Are Pediatric ED Nurses Delivering Tobacco Cessation Advice to Parents?

Deckter, Leslie; Mahabee‐Gittens, E. Melinda; Gordon, Judith S.

doi:10.1016/j.jen.2007.10.018

Cited by 14 publications

(17 citation statements)

References 17 publications

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“…These barriers include lack of visit time and reimbursement for these services, lack of infrastructure for parental tobacco screening and counseling, and most notably, lack of practitioner comfort in counseling adult smokers. 16,17 …”

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confidence: 99%

Parental Tobacco Screening and Counseling in the Pediatric Emergency Department: Practitioners’ Attitudes, Perceived Barriers, and Suggestions for Implementation and Maintenance

Mahabee‐Gittens

Dixon

Vaughn

et al. 2014

Journal of Emergency Nursing

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Objective The pediatric emergency department (PED) is a venue that underutilizes parental tobacco screening and brief cessation counseling. We sought to explore PED practitioners’ attitudes and perceived barriers regarding the implementation and adoption of tobacco screening/cessation counseling of parental smokers in the PED setting, and to solicit suggestions for improving the sustainability and maintenance of such practices. Methods We conducted an exploratory, qualitative study of a convenience sample of PED practitioners using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Individual, focused interviews were conducted to determine factors that would maximize the implementation and maintenance of parental tobacco screening and intervention counseling as standard PED practice. Results Thirty interviews were conducted from which relevant data, patterns, and themes were identified. Reach factors included targeting parental smokers with children with respiratory diseases, having adequate training of practitioners, and providing “pre-arranged” counseling packages. Effectiveness factors included practitioner desire for outcome data about intervention effectiveness (e.g., changes in children’s secondhand smoke exposure and parental quit rates). Solutions to increase intervention adoption included quick electronic health record prompts and the provision of on-site tobacco cessation experts. Implementation suggestions emphasized the importance of financial support and the alignment of tobacco screening/counseling with strategic plans. Maintenance factors included institutional and technical support, and the importance of intervention “champions” in the PED. Conclusions By highlighting important viewpoints of practitioners regarding tobacco screening and counseling, the findings can help guide and direct the development and evaluation of sustainable interventions to facilitate tobacco use treatment in the PED.

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confidence: 99%

Parental Tobacco Screening and Counseling in the Pediatric Emergency Department: Practitioners’ Attitudes, Perceived Barriers, and Suggestions for Implementation and Maintenance

Mahabee‐Gittens

Dixon

Vaughn

et al. 2014

Journal of Emergency Nursing

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“…[19][20][21][22] Although national respiratory and nursing associations and others have long advocated for regular provision of tobacco cessation interventions by their members, [26][27][28][29][30][31][32][33] pediatric RTs and RNs still do not use their patients' visits to motivate parents to quit smoking. [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Our study provides additional evidence to support this claim. It also showed that, before enrolling in WeBREATHe, participating RTs and RNs asked parents about their tobacco use only some of the time and almost never provided any type of assistance.…”

Section: Discussionmentioning

confidence: 58%

“…[26][27][28][29][30][31][32] Although RTs, RNs, and NPs are interested in addressing tobacco use with patients, few incorporate cessation into routine care. 23,29,[33][34][35][36][37][38] Many lack confidence in providing cessation advice and fear that they may antagonize and alienate the smoker. 36,39 Provision of tobacco cessation intervention training and self-help materials can offset these concerns.…”

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confidence: 99%

A Randomized Clinical Trial of a Web-Based Tobacco Cessation Education Program

et al. 2013

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“…9,10 Prior work has demonstrated that RNs are willing to receive training so that they can provide tobacco treatment and TSE advice to caregivers and that RN-assisted tobacco counseling is accepted by staff and caregivers. 11,12 However, PED RNs do not deliver TSE counseling in a systematic way due to barriers such as lack of training, time, and structured systems in intervening with adults. 5,6,11,13–16 …”

Section: Introductionmentioning

confidence: 99%

“…11,12 However, PED RNs do not deliver TSE counseling in a systematic way due to barriers such as lack of training, time, and structured systems in intervening with adults. 5,6,11,13–16 …”

Section: Introductionmentioning

confidence: 99%

Development of a Tobacco Cessation Clinical Decision Support System for Pediatric Emergency Nurses

Mahabee‐Gittens

Dexheimer

Gordon

2016

CIN: Computers, Informatics, Nursing

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Almost 50% of children who visit the pediatric emergency department are exposed to tobacco smoke. However, pediatric emergency nurses do not routinely address this issue. The incorporation of a clinical decision support system into the electronic health record may improve the rates of tobacco exposure screening and interventions. We used a mixed-methods design to develop, refine, and implement an evidence-based clinical decision support system to help nurses screen, educate, and assist caregivers to quit smoking. We included an advisory panel of emergency department experts and leaders, and focus and user groups of nurses. The prompts include: 1) ASK about child smoke exposure and caregiver smoking, 2) ADVISE caregivers to reduce their child’s smoke exposure by quitting smoking, and 3) ASSESS interest and 4) ASSIST caregivers to quit. The clinical decision support system was created to reflect nurses’ suggestions, and was implemented in 5 busy urgent care settings with 38 nurses. The nurses reported that the system was easy to use, and helped them to address caregiver smoking. The use of this innovative tool may create a sustainable and disseminable model for prompting nurses to provide evidence-based tobacco cessation treatment.

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Are Pediatric ED Nurses Delivering Tobacco Cessation Advice to Parents?

Cited by 14 publications

References 17 publications

Parental Tobacco Screening and Counseling in the Pediatric Emergency Department: Practitioners’ Attitudes, Perceived Barriers, and Suggestions for Implementation and Maintenance

Parental Tobacco Screening and Counseling in the Pediatric Emergency Department: Practitioners’ Attitudes, Perceived Barriers, and Suggestions for Implementation and Maintenance

A Randomized Clinical Trial of a Web-Based Tobacco Cessation Education Program

Development of a Tobacco Cessation Clinical Decision Support System for Pediatric Emergency Nurses

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