Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infect
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RESEARCH
Open Access
Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients Danielle M. Schulte1,2, Megan Duster1, Simone Warrack1, Susan Valentine1, Douglas Jorenby1,3, Daniel Shirley1, James Sosman1, Sheryl Catz4 and Nasia Safdar1,5,6*
Abstract Background: Smoking increases hospitalization and healthcare-associated infection. Our primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. S. aureus carriage, healthcare-associated infections and infections post discharge were exploratory outcomes. Methods: Current inpatient smokers from a university hospital facility were randomized to usual care or a face to face tobacco cessation counseling session where patients’ tobacco use and strategies for quitting were discussed. Patient engagement, satisfaction and withdrawal symptoms were measured at 1 week and 12 weeks post discharge. Nasal swabs were collected at enrollment and discharge and assessed for S. aureus colonization. P-values were calculated using Fisher’s exact and t-tests were used to compare groups. Results: For the study’s primary outcome, participants reported the intervention as being generally acceptable and reported high overall levels of satisfaction, with a Likert scale score of at least 4/5 for all measures of satisfaction. No subjects utilized free tobacco cessation services after discharge. 83 % of the intervention group and 93 % of the control group smoked at least one cigarette after discharge. Secondary outcomes with regard to infections showed that, at discharge, 12 % of the intervention group (n = 17) and 18 % of the control group (n = 22) tested positive for S. aureus. After 3 months, 9 % of the intervention group developed infection, 41 % visited an emergency room, and 24 % were readmitted within 3 months post-discharge, compared to 27, 32 and 36 % of the control group respectively. Conclusions: With regards to the primary aim of this study, there were overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients. However, more intensive interventions in hospitalized patients and impact on healthcare-associated infections and post-discharge infections should be explored. Keywords: Healthcare-associated infections, Staphylococcus aureus, MRSA, Tobacco cessation, Infection control
* Correspondence: [email protected] 1 Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA 5 University of Wisconsin Hospitals and Clinics, Madison, WI, USA Full list of author information is available at the end of the article © 2016 Schulte et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provide
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