nico-hosp-intro 1.1 smoke-free hospital european training guide training programme designed for...
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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
Nico-hosp-intro 1.2Smoke-free hospital European Training guide
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
Nico-hosp-intro 1.3Smoke-free hospital European Training guide
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?
Nico-hosp-intro 1.4Smoke-free hospital European Training guide
Justification of the training manual
Nico-hosp-intro 1.5Smoke-free hospital European Training guide
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.
Nico-hosp-intro 1.6Smoke-free hospital European Training guide
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.
Nico-hosp-intro 1.7Smoke-free hospital European Training guide
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
Nico-hosp-intro 1.8Smoke-free hospital European Training guide
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!
Nico-hosp-intro 1.9Smoke-free hospital European Training guide
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.
Nico-hosp-intro 1.10Smoke-free hospital European Training guide
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…
Nico-hosp-intro 1.11Smoke-free hospital European Training guide
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
Nico-hosp-intro 1.12Smoke-free hospital European Training guide
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