Running head: COPD SMOKERS 1
NR 505 Week 6 Assignment: The COPD Patient in the ED: Education for Smoking
Cessation
,COPD SMOKERS 2
The COPD Patient in the ED: Education for Smoking Cessation
Working in any Emergency Department across the country, one can count on seeing COPD
patients that smoke tobacco in some form or another. A number of these patients have quit smoking,
but many more continue to do so. While not all COPD patients are smokers, smoking is the biggest
risk factor for developing COPD (Lo Tam Loi et al., 2013). Many of these COPD patients that
smoke continue to do so, even with having symptoms of respiratory illness, and many times require
intensive assistance to stop smoking. One such study found that smokers who were given an
intensive smoking cessation program did much better over the long term (Gratziou et al., 2014). The
goal of this paper is to discuss the COPD smoker that comes into the Emergency Department and
whether or not smoking cessation education while in the Emergency Department assists the patient
with smoking cessation. Discussions will include how this issue impacts the Master of Science in
Nursing Family Nurse Practitioner specialty track; what the issue actually is, why it is an issue, and
discussing how the literature has been researched for this paper; and a conclusion, providing a
summary of the key elements, discussing expected outcomes for this project proposal, and self-
reflection regarding this assignment.
Application to Selected MSN Program Specialty Track
There are several ways to apply the issue of the smoking COPD patient coming into the
Emergency Department over and over because of their illness, and being able to assist them with
education while they are in the Emergency Department regarding smoking cessation. This writer is
currently working in the Emergency Department as a Registered Nurse, but will possibly not be
continuing employment in the Emergency Department as a Family Nurse Practitioner. This has not
been completely decided yet, so for the purpose of this paper both aspects will be discussed.
Description of Impact to Family Nurse Practitioner Specialty Track
, COPD SMOKERS 3
The majority of the time in the Emergency Department, when patients get discharged, they
get printed instructions in their discharge packet. The information in this packet ideally should have
already been discussed with them by the provider that saw them while they were in the Emergency
Department and should ideally be discussed again by the discharging nurse. In real life, sometimes at
least one of these discussions does not take place, most often the one that should be done by the
Emergency Department provider. This leaves a large responsibility on the shoulders of the
discharging nurse.
Emergency Department Family Nurse Practitioner
As a Family Nurse Practitioner in the Emergency Department, the opportunity to change this
is offered up. However, one more change needs to be made for the smoking COPD patient in the
Emergency Department: smoking cessation education and resources should be provided. As
mentioned in the introductory paragraph, many of the COPD smokers are still smoking. From
personal Emergency Department nursing experience, many of the patients encountered have the
mindset that they have already damaged their lungs, so there is no sense in trying to quit now.
However, it has been shown that smoking cessation is the single best intervention in slowing down
the disease process of COPD and decreasing the signs and symptoms; smokers also tend to need
intense education and follow-up in order to be successful in smoking cessation (Gratziou et al.,
2014). Obviously, this cannot all be done in the Emergency Department; but if it can be started there,
then possibly the initial prompting will inspire more smoking COPD patients to stop.
A trial that was done in 2015 studied whether or not a predischarge bundle instituted in one
particular hospital had any effect on decreasing return visits to the Emergency Department and
readmissions to the hospital. This bundle had a screening tool and an educational tool that were
given to patients who were in acute exacerbations of COPD while in the Emergency Department.
The study was conducted over a period of three years and included 172 patients, which were
NR 505 Week 6 Assignment: The COPD Patient in the ED: Education for Smoking
Cessation
,COPD SMOKERS 2
The COPD Patient in the ED: Education for Smoking Cessation
Working in any Emergency Department across the country, one can count on seeing COPD
patients that smoke tobacco in some form or another. A number of these patients have quit smoking,
but many more continue to do so. While not all COPD patients are smokers, smoking is the biggest
risk factor for developing COPD (Lo Tam Loi et al., 2013). Many of these COPD patients that
smoke continue to do so, even with having symptoms of respiratory illness, and many times require
intensive assistance to stop smoking. One such study found that smokers who were given an
intensive smoking cessation program did much better over the long term (Gratziou et al., 2014). The
goal of this paper is to discuss the COPD smoker that comes into the Emergency Department and
whether or not smoking cessation education while in the Emergency Department assists the patient
with smoking cessation. Discussions will include how this issue impacts the Master of Science in
Nursing Family Nurse Practitioner specialty track; what the issue actually is, why it is an issue, and
discussing how the literature has been researched for this paper; and a conclusion, providing a
summary of the key elements, discussing expected outcomes for this project proposal, and self-
reflection regarding this assignment.
Application to Selected MSN Program Specialty Track
There are several ways to apply the issue of the smoking COPD patient coming into the
Emergency Department over and over because of their illness, and being able to assist them with
education while they are in the Emergency Department regarding smoking cessation. This writer is
currently working in the Emergency Department as a Registered Nurse, but will possibly not be
continuing employment in the Emergency Department as a Family Nurse Practitioner. This has not
been completely decided yet, so for the purpose of this paper both aspects will be discussed.
Description of Impact to Family Nurse Practitioner Specialty Track
, COPD SMOKERS 3
The majority of the time in the Emergency Department, when patients get discharged, they
get printed instructions in their discharge packet. The information in this packet ideally should have
already been discussed with them by the provider that saw them while they were in the Emergency
Department and should ideally be discussed again by the discharging nurse. In real life, sometimes at
least one of these discussions does not take place, most often the one that should be done by the
Emergency Department provider. This leaves a large responsibility on the shoulders of the
discharging nurse.
Emergency Department Family Nurse Practitioner
As a Family Nurse Practitioner in the Emergency Department, the opportunity to change this
is offered up. However, one more change needs to be made for the smoking COPD patient in the
Emergency Department: smoking cessation education and resources should be provided. As
mentioned in the introductory paragraph, many of the COPD smokers are still smoking. From
personal Emergency Department nursing experience, many of the patients encountered have the
mindset that they have already damaged their lungs, so there is no sense in trying to quit now.
However, it has been shown that smoking cessation is the single best intervention in slowing down
the disease process of COPD and decreasing the signs and symptoms; smokers also tend to need
intense education and follow-up in order to be successful in smoking cessation (Gratziou et al.,
2014). Obviously, this cannot all be done in the Emergency Department; but if it can be started there,
then possibly the initial prompting will inspire more smoking COPD patients to stop.
A trial that was done in 2015 studied whether or not a predischarge bundle instituted in one
particular hospital had any effect on decreasing return visits to the Emergency Department and
readmissions to the hospital. This bundle had a screening tool and an educational tool that were
given to patients who were in acute exacerbations of COPD while in the Emergency Department.
The study was conducted over a period of three years and included 172 patients, which were
