Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Nursing

Date of Defense

12-17-2009

Graduate Advisor

Roberta K Lee, DrPH

Committee

Hsueh, Kuei-Hsiang

Borcherding, Kathy

Ulione, Margaret

Highstein, Gabe

Abstract

Problem: An evaluation of a smoking cessation educational intervention for direct care RNs. Design: A randomized controlled trial. Methods: The study was conducted at a large Midwestern academic medical center. Direct care Registered nurses (dcRN’s) employed at least .7 FTE and spending 80% of their time in direct patient care on general medicine or general surgery units were recruited. Recruitment occurred between April and May, 2009. Outcome data was abstracted from charts of patients receiving care from the intervention group. Interventions: Participants were randomized to either ‘Rx for Change’ which was a training program regarding tobacco cessation or to a ‘usual care’ group. Pre-testing was completed upon randomization and post-testing was done 6 weeks later. The intervention was adapted from the full ‘Rx for Change Program’ which consisted of didactic material and role playing exercises and was completed in four hours. Objective: Determine if providing dcRN with educational seminars (Rx for Change) makes an impact on smoking cessation intervention with hospitalized patients compared with intervention rates by nurses without exposure to ‘Rx for Change’. Outcome measures included improvement in skill, confidence, knowledge about tobacco addiction and smoking cessation interventions with currently smoking patients. Outcomes included increases in documented interventions with smoking patients following ‘Rx for Change’. Randomization: Randomization was computer-generated. Results: 176 participants volunteered. 71 were randomized to the control group and 105 were randomized to the intervention group. Retention was 94% for controls and 53% for ‘Rx for Change’. Outcome: The ‘Rx for Change’ showed significant increases in skill (p<0.005, confidence ((p<0.0005), knowledge (p<0.0005) and intent to actively intervene with smoking patients (p=0.03) compared to the control group. Chart audit reveal 42% voluntary charting of patient intervention. Conclusions: ‘Rx for Change’ is an effective way to educate dcRNs about tobacco use and promoted active intervention with smoking patients.

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Nursing Commons

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