Smoking Cessation Counseling in the PreAnesthesia Testing Clinic: A Quality Improvement Initiative

Abstract

Purpose: To determine the feasibility and effectiveness of an Advanced Practice Provider (APP) led smoking cessation counseling service integrated into the preanesthesia evaluation for adults preparing for an elective procedure who smoke.

Design: Quasi experimental study.

Methods: An educational in-service was provided to staff members in the Preanesthesia Testing Clinic prior to the integration of the smoking cessation counseling intervention. Knowledge retention was assessed using a pre- and post-test. After the training was complete, staff members began to identify eligible individuals for smoking cessation counseling. Individuals who met the inclusion criteria were stratified into two groups based on their perioperative risk and medical history. High-risk individuals were counseled immediately by the APP. Low risk individuals were first screened by the Registered Nurse and internally referred to the APP for cessation counseling. Those who received smoking cessation counseling were referred to third party smoking cessation support services for ongoing follow up.

Findings: Individuals stratified into the low-risk group reported smoking significantly less postoperatively after preoperative telephonic smoking cessation counseling.

Conclusion: The results demonstrate positive smoking cessation outcomes supporting that it is feasible and advantageous to integrate smoking cessation counseling into the preanesthesia evaluation for adults preparing for an elective procedure.

Keywords: preanesthesia; preoperative; quality improvement; smoking cessation; smoking cessation intervention.