Tobacco cessation: a quality improvement project in an ear, nose, and throat clinic

Abstract

Background: Due to the correlation of head and neck cancers with tobacco use, tobacco cessation conversations are crucial. Healthcare professionals play a vital role in consistently identifying and documenting the smoking status of their patients. Problem Statement: While the clinic nurses at one Montana ear, nose, and throat (ENT) clinic are aware of the cancer risks involved with tobacco use, they were not screening 100% of their patients or providing tobacco users with educational materials to assist in cessation. Methods: During a six-week project, the Replicating Effective Programs (REP) quality improvement model was used. Data was evaluated using descriptive statistics. Interventions: Three nursing interventions were initiated: new ENT adult patients were screened for tobacco use (intervention 1), tobacco users were offered a Montana Quitline educational brochure (intervention 2) and referral (intervention 3). Results: The screening rate increased from 63% during the pre-implementation phase to 100% during the fourth week of the implementation phase. During the implementation phase, 16% of the tobacco users identified were agreeable to a Montana Quitline brochure and 5% were agreeable to a referral to the Montana Quitline. Conclusion: The project did increase nurses' rates of tobacco screening. However, the implications of time constraint on the nurses and a patient's readiness to quit proved to minimally impact the accepted number of brochures and referrals.