& n o i t a s s e c g n i k o m s t n e i t a p l a c i g r u s e h t
t n e t con
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The problem
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Low hanging fruit
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Next steps
04
References
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01
The problem: surgical patients who smoke experience: more frequent admission to the intensive care unit more pulmonary complications more postoperative pain longer length of hospital stay increased post-surgical infections delayed wound healing increased incidence of DVT/PE
02
Low hanging smoking cessation in the surgical patient fruit
PreCare inservice
ID TTP champions in PreCare
signage & brochures (PreCare & surgeons office)
retros audit of smoking status ID data postinservice (monthly) audit of smoking status ID data, # referrals, surgical inpatient tob+ census & IP consults Clarify documentation of smoking status intake data (check sources) to ensure that al surgical patients have tobacco status documented
capture data IP visits
[
identify 2 surgical services w/ high interest (joints/spines?) weekly smoking cessation class in PreCare?
PEDS/2nd hand smoke
Information Needed for Data Collection Identify and contact Department of Anesthesiology EPIC/IT expert. Identify and contact TTP EPIC/IT expert. Is current smoking status ID data element the same for Surgeon, PreCare RN, Preop note and TTP? if not, is an automatic import from nonTTP data elements to data element recognized by TTP possible?
DATA demographics LOS infection readmission pulmonary.complications cardiac complications DVT/PE ect
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Next steps Reach out to Vishal Reach out to RN & CRNA lead in PreCare Schedule PreCare Inservice Discovery : Anesthesiology v Perioperative Services v Surgery EPIC lead
talking points for PreCare #1. negative consequences of tobacco in the surgical patient
#2. positive impact of tobacco cessation in the surgical patient
#3. teachable moment: surgical date to “pivot” from smoker to non-smoker status
#4. TTP resources available to smokers
References
Tanabe K, Nakagawa M, Yamashita C, Yonekura H, Iida M, Fukuda I. A practical guide for perioperative smoking cessation. J Anesth. 2022 Oct;36(5):583-605. doi: 10.1007/s00540-022-03080-5.
SunK,LiuD,ChenJ,YuS,BaiY,ChenC,Yao Y,YuL,Yan M. Moderate-severe postoperative pain in patients undergoing video-assisted thoracoscopic surgery: a retrospective study. Sci Rep. 2020;10:795. Andrew Prestwich1*, Sally Moore2, Alwyn Kotze3, Luke Budworth1, Rebecca Lawton1,2 and Ian Kellar1 Front. Psychol., 07 June 2017 https://doi.org/10.3389/fpsyg.2017.00915 How Can Smoking Cessation Be Induced Before Surgery? A Systematic Review and Meta-Analysis of Behavior Change Techniques and Other Intervention Characteristics
Schaaf D. Smoking Cessation Counseling in the PreAnesthesia Testing Clinic: A Quality Improvement Initiative. J Perianesth Nurs. 2022 Oct;37(5):607-612. doi: 10.1016/j.jopan. 2021.11.004. Epub 2022 May 14. PMID: 35577656.
Greenberg JA, Zwiep TM, Sadek J, Malcolm JC, Mullen KA, McIsaac DI, Musselman RP, Moloo H. Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking. Can J Surg. 2021 Oct;64(5):E491-E509. doi: 10.1503/cjs.011519. https://apps.who.int/iris/bitstream/han dle/10665/330485/9789240000360eng.pdf Michael V. Burke, Sarah Cha, Therese M. Shumaker, Margaret LaPlante, Laura McConahey, Amanda L. Graham, Delivery of smoking cessation treatment via live chat: An analysis of client-centered coaching skills and behavior change techniques, Patient Education and Counseling, Volume 105, Issue 7, 2022,