PURPOSE: ISPCs are effective in promoting smoking abstinence. Our ISCP began in July, 2004. The 7 counselors have other primary responsibilities (no new hires). Each covers 1 or more AM or PM slots on a weekly schedule. With limited resources, the most difficult task was prompt identification of hospitalized smokers.
METHODS: Smokers were defined as smoking within the past 12 months. We estimated about 3800 smokers are admitted to our facility annually (20,000 discharges per year X 19% smoking prevalence in Brooklyn). The initial method for identification of smokers was a daily roster compiled by nurse managers on each unit. At 1 year our ISCP saw only 920 smokers or about 1/4 of the expected number. Additionally, a room-by-room assessment by nursing students during a 4 month elective in smoking cessation corroborated this deficiency. We designed a smoking query (“SMKD 12 MO?”) as a mandatory field in the hospital’s electronic admission screen. This field must be populated with “Y” or “N” for admission to complete. Registrars were in-serviced. A list of smokers and locations is generated daily from the hospital’s admission information system.
RESULTS: The mandatory query in the admission screen resulted in marked improvement in capture of admitted smokers. Data from the nursing student smoking cessation program showed ≥ 90% of smokers were being identified via the admission screen.
CONCLUSION: The most efficient method for identification / counseling of smokers is via staffers on each unit (RNs MDs etc). This fails in most institutions because unit personnel lack time and enthusiasm for the task. A daily room-by-room search, although effective, is unrealistic without staff assigned primarily to this role. Our experience suggests that inclusion of a smoking query as a mandatory field in the electronic admission screen is efficient and reliable for prompt identification of hospitalized smokers.
CLINICAL IMPLICATIONS: A mandatory smoking query on the electronic admission screen is reliable and cost effective for capture of hospitalized smokers for smoking cessation interventions.
DISCLOSURE: Kathy Garrett-Szymanski, None.