Integrated Care Pathway for the Management of Nicotine ... MacDonald.pdf · Integrated Care Pathway...

Integrated Care Pathway for the

Management of Nicotine

Addiction

18.04.2013

Jacqueline MacDonald

Stop Smoking Specialist Nurse

Hairmyres Hospital

Coathill Cluster

Community

Stop Smoking

Service

Monklands Hospital

Stop Smoking

Service

Hairmyres Hospital

Stop Smoking

Service

Wishaw Cluster

Community

Stop Smoking

Service

Wishaw Hospital

Stop Smoking

Service

Udston Cluster

Community

Stop Smoking

Service

NHS Lanarkshire Stop Smoking Service

Pharmacies

Seamless

Service

Integrated Care Pathway

‘‘Integrated care pathway (ICP) determines

locally agreed multidisciplinary practice based

on guidelines and evidence where available

for a specific patient/client group. It forms all

or part of the clinical record, documents the

care given, and facilitates the evaluation of

outcomes for continuous quality

improvement.’’ National Pathways Association,1998

ICP would support National

and Local Guidelines Smoking Cessation Guidelines (2010)

CEL(1) Health Promoting Health Service :

Action into Hospital Settings (2012)

Creating A Tobacco-Free Generation: A

Tobacco Control Strategy for Scotland (2013)

Quality strategy(2010)

The need for effective health care services through reducing inappropriate

variation and practices and ensuring that the most appropriate treatments,

interventions, support and services are provided at the right time to

everyone who could benefit.

Preparation ICP Group (multidisciplinary)

Project Initiation Document (PID)

• Pilot

• Identified 3 key areas: Coronary Care Unit

Respiratory Ward

Ward Emergency Care

• Senior/Ward managers

• Link Nurses

• Training

• Pharmacy

• Document

• Resources

Outcomes Improve patient comfort

• Appropriate referrals

• Patient choice

• Equity and consistency of care

• Increase in quit attempts and successful four week quits

• Lower incidence of patients smoking within acute sites (as part of the Smoke Free Policy work)

• Increased staff knowledge

• Increased availability of NRT

Example of Admission Documentation

How we planned to evaluate

Referrals

Quits made

Patient survey

Staff survey

Referrals 2 months pilot period(2012) in comparison to previous

year (2011)

12-53

Pilot Area

47-111

Hospital overall

Staff Survey

(36 completed survey)

• Raised Awareness - 29

• Increased confidence -21

• Requesting further training-19

• Access to NRT -33

• Made a difference to patient comfort -23

Staff Feedback

“Would like

more training”

“Recognise

Nicotine withdrawal

symptoms”

“Feel more confident

To discuss stopping

smoking with

Patient”

“Understand

Nicotine addiction”

Findings From Patient Survey

100 ICP Completed /53 patients contactable

• Unaware of service -34

• Asked on admission – 42

• Prescribed NRT- 31

• Quit - 49

• Health reasons - 32

• Policy - 28

• Very satisfied/satisfied - 53

• More at ease coming into hospital - 51

• Recommend service - 51

Patient’s Feedback

“NRT helped”

“Would recommend”

“Great Service”

“Felt more relaxed”

“Stopped because

help was offered”

ANY

QUESTIONS?

Jacqueline.MacDonald@lanarkshire.scot.nhs.uk

Phone 01355 585502