SPIN-IT and Quit It: A Nurse-Driven Protocol to Improve Inpatient Interventions for Tobacco Use Disorder

Abstract

Introduction

Tobacco smoking remains a leading cause of preventable disease and death in the U.S., with a high prevalence among individuals with mental health disorders (MHD). Despite regulatory efforts to increase tobacco use disorder (TUD) treatment in psychiatric inpatient units (an ideal setting), compliance of offering and using these interventions remains suboptimal.

Aims

This project aimed to examine the effectiveness of a nurse-driven protocol, Smoking treatment Protocol for Inpatients via Nurse-driven Interventions & Teaching (SPIN-IT), on improving compliance with evidence-based TUD treatment interventions in an inpatient psychiatric unit.

Methods

SPIN-IT was developed and implemented in a 20-bed inpatient psychiatric unit. The protocol allowed registered nurses (RNs) to deliver TUD counseling and prescribe nicotine replacement medication based on an algorithm without an independently licensed provider (LIP). Data on compliance with CMS tobacco measures (TOB-2 and TOB-2a) were collected for 12 months before and after SPIN-IT implementation and analyzed for statistical significance.

Results

The project included 835 patients over 2 years. Post-intervention TOB-2 compliance increased significantly from 84.7% to 99.3% (p < .001), and TOB-2a compliance rose from 24% to 56% (p < .001). The protocol resulted in more patients being offered and receiving TUD treatment counseling and medications.

Conclusion

The SPIN-IT protocol significantly improved TUD treatment compliance in an inpatient psychiatric setting. It supports the effectiveness of nurse-driven protocols in enhancing patient outcomes and adherence to TUD treatment measures. Further research is needed to evaluate the long-term impact on TUD treatment and to explore the perceptions of nursing staff, physicians, and patients related to the protocol.

Keywords

nurse-driven protocol tobacco use disorder treatment quality improvement inpatient psychiatry

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