Program prevents nicotine withdrawal among patients getting trauma and emergency surgery

May 16, 2018 by Lesley Young, University of Alberta
A program at the U of A Hospital for trauma and emergency surgery patients who smoke nearly doubled screening rates for tobacco use, and increased rates of nicotine replacement therapy use to 89 per cent from 50 per cent. Credit: University of Alberta

Smokers who experience immediate, forced and involuntary nicotine abstinence after day or emergency surgery due to smoke-free hospital policies may find relief in a new University of Alberta program.

"While elective surgery patients who smoke are offered nicotine replacement therapies (NRT) in their pre-op appointments, we saw a gap where trauma or patients were missing out on nicotine addiction management," said Barry Finegan, a smoking cessation expert and anesthesiologist in the U of A's Faculty of Medicine & Dentistry.

"This intervention does not support smoking; rather, it endeavours to support people who have addictions by not allowing them to go into withdrawal."

A quality improvement approach was developed and tested in the post-anesthesia care unit at the University of Alberta Hospital. It included identifying smokers, offering NRT (patch and mouth spray only) and starting the therapy before patients were transferred to the ward.

It showed an increase in screening for tobacco use to 95 per cent from 54 per cent, and an increase in use of NRT to 89 per cent from 50 per cent prior to transferring the patient to the ward.

"We showed that such a program can help patients manage their withdrawal symptoms. And by modifying their behaviour, the hope is that they don't have to go outside to smoke and endure difficult weather conditions."

The intervention may also be many ' first introduction to an alternative to smoking, noted Finegan, adding that the researchers did not assess the impact of the NRT on smoking cessation.

"Our efforts do show that it is logistically feasible to institutionalize an approach of this kind in hospitals," he said. "And it is relatively simple provided all the aspects are co-ordinated. It is an example that a nicotine withdrawal management is achievable when everyone works together."

"The main challenge with a program like this is getting everyone on board," explained Finegan, who credited the study's co-author, operating room RN Daniel Roblin, for playing a huge role in co-ordinating the many practitioners involved.

"This truly was a collaborative effort that required an interplay between nursing staff and physicians," said Roblin. "Nurses needed to be engaged and educated, but it also required anesthesiologists to order the medication, and even beyond that, getting pharmacists involved to help maintain supplies, the unit clerk for data entry and even IT for data collection tools."

He added that not only did teams buy in, but now the program is ingrained in the culture of the nursing staff.

"This is extra work for nurses," pointed out Finegan, "but it's an important improvement in quality of care."

The study was published in the International Journal for Quality in Health Care.

Explore further: E-cigarettes could be helpful for smoking cessation in hospitals

More information: Barry A Finegan et al. Nicotine addiction management following surgery: a quality improvement approach in the post anesthesia care unit, International Journal for Quality in Health Care (2018). DOI: 10.1093/intqhc/mzy036

Related Stories

E-cigarettes could be helpful for smoking cessation in hospitals

February 23, 2018
Research published today in the New Zealand Medical Journal indicates electronic cigarettes, used as an alternative form of nicotine replacement, are well tolerated by alcoholics admitted to hospital for detoxification and ...

Little 'quit-smoking' help at U.S. mental health centers

May 10, 2018
(HealthDay)—Many mental health and addiction treatment centers in the United States don't help patients quit smoking, a new government study finds.

Tobacco cessation support lacking in mental health facilities

May 12, 2018
(HealthDay)—Many patients in mental health and substance abuse treatment facilities are not screened for tobacco use or offered treatments to facilitate tobacco cessation, according to research published in the May 11 issue ...

Study aims to help patients quit smoking before surgery

December 17, 2015
Researchers from the University of Alberta are examining how to help smokers kick the habit before undergoing elective surgery.

Running away from addiction: How exercise aids smoking cessation

December 20, 2017
New research in mice sheds light on the mechanism underlining exercise's protective effect against nicotine dependence and withdrawal.

Drop in violence associated with smoke-free policy at psychiatric hospital

June 15, 2017
New King's College London research reveals a 39 per cent drop in physical assaults—both between patients and towards staff—following the introduction of a smoke-free policy at the South London and Maudsley NHS Foundation ...

Recommended for you

Students more likely to eat school breakfast when given extra time, new study finds

August 18, 2018
Primary school students are more likely to eat a nutritional breakfast when given 10 extra minutes to do so, according to a new study by researchers at Virginia Tech and Georgia Southern University.

Moderate carbohydrate intake may be best for health

August 17, 2018
Eating carbohydrates in moderation seems to be optimal for health and longevity, suggests new research published in The Lancet Public Health journal.

Like shark attack and the lottery, unconscious bias influences cancer screening

August 17, 2018
What do shark attack, the lottery and ovarian cancer screening having in common? It turns out our judgments about these things are all influenced by unconscious bias.

Phantom odors: One American in 15 smells odors that aren't there, study finds

August 16, 2018
Imagine the foul smell of an ash tray or burning hair. Now imagine if these kinds of smells were present in your life, but without a source. A new study finds that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences ...

US drug overdose deaths surge amid fentanyl scourge

August 16, 2018
US drug overdose deaths surged to nearly 72,000 last year, as addicts increasingly turn to extremely powerful synthetic opioid fentanyl as the supply of prescription painkillers has tightened.

Parental life span predicts daughters living to 90 without chronic disease or disability

August 15, 2018
Researchers at the University of California San Diego School of Medicine report that women whose mothers lived to at least age 90 were more likely to also live to 90, free of serious diseases and disabilities.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.