Improving Pre-Anesthesia Staff Knowledge and Counseling Practices on Smoking Cessation

Abstract

Background: Smoking is a modifiable risk factor that increases the risk of many postoperativecomplications, including delayed wound healing, adverse respiratory events, and prolonged recovery. Evidence shows that preoperative smoking cessation interventions, even brief counseling, can improve surgical outcomes. Purpose: The purpose of this DNP project was to improve the knowledge, attitudes, and practices of pre-anesthesia clinic staff at MountainView Regional Medical Center related to smoking cessation counseling for surgical patients. The aim was to integrate evidence-based smoking cessation education into preoperative counseling workflows to support patient engagement and reduce postoperative complications. Methods: The design of this quality improvement project was a pre- and post-survey educational session to assess the impact of the intervention using a Smoking Knowledge, Attitudes, and Practices (S-KAP) questionnaire. Results: 12 pre-anesthesia clinic nurses participated in the intervention. Knowledge scores improved significantly following the education session (median 22 [IQR 21-23] pre-intervention vs 24.5 [IQR 24-25] post-intervention; Wilcoxon p =.006). Attitudes demonstrated some increase but did not reach statistical significance, with a Wilcoxon p= .36. Practice domain scores increased substantially from a median of 4.5 (IQR 1.5-9.5) pre-intervention to 20 (IQR 15.5-20) post-intervention (p < .001), indicating significant improvement in smoking cessation assessment, counseling, documentation, and referral behaviors. Conclusions: A brief, targeted educational intervention improved pre-anesthesia clinic staff knowledge and significantly increased smoking cessation counseling practices. Integrating structured smoking cessation education into preoperative workflows may be a practical strategy to enhance perioperative risk reduction efforts.