690 Quality Improvement Project: Improving Engagement with Smoking Cessation Services Among Emergency Surgical Admissions
V Ngo, J Hutching, F Fyles, P Rodrigues, G Jones- Surgery
Abstract
Aim
Smoking status has a significant impact on surgical patient outcomes, with significantly increased rates of intra- and post-operative complications. Within Liverpool University Hospitals NHS Foundation Trust (LUHFT), the CURE team is a dedicated smoking cessation service that uses an electronic proforma to identify smokers and offer support. We assessed smoking cessation efforts among emergency surgical admissions pre- and post-teaching intervention.
Method
Two rounds of audit were completed: a baseline audit of emergency surgical admissions from 01/01/21 to 31/01/21(n = 202); and a reaudit of emergency surgical admissions from 01/11/22 to 30/11/22 (n = 163), following a structured teaching session on smoking cessation, delivered to incoming doctors in August 2022. We assessed documentation of smoking status within patient notes, completion of the smoking status proforma, prescription of nicotine replacement therapy (NRT), and assessment/follow up from CURE.
Results
Following intervention, smoking status documentation improved from 83% (n = 166) to 96% (n = 157), and proforma completion from 55% (n = 112) to 91% (n = 148). Among documented smokers (cycle 1 n = 49; cycle 2 n = 47), NRT prescription improved from 29% to 40%, and CURE involvement increased from 31% to 64%. Overall, following intervention, 21% of smokers accepted ongoing support from CURE during and post-admission, compared to 10% at baseline.
Conclusions
Use of electronic smoking status proforma and a dedicated inpatient smoking cessation team has high rates of engagement among emergency surgical inpatients. The use of structured teaching sessions to highlight the importance of smoking cessation among these patients has led to improved rates of smoking cessation support, benefiting surgical outcomes.