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Randomized Controlled Trial
. 2016 Apr 26:11:15.
doi: 10.1186/s13011-016-0059-0.

Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients

Danielle M Schulte  1   2 , Megan Duster  1 , Simone Warrack  1 , Susan Valentine  1 , Douglas Jorenby  1   3 , Daniel Shirley  1 , James Sosman  1 , Sheryl Catz  4 , Nasia Safdar  5   6   7
Affiliations
Randomized Controlled Trial

Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients

Danielle M Schulte et al. Subst Abuse Treat Prev Policy. .

Abstract

Background: Smoking increases hospitalization and healthcare-associated infection. Our primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. S. aureus carriage, healthcare-associated infections and infections post discharge were exploratory outcomes.

Methods: Current inpatient smokers from a university hospital facility were randomized to usual care or a face to face tobacco cessation counseling session where patients' tobacco use and strategies for quitting were discussed. Patient engagement, satisfaction and withdrawal symptoms were measured at 1 week and 12 weeks post discharge. Nasal swabs were collected at enrollment and discharge and assessed for S. aureus colonization. P-values were calculated using Fisher's exact and t-tests were used to compare groups.

Results: For the study's primary outcome, participants reported the intervention as being generally acceptable and reported high overall levels of satisfaction, with a Likert scale score of at least 4/5 for all measures of satisfaction. No subjects utilized free tobacco cessation services after discharge. 83 % of the intervention group and 93 % of the control group smoked at least one cigarette after discharge. Secondary outcomes with regard to infections showed that, at discharge, 12 % of the intervention group (n = 17) and 18 % of the control group (n = 22) tested positive for S. aureus. After 3 months, 9 % of the intervention group developed infection, 41 % visited an emergency room, and 24 % were readmitted within 3 months post-discharge, compared to 27, 32 and 36 % of the control group respectively.

Conclusions: With regards to the primary aim of this study, there were overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients. However, more intensive interventions in hospitalized patients and impact on healthcare-associated infections and post-discharge infections should be explored.

Keywords: Healthcare-associated infections; Infection control; MRSA; Staphylococcus aureus; Tobacco cessation.

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Figures

Fig. 1
Fig. 1
Recruitment Consort Diagram
Fig. 2
Fig. 2
Subject Satisfaction with Intervention Procedures. Legend: Number analyzed: Intervention group n = 16
See this image and copyright information in PMC

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