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Tobacco cessation in acute and critical care nursing practice: challenges and approaches
1Georgetown University School of Nursing and Health Studies, 3700 Reservoir Road NW, Washington, DC 20057, USA. jss@georgetown.edu
Abstract:
Recently, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) implemented new national core measures, including tobacco-cessation interventions for patients hospitalized because of pneumonia or other pulmonary-related illnesses, acute myocardial infarction, or heart failure. All interventions performed for such patients must be documented in the patient's chart. Because the JCAHO standards for tobacco cessation are implemented hospital-wide, acute and critical care nurses must take an active role in their execution. This article discusses the challenges to integrating tobacco cessation in daily acute and critical care nursing practice and makes recommendations regarding cessation approaches designed to improve health outcomes for tobacco-dependent patients.
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The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.