A practice improvement project improving tobacco and nicotine dependence treatment education in a doctor of nursing practice program
Abstract
Tobacco use is a global epidemic and the leading cause of preventable mortality and morbidity in the United States (Centers for Disease Control and Prevention [CDC], 2022h). Approximately 5.4 million people die annually due to tobacco-related illnesses. About 70% of tobacco users visit primary care clinics annually and even brief advice from clinicians can improve cessation rates ( United States Department of Health and Human Services [USDHHS], 2020). However, four out of nine adult smokers who visited healthcare providers did not receive any advice or counseling on quitting smoking. Lack of training and confidence were identified as a barrier among providers as to why they were not providing regular counseling or pharmacologic intervention (Meijer et al., 2019).
This practice improvement project improved the tobacco and nicotine dependence treatment education curriculum in North Dakota State University’s (NDSU) Doctor of Nursing Practice (DNP) program based on the recommendation provided by former DNP student, Dr. Doan (Doan, 2023). Dr. Doan first incorporated tobacco and nicotine dependence treatment education into the DNP curriculum in 2022. This project was implemented in NURS 810 class among DNP students. The education consisted of an online program (NDQuits QuitLogix) and an in-class presentation. Students were provided with toolkits.
NDSU DNP students’ knowledge, motivation, confidence in helping people quit tobacco and nicotine, and comfort with providing information about cessation medications, programs and services, and referrals for evidence-based tobacco and nicotine dependence treatment were assessed through pre- and 2-month post-education questionnaires. Motivation to help users quit was high before the intervention began and did not have a significant increase post-intervention. Significant increases in knowledge, confidence, and comfort were observed in helping patients quit and in providing information about cessation medications, programs and services, and referrals for tobacco and nicotine dependence treatment. The results of this practice improvement support the effectiveness of formal tobacco and nicotine dependence treatment curriculum for DNP programs. Additionally, this project serves as a guide for DNP and other primary care programs for adding tobacco and nicotine dependence treatment curriculum into DNP and other primary care professional programs.