Aims
Audit carried out to assess whether or not patients had been asked about their smoking status during admission onto an acute adult mental health ward, as well as if they had received any smoking cessation advice or offered nicotine replacement therapy.
Method
A cross-sectional review of all 34 inpatients across four general adult acute psychiatric wards.
Patient records were explored using the Aneuran Bevan Health Board admission proformas to identify evidence of smoking status and whether advice was offered.
Result
Smoker but not given cessation advice n = 13 (38%)
Not asked about smoking n = 11 (32%)
Smoker and given cessation advice n = 4 (12%)
Non-smoker n = 6 (18%)
Conclusion
Patients were asked about their smoking status the majority of the time (68%) but provision of advice or nicotine replacement therapy was only done in 14% of potential smokers (identified smokers and patients not asked about smoking status).
A consideration to be taken into account is that on admission, a patient's physical health status may be unknown, with the additional difficulty of a patient's acute distress complicating the physical examination, smoking status and modification of patient's smoking status may not be the highest priory in that context.
Data regarding asking about smoking were different amongst wards, potentially signifying differences between assessors willingness to ask about smoking status.
There is a lack of smoking cessation literature available on the wards and patients are often unaware of what options are available to quit smoking.
The audit simply determined whether or not assessors were documenting smoking status, it does not measure the quantity or quality of smoking cessation advice provided.
Further quality improvement projects should be launched, with focus groups as the intial step at further investigating inpatient smoking rates, as well as attempting to reduce them in a more systemic way.