Doctor of Nursing Practice Program
Brittany Kirby, DNP, MSN, APRN, FNP-C
Committee Chair Name & Credentials:
Jennifer Barut, PhD, MSN, RN
DNP Project Abstract
Assessing Readiness to Quit Smoking in Vascular Surgery Patients
Smoking cigarettes contributes to the development of numerous disease processes including atherosclerotic cardiovascular disease and abdominal aortic aneurysm. Evidence suggests that while the majority of patients desire to quit smoking, less than one-third receive smoking cessation assistance by a healthcare provider. The purpose of this quality improvement project was to increase assessment of readiness to quit smoking by incorporating a standardized assessment tool into provider workflow at an outpatient vascular surgery specialty clinic.
This quality improvement project was conducted over two weeks. Retrospective chart review for patients self-identified as currently smoking was conducted pre- and post implementation of workflow change introducing standardized readiness to quit assessment tool into the nurse practitioner's workflow. The nurse practitioner administered assessment tool and documented results in EHR as part of workflow change.
Of the 15 patients self-identifying as current smokers, 14 (93.3%) received readiness to quit assessment with subsequent documentation of scores in the EHR compared to 0% pre-implementation. The results demonstrate that a workflow change to incorporate a standardized readiness to quit assessment tool into provider workflow leads to increased assessment of a patient's readiness to quit smoking.
Implications for Practice
Smoking cigarettes is a modifiable risk factor contributing to the morbidity and mortality of vascular surgery patients. Leading health authorities recommend assessing for readiness to quit smoking during each patient encounter. However, no agreed upon method or tool is agreed upon in the literature. This project demonstrates the effectiveness of implementing a standardized readiness to quit assessment tool to improve assessment rates in the outpatient setting. More research is needed to determine whether or not smoking cessation assessment tools impact rates of smoking cessation. Next steps for this clinic include implementation of the assessment tool for all clinic patients and impact on smoking cessation.