Implementation of smoking cessation guidelines in the emergency department: a qualitative study of staff perceptions

摘要: Background: The US Public Health Service smoking cessation practice guideline specifically recommends that physicians and nurses strongly advise their patients who use tobacco to quit, but the best approach for attaining this goal in emergency department (ED) remains unknown. aim of study was characterize physicians’ (EPs) nurses’ (ENs) perceptions counseling identify barriers facilitators implementation 5 A’s framework (Ask-Advise-Assess-Assist-Arrange) ED. Methods: We conducted semi-structured, face-to-face interviews 11 EPs 19 ENs following a pre-post trial guidelines two EDs. used purposeful sampling target with different attitudes toward counseling, based on responses written survey (Decisional Balance Questionnaire). Conventional content analysis inductively issues raised by participants construct coding structure, which then applied transcripts. Results: main findings converged upon three overarching domains: 1) reactions intervention; 2) patients’ receptivity counseling; 3) perspectives ED preventive care. staff expressed ambivalence guidelines. Both agreed delivery is important, it not always practical account time constraints, competing demands acute care, resistance from patients. Participants also called attention need improved role clarity teamwork when implementing Conclusions: There are numerous challenges generally willing take lead offering brief efforts be reinforced EPs. systems address workflow, teamwork, policies facilitate prescription medication, referral follow-up primary results qualitative evaluation can guide design future intervention studies.