The Emergency Department Action in Smoking Cessation (EDASC) trial: impact on delivery of smoking cessation counseling.

摘要: ACADEMIC EMERGENCY MEDICINE 2012; 19: 409–420 © 2012 by the Society for Academic Emergency Medicine Abstract Objectives:  The focus on acute care, time pressure, and lack of resources hamper delivery smoking cessation interventions in emergency department (ED). aim this study was to 1) determine effect an nurse–initiated intervention counseling based 5As framework (ask–advise–assess–assist–arrange) 2) assess ED nurses’ physicians’ perceptions counseling. Methods:  authors conducted a pre–post trial 789 adult smokers (five or more cigarettes/day) who presented two EDs. focused improving nurses physicians included face-to-face training online tutorial, use charting/reminder tool, fax referral motivated state tobacco quitline proactive telephone counseling, group feedback staff. To performance interview subjects shortly after visit. Nurses’ self-efficacy, role satisfaction, attitudes toward were assessed survey. Multivariable logistic regression used 5As, while adjusting key covariates. Results:  Of 650 completed post-ED interview, greater proportion had been asked about nurse (68% vs. 53%, adjusted odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.3 2.9), willingness quit (31% 9%, OR= 4.9, CI = 2.9 7.9), assisted quitting (23% 6%, OR = 5.1, CI = 2.7 9.5) arrangements follow-up (7% 1%, OR = 7.1, CI = 2.3 21) during compared baseline period. A similar increase observed (EPs). self-efficacy satisfaction significantly improved following intervention; however, there no change “pros” “cons” either physicians. Conclusions:  can effectively deliver time-efficient manner. This also provides empirical support expert recommendations that call nursing staff play larger delivering public health ED.