Purpose: Comment the Discussion

To Comment

Majority of healthcare organizations are looking for ways to increase smoking cessation or to provide care for the cessation of smoking. Addressing the use of tobacco within a healthcare setting requires program, clinical, and system-level changes.

The change under consideration is a system change through the implementation of various strategies to enhance the rate of smoking cessation (Thomas et al., 2017). Specifically, all healthcare settings are mandated to as the tobacco use status of individuals who consult with them, should advise smokers to quit, and should be able to refer smokers to the quit line. Some of the strategies addressed by the article include advising smokers to quit, counseling to quit, and providing medicines to smokers to enable them to quit (Thomas et al., 2017).

Overall, the quality of the evidence from the research was judged to be low due to the small number of the available studies and fewer study designs. In addition, none of the included studies implemented all the changes as recommended (Thomas et al., 2017). The quality of evidence for all the outcomes was very low that the researchers could not come up with a robust conclusion regarding the usefulness of system change interventions.

One of the barriers to the implementation system change is lack of reimbursement as frequently cited by clinicians. Other barriers to providing support for smoking cessation include lack of organizational support, perceived patient objections, lack of systems to identify smokers, lack of time and skill among staff, perceived inability to change the practices, cost of care provision, and perceived lack of efficacy (Thomas et al., 2017).

In order to address these factors, it is necessary to have a strategic system change approach. The healthcare systems should also reconfigure themselves to address the patient needs and concerns. In addition, healthcare financing for healthcare systems and tobacco users should be put in place in order to reduce the costs for tobacco smokers or healthcare providers for providing treatment (Hartmann-Boyce et al., 2013).

This article is useful to me in my role since I encounter patients who suffer from tobacco addiction and dependency. Despite the fact that the quality of evidence from the research is generally low, the proposed system change interventions are imperative and worth implementing in order to increase the rate of smoking cessation among patients. Other nurses can implement these recommendations to ensure improved smoking cessation outcomes for the patient.

References:

Melnyk, B. M., & Fineout-Overholt, E. (2014). Evidence-based practice in nursing and healthcare: a guide to best practice. Wolters Kluwer/Lippincott Williams et Wilkins.

Hartmann-Boyce, J., Stead, L. F., Cahill, K., & Lancaster, T. (2013). Efficacy of interventions to combat tobacco addiction: Cochrane update of 2012 reviews. Addiction, 108(10), 1711- 1721.

Thomas, D., Abramson, M. J., Bonevski, B., & George, J. (2017). System change interventions.

Thing to Remember:

• Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

• 1 References, find resources that are 5 years or less

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