(VP009) ADVANCED PRACTICE NURSING AND SMOKING CESSATION

Background: A tertiary cardiovascular center has made smoking cessation a priority using a specialist smoking cessation model by having an in-hospital smoking cessation department with dedicated nurses specialized in smoking cessation. The department’s focus is on offering all admitted patients who have used any form of tobacco in the last 6 months smoking cessation consultations and pharmacotherapy. The department is managed by an Advanced Practice Nurse (APN) who oversees the various initiatives and programs. The various required competencies of an APN speak to the role diversity that an APN can take on. Utilizing the role of an APN specialized in smoking cessation in a tertiary cardiovascular hospital significantly improves safety, promotes positive health outcomes, and reduces costs.

METHODS AND RESULTS: In 2021, the smoking cessation department reached 89.5% of all admitted patients who had used any form or tobacco in the last 6 months. This was accomplished by running daily reports in the EMR to filter all admitted patients by smoking status on admission. The Ottawa Model for Smoking Cessation (OMSC) follow-up program includes monthly automated IVR (Interactive Voice-Recognition) phone calls that are monitored by the same nurses who saw the patients when they were admitted at the hospital. Depending on the answers provided by patients during the automated phone calls, the nurses provide additional telephone counselling and support. With a specialist model, most patients agree to post-discharge follow-up, with only 25% of eligible patients declining.
The benefits of implementing an APN led specialist smoking cessation model, has resulted in much higher patient reach and significant smoking cessation rates at 6-months post discharge. Over a 5-year period (2017-2022) the automated phone follow-up program demonstrated a 69.8% response rate and a self-reported 7-day PPA quit rate of 57.7% at 6 months post discharge. The overall program intention to treat 7-day PPA quit rate was 40.2%.

Conclusion: Utilizing the expertise of advanced nursing practice brings value to clients, practice settings and organizations to improve safety, promote positive health outcomes and reduce costs (CNA, 2019). More than $547 million is spent each year in Ontario on hospitalizations for acute myocardial infarction, unstable angina, heart failure, and chronic obstructive pulmonary disease alone (Mullen et al., 2014). Offering a specialist APN led smoking cessation department undeniably adds value to the healthcare system which is measured by an increase in patients’ health outcomes for the cost of achieving that improvement.