapes ► Computer programs/chat rooms ► Internet-based cessation programs ► Telephone hotlines These materials are more effective than no intervention and should be tailored to the individual tobacco user.
Pinnacle Resources ► Intranet: Click on “Departments” then “Learning Institute” ► For patient education handouts, click on “Patient Education” ► Click on “T” for Tobacco Cessation Module. Includes list of Tobacco Cessation resources and FREE QUITLINE: 1-877-724-1090 http://home.pinnaclehealth.org/PatientEd/TobaccoPreparingT oQuit.pdf http://home.pinnaclehealth.org/PatientEd/TobaccoPreparingT oQuit.pdf
Pinnacle Resources ► Intranet home page, click on “Departments”, click on “Women Care Resource Centers” ► Site has many helpful resources for women ► May be helpful to pts/families or staff looking for support ► http://home.pinnaclehealth.org/womancare/ inwcare.htm http://home.pinnaclehealth.org/womancare/ inwcare.htm http://home.pinnaclehealth.org/womancare/ inwcare.htm
Internet Resources ► http://www.tobaccofreekids.org/http://www.tobac cofreekids.org/research/ ► http://www.tobaccofreekids.org/http://www.tobac cofreekids.org/research/ ://www.tobaccofreekids.org/http://www.tobac cofreekids.org/research/://www.tobaccofreekids.org/http://www.tobac cofreekids.org/research/ Tobacco Free Nurses - second one is their fact sheet on nurses Tobacco Free Nurses - second one is their fact sheet on nurses ► http://www.tobaccofreenurses.org.http://tobaccofreenurse s.org/media/documents/factsscreen.pdf ► http://www.tobaccofreenurses.org.http://tobaccofreenurse s.org/media/documents/factsscreen.pdf http://www.tobaccofreenurses.orghttp://tobaccofreenurse s.org/media/documents/factsscreen.pdf http://www.tobaccofreenurses.orghttp://tobaccofreenurse s.org/media/documents/factsscreen.pdf This site is the guide for nurses using the 5As, gives some resources for pts, and lists pharmacotherapies and their durations This site is the guide for nurses using the 5As, gives some resources for pts, and lists pharmacotherapies and their durations
Internet Resources, cont. ► http://www.ahrq.gov/about/nursing/hlpsmksqt.htm ► http://www.ahrq.gov/about/nursing/hlpsmksqt.htm http://www.ahrq.gov/about/nursing/hlpsmksqt.htm Has a 5-Day Countdown to Your Quit Date sheet telling patients what to do Has a 5-Day Countdown to Your Quit Date sheet telling patients what to do ► http://www.surgeongeneral.gov/tobacco/5daybo ok.htm ► http://www.surgeongeneral.gov/tobacco/5daybo ok.htm http://www.surgeongeneral.gov/tobacco/5daybo ok.htm http://www.surgeongeneral.gov/tobacco/5daybo ok.htm "Treating Tobacco Use and Dependence" - quick reference guide from Surgeon General "Treating Tobacco Use and Dependence" - quick reference guide from Surgeon General
Internet Resources, cont. ► http://www.surgeongeneral.gov/tobacco/tobaqrg. htm ► http://www.surgeongeneral.gov/tobacco/tobaqrg. htm http://www.surgeongeneral.gov/tobacco/tobaqrg. htm http://www.surgeongeneral.gov/tobacco/tobaqrg. htm Interactive TIPS sheet from the CDC showing how various organs look after you've smoked Interactive TIPS sheet from the CDC showing how various organs look after you've smoked ► http://www.cdc.gov/tobacco/sgr/sgr_2004/sgranim ation/flash/index.html http://www.cdc.gov/tobacco/sgr/sgr_2004/sgranim ation/flash/index.html http://www.cdc.gov/tobacco/sgr/sgr_2004/sgranim ation/flash/index.html PA 24 hr Quitline: 1-877-724-1090 PA 24 hr Quitline: 1-877-724-1090
One Final Word..... Don’t Forget to Document!! Select Education Documentation
► Anderson, J.E., Jorenby, D.E., Scott, W. J. & Fiore, M.C. (2002). Treating tobacco use and dependence: An evidence-based clinical practice guideline for tobacco cessation. Chest, 3, p. 932-941. http://www.chestjournal.org/cgi/reprint/121/3/932 http://www.chestjournal.org/cgi/reprint/121/3/932 ► Joanna Briggs Institute – Smoking Cessation Interventions and Strategies Information Sheet, 2001. http://www.joannabriggs.edu.au/best_practice/BPISsmok.php http://www.joannabriggs.edu.au/best_practice/BPISsmok.php ► National Clearing House for Practice Guidelines http://www.guidelines.gov/search/searchresults.aspx?Type=3&txtSearch=Trea ting+Tobacco&num=20 http://www.guidelines.gov/search/searchresults.aspx?Type=3&txtSearch=Trea ting+Tobacco&num=20 http://www.guidelines.gov/search/searchresults.aspx?Type=3&txtSearch=Trea ting+Tobacco&num=20 ► Nursing Best Practice Guideline: Integrating Smoking Cessation into Daily Nursing Practice http://www.rnao.org/bestpractices/PDF/BPG_smoking_cessation.pdf http://www.rnao.org/bestpractices/PDF/BPG_smoking_cessation.pdf References