Christine Greenidge, MSN, APRN, BC
Director of Nursing Professional Practice
Smoking is one of the most important preventable causes of untimely mortality and morbidity, contributing to approximately 419,000 deaths in the U.S. each year. Smoking cessation reduces mortality and morbidity, and patients who receive smoking-cessation advice from care providers are more likely to quit. National guidelines strongly recommend smoking-cessation counseling for persons with heart disease, however it is rarely provided to eligible older patients hospitalized with chronic heart failure (CHF) and acute myocardial infarction (AMI).
In consultation with Bronx Breathes, a nonprofit organization that assists healthcare providers in implementing tobacco control treatment programs, Montefiore Medical Center has implemented a smoking cessation counseling strategy geared particularly toward patients with CHF and AMI. Program components include the following:
- Smoking cessation counseling offered to CHF patients as part of discharge instructions
- A series of Nursing Grand Rounds focusing on the Joint-Commission-defined Core Measures for smoking cessation advice/counseling
- Smoking cessation strategies
- Patient education literature
- Revised nursing forms
With the goal of providing patients with optimal education and appropriate documentation, this initiative has achieved great success in establishing smoking cessation counseling as a regular component of CHF discharge instructions. As of 2008, 100% of Montefiore patients hospitalized with AMI and CHF were offered smoking cessation couseling during discharge.