December 8, 2006

VUSN program targets patients’ tobacco use

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VUSN program targets patients’ tobacco use

Vanderbilt University School of Nursing is teaching its students how to help patients snuff out their tobacco habit.

The school has become the first in the nation to adopt a wide-ranging educational program that integrates standardized smoking cessation strategies into its curriculum for students to use with their encounters with patients who use tobacco.

VUSN presented the concept to Vanderbilt-Ingram Cancer Center last spring. The program grew from there to involve expertise and support from the Tennessee Department of Health, Metro Health Department and the National Cancer Institute, which has long been looking for health providers to implement meaningful cessation activities.

“Institutions of higher learning have a responsibility to push the envelope and become catalysts for change,” said Linda Norman, D.S.N., senior associate dean of academics. “Nowhere is this more important than in dealing with health issues like the toll tobacco use is taking on our patients. Smoking is the single most preventable cause of chronic diseases, and therefore, offers the opportunity for us to make the biggest difference,” added Norman.

Nearly 21 percent of U.S. adults smoke, but Tennessee, at 26 percent, is home to the third highest percentage of smokers in the country. Also, 27.6 percent of Tennesse high schoolers smoke.

The Centers for Disease Control reports that 70 percent of smokers trying to quit want help, but only 36 percent of tobacco-using patients receive any information on how to quit or where to get support.

Many, including VUSN's Cathy Taylor, Dr.P.H., M.S.N., and Sarah Fogel, Ph.D., R.N., think those figures are unacceptable. They have launched the VUSN portion of the program that expands tobacco cessation training for nursing students, include it in the curriculum and incorporate it in targeted care plans.

“Nursing is at the top of the list when it comes to most-trusted professions,” said Taylor. “Nurses, nurse-faculty and nursing students are well-positioned to implement tobacco cessation efforts in our curriculum and, most importantly, with patients.”

Additionally, first-year students in each of VUSN's core clinical courses are learning how to approach tobacco cessation as a mix of behavioral, emotional and physical changes. They are learning the best approaches to intervene in a patient's care, starting with their clinical rotations as nursing students, and will learn the appropriate ways to initiate the issue, advise patients and assess nicotine dependence.

One vital resource recently made available to Tennesseans through the State Department of Health, is the 1-800-QUIT-NOW phone line. The hotline connects smokers who want to quit with individual “quit coaches” who are accessible for free for up to 12 months. Helpline counselors can also direct callers to specific programs or group support in their local communities.

“We want to encourage tobacco cessation among all populations in Tennessee,” said Donna Henry, M.P.H., director of the department's Division of Health Promotion. “Whether someone is a smoker or smokeless tobacco user, the Quit Line can help because it relies on relationship building between caller and counselor and is an interactive and ongoing resource.”

This tobacco cessation project is also a model of collaboration between varied public health care concerns and sound evidenced-based practice.

For instance, the State's Quit Line information and the VUSN students' clinical interventions will be linked.

The number of patients who are referred to the Quit Line as a part of VUSN clinical interventions will be tracked to determine the effectiveness of the educational program.

“Our goal in coming together in this way is to provide the evidence that will link prevention with ultimate outcomes such as mortality and morbidity,” said Elizabeth Williams, Ph.D., associate director of VICC's Office of Minority Affairs.

This academic year, the program is focusing on first-year students. Next year, Taylor and Fogel will expand the programs to include second-year students. They hope the VUSN program will become a model for other nursing schools.

“We will graduate roughly 250 advanced nurse practitioners each year with a greater understanding of tobacco cessation methods and specific sources,” said Taylor.

“Our graduates will become leaders in the community and drive the importance of tobacco cessation in their careers.”

“We have a group of dedicated public health partners that have participated at every step along the way and without the involvement of each on the local, statewide and national levels, we couldn't have pulled this together,” said Taylor.

“The issue is important; the time is right; and we're ready to make a difference.”