Implementation of a clinical practice guideline for smoking cessation in a public antenatal care setting

Flenady, Vicki, Macphail, Julie, New, Karen, Devenish-Meares, Paul and Smith, Julie (2008) Implementation of a clinical practice guideline for smoking cessation in a public antenatal care setting. Australian and New Zealand Journal of Obstetrics and Gynaecology, 48 6: 552-558. doi:10.1111/j.1479-828X.2008.00907.x

Author Flenady, Vicki
Macphail, Julie
New, Karen
Devenish-Meares, Paul
Smith, Julie
Title Implementation of a clinical practice guideline for smoking cessation in a public antenatal care setting
Journal name Australian and New Zealand Journal of Obstetrics and Gynaecology   Check publisher's open access policy
ISSN 0004-8666
Publication date 2008-12-01
Year available 2008
Sub-type Article (original research)
DOI 10.1111/j.1479-828X.2008.00907.x
Volume 48
Issue 6
Start page 552
End page 558
Total pages 7
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell
Language eng
Formatted abstract
Background: Despite high level evidence showing that antenatal smoking cessation programs are effective in reducing the number of women who smoke during pregnancy and the number of low birthweight and preterm births, few Australian hospitals have adopted a systematic approach to assist pregnant women to stop smoking.
Aims: The aim of this study was to assess the effectiveness of a smoking cessation guideline, developed specifically for clinicians providing antenatal care in public maternity hospitals, combined with an implementation program on the uptake of evidence- based practice.
Methods: A clinical practice guideline was developed and an implementation strategy was tested, using a prospective before-and- after study design, at the Mater Mothers' Hospital in Brisbane. Women were surveyed in late pregnancy, pre- and post-implementation. The primary outcome measures were women's report of appropriate smoking cessation support received, specifically, information brochures and referral to Quitline. Secondary outcome measures included women's report of smoking status in late pregnancy and relapse rates.
Results: Post-implementation, more women reported receiving written materials on smoking cessation (76% vs 35%; relative risk (RR) 3.4; 95% confidence interval (CI) 2.7, 4.2) and referral to Quitline (67% vs 14%; RR 4.9; 95% CI 3.0, 8.0). While not statistically significant, fewer women post-implementation reported smoking in late pregnancy (19.5% vs 16.7%) and fewer reported smoking > 10 cigarettes per day (38% vs 25%).
Conclusions: Clinical practice guidelines specifically designed for a public maternity care setting combined with an implementation program resulted in an increase in evidence-based practice with some indication of improved smoking behaviour for women.
Keyword Antenatal care
Clinical practice
Introduction, pregnancy
Smoking cessation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
School of Nursing, Midwifery and Social Work Publications
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