nico-hosp-intro 1.1 smoke-free hospital european training guide training programme designed for...

Nico-hosp-intro 1.1Smoke-free hospital European Training guide

Training programme designed Training programme designed for hospital staff to deal with for hospital staff to deal with

smokingsmokingVersion 2003

Smoke-free HospitalEuropean Training

GuideNico-hosp


Navigate in Navigate in Nico-hospNico-hosp

Introduction

Assessment and Evaluation

Motivation : health effects

Minimum/Basic Activities

Communication and Motivation

NRT

Bupropion

Consultation

Motivation : addiction


Introduction

1. Justification of the training manual

2. European Smoke-free Code

3. Clinical staff role in smoking cessation

4. Smoking concerns all hospital staff

5. What staff must do?


Justification of the training manual


Justification (I)Justification (I)Smoking is a health priority. It is the leading preventable cause of premature death and disability in developed countries.

The reduction of the tobacco consumption is the most important public health measure that can be adopted by developed countries to improve both health and economy.

The benefits achieved by smoking cessation are obvious, with a marked reduction in mortality and morbidity due to smoke related illness.

To deal with smoking we need multidisciplinary and comprehensive actions.


Justification (II)Justification (II)Health Care Professionals play an important role both as clinicians and health educators.

Currently, training in smoking prevention and therapy is poor or virtually nil in university curriculum.

It is necessary to improve periodically our knowledge regarding this problem.

All Hospital Workers must contribute to create a fine environment for health education, avoiding smoke at the hospital, enforcing smoke banning and guaranteeing that in all waiting rooms there are leaflets and journals promoting healthy ways of life.


Guide ObjectivesGuide Objectives To update the knowledge of Health Care Professionals and provide specific training on:

• Tobacco related illnesses

• Relevant aspects regarding smoking consumption: behaviour related, tobacco consumption, determining factors and relapse reasons.

• Diagnosis of smoking in people.

• Effective intervention techniques:

• No smoking advice

• Pharmacological therapies

• Physiological support


Smoke-free Hospital codeSmoke-free Hospital code

• Engage decision-makers. Inform all personnel and patients. • Appoint a working group. Develop a strategy and an implementation plan. • Set up a training plan to instruct all staff on how best to approach smokers. • Organise cessation support facilities for patients and staff in the hospital and

ensure continuity of support on discharge into the community. • Indicate smoking zones clearly, for as long as they are considered necessary,

and keep them away from clinical and reception areas. • Adopt appropriate signage, including posters, signposts, etc and remove all

incentives to smoke (such as ashtrays, tobacco sales, etc.). • Support systems are in place to protect and promote the health of all that

work in the hospital. • Promote smoke-free actions in the community setting. • Renew and broaden information to maintain commitment to the policy.

Ensure follow-up and quality assurance. • First convince,then constrain considering legislation if needed. Have

patience!


Clinical staff role in smoking cessationClinical staff role in smoking cessationPast• In Northern Europe, tradition of nurses dealing with nicotinic weaning. • In France, tradition of doctors dealing with nicotinic weaning,• In the States, tradition of psychologists dealing with smoking cessation,

Present• NRT are available OTC (possible self medication ).• Nicotine substitutes are available in hospitals.

Future• Staff have a central information role.• Smoking : a nurse diagnosis as well as medical one• Smoking amongst patients: nurses and other health professionals are often the

closest.


Smoking concerns all hospital staffSmoking concerns all hospital staff

All hospital staff in contact with in and out patients. All hospital staff in contact with in and out patients.

Smoking cessation consultation for the most severe Smoking cessation consultation for the most severe patients (<3%).patients (<3%).

Smoking cessation facilitators/units to help various Smoking cessation facilitators/units to help various services in dealing with smoking patients.services in dealing with smoking patients.

Doctors, surgeons of all specialities,Doctors, surgeons of all specialities,

Other health care professionals; pharmacists, etc…Other health care professionals; pharmacists, etc…


What staff must do ?What staff must do ?• Identify smokers• Note down smoking with vital signs

(pulse,...)

• Collect smoking history• Getting the smoker to progress towards

quitting (not ready, hesitating, ready)• Provide help and assistance to smokers

willing to quit• Prevent relapse

• Explain why smoking is not allowed• Supply NRT to smokers in need

Smoking diagnosis

for all

Smoking diagnosis

for all

Advancing towards preparing smokers to

quit

Advancing towards preparing smokers to

quit

Reduce risks and substitute lacks with

those who do not want to quit

Reduce risks and substitute lacks with

those who do not want to quit

Help smokers who are ready with NRT

Help smokers who are ready with NRT

Help with other treatments

Help with other treatments


European adaptation will be developed with many contributor : :BelgiumBelgiumMichael Pettiaux. Fares - Brussel

SpainSpainGalice

Begoña Alonso. Direction Générale de la santé publique. Gouvernement de Galice. Santiago de CompostelaJorge Suanzes. Direction de la santé publique. Gouvernement de Galice. Santiago de Compostela

CatalognePilar Roig. Hopital Sant Joan de Reus. TarragonaEsteve Salto. Direction Générale de la santé publique. Catalan Government. BarcelonaElvira Mendez. Institut Catalan d’Oncologie. Barcelona Tarsila Ferro. Institut Catalan d’Oncologie. Barcelona

FranceFranceAnne-Laure Douspis. AP-HP – European Network for Smoke-free Hospital. ParisLoïc Josseran. AP-HP - European Network for Smoke-free Hospital ParisAnne Marie Schoelcher AP-HP - Network for Smoke-free Hospital ParisBertrand Dautzenberg. AP-HP - European Network for Smoke-free Hospital Paris

IrelandIrelandAnn O`Riordan, National Health Promoting Hospitals Network, Ireland

This training guide is base on the French Nicomède training module developed with the help of French

Ministry of Health

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