“Let Me Get You a Nicotine Patch”: Nurses' Perceptions of Implementing Smoking Cessation Guidelines for Hospitalized Veterans

David A Katz; Kenda Stewart; Monica Paez; John Holman; Susan L Adams; Mark W Vander Weg; Catherine T Battaglia; Anne M Joseph; Marita G Titler; Sarah Ono

doi:10.7205/MILMED-D-15-00101

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“Let Me Get You a Nicotine Patch”: Nurses' Perceptions of Implementing Smoking Cessation Guidelines for Hospitalized Veterans

Journal article

Open access

Peer reviewed

“Let Me Get You a Nicotine Patch”: Nurses' Perceptions of Implementing Smoking Cessation Guidelines for Hospitalized Veterans

David A Katz, Kenda Stewart, Monica Paez, John Holman, Susan L Adams, Mark W Vander Weg, Catherine T Battaglia, Anne M Joseph, Marita G Titler and Sarah Ono

Military medicine, Vol.181(4), pp.373-382

04/2016

DOI: 10.7205/MILMED-D-15-00101

PMID: 27046185

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Abstract

Many hospitalized smokers do not receive guideline-recommended tobacco treatment, but little is known about the perceptions of inpatient nurses with regard to tobacco treatment. We used a sequential explanatory mixed methods design to help explain the findings of an academic detailing intervention trial on the inpatient medicine units of four Veterans Affairs (VA) hospitals. We surveyed 164 nurses and conducted semistructured interviews in a purposeful sample of 33 nurses with different attitudes toward cessation counseling. Content analysis was used to inductively characterize the issues raised by participants. Emerging themes were categorized using the knowledge-attitudes-behavior framework of guideline adherence. Knowledge-related and attitudinal barriers included perceived lack of skills in cessation counseling and skepticism about the effectiveness of cessation guidelines in hospitalized veterans. Nurses also reported multiple behavioral and organizational barriers to guideline adherence: resistance from patients, insufficient time and resources, the presence of smoking areas on VA premises, and lack of coordination with primary care. VA hospitals should train inpatient staff how to negotiate behavior change, integrate cessation counseling into nurses' workflow, develop alternative referral mechanisms for post-discharge cessation counseling, and adopt hospital policies to promote inpatient abstinence.

Details

Title: Subtitle: “Let Me Get You a Nicotine Patch”: Nurses' Perceptions of Implementing Smoking Cessation Guidelines for Hospitalized Veterans
Creators: David A Katz
Kenda Stewart
Monica Paez
John Holman
Susan L Adams
Mark W Vander Weg
Catherine T Battaglia
Anne M Joseph
Marita G Titler
Sarah Ono
Resource Type: Journal article
Publication Details: Military medicine, Vol.181(4), pp.373-382
DOI: 10.7205/MILMED-D-15-00101
PMID: 27046185
NLM abbreviation: Mil Med
ISSN: 0026-4075
eISSN: 1930-613X
Language: English
Date published: 04/2016
Academic Unit: Epidemiology; Psychological and Brain Sciences; Injury Prevention Research Center; General Internal Medicine; Community and Behavioral Health; Internal Medicine
Record Identifier: 9984063200502771

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