1. Pevalence of thirdhand smoke in pediatric and neonatal intensive care units
Cassie Anzalone, Jessica Nizich, Victoria Shaffer with special thanks to Michelle Ames, MSN, RN | Binghamton University
Practice Problem
Pediatric and neonatal patients are involuntarily exposed to thirdhand
smoke. This exposure can put them at risk for developing respiratory
infections and illnesses.
Background
Interventions
Methodology
Purpose
Conclusion
References
Increasing evidence of the harmful effects of thirdhand smoke supports the
risk of children and infants in the hospital developing asthma and other
respiratory infections from their physical interactions with smokers. There
is concern that the patients’ exposure to clothing and other items
associated with smokers will contribute to negative alterations in their
health. This exposure may also lead to more diagnoses of respiratory
issues and a longer hospital stay which will further result in an increase of
cost. A study conducted in a NICU looked at thirdhand smoke exposure in
infants and found that infants of smokers had high cotinine levels and the
incubators, cribs, and hospital furniture were positive for nicotine (Northrup,
Khan, Jacob, Benowitz, Hoh, Hovell, Matt, & Stotts, 2015).
The purpose of this study is to decrease the amount of pediatric and
neonatal respiratory diagnoses by decreasing thirdhand smoke exposure.
Objectives:
• Nurses and parents will be surveyed on their knowledge and perceptions
of thirdhand smoke.
• Hospital will provide in-service education on thirdhand smoke to nurses.
• Nurses will provide cessation counseling and education to parents on
thirdhand smoke.
• All units will implement informational posters about thirdhand smoke.
• All units will provide gowns and wipes for parents/visitors and nurses to
use if they choose.
Northrup, T. F., Khan, A. M., Jacob, P., Benowitz. N. L., Hoh, E., Hovell, M. F., Matt,
G. E., & Stotts, A. L. (2015). Thirdhand smoke contamination in hospital settings:
Assessing exposure risk for vulnerable paediatric patients.Tobacco Control, 2015;
tobaccocontrol-2015-052506 doi:10.1136/tobaccocontrol-2015-052506
Tyc, V. L., Huang, Q., Nicholson, J., Schultz, B., Hovell, M. F., Lensing, S., & ...
Zhang,H. (2013). Intervention to reduce secondhand smoke exposure among
children with cancer: A controlled trial. Psycho-Oncology, 22(5), 1104-1111.
doi:10.1002/pon.3117
Two surveys were created to assess nurse and parent knowledge on
thirdhand smoke. The data collected will be analyzed and will support the
need for intervention.
The poster (below) will be posted on the unit and gowns and wipes will be
provided for nurses and parents/visitors to use when they come in contact
with a patient after smoking. Nurses will be able to provide cessation
counseling and education on thirdhand smoke to parents after receiving in-
service education regarding the topic.
Results
These interventions should be adopted across all pediatric and neonatal
units. The proposed interventions would hopefully decrease the amount of
thirdhand smoke exposure to pediatric patients. This decrease in exposure
may contribute to a decrease in pediatric respiratory illnesses and the
decrease of healthcare costs.
Past studies have shown that cessation counseling and education on the
effects that cigarette smoke has on children have lead to a decrease in
children’s amount of exposure to cigarette smoke (Tyc, Huang, Nicholson,
Schultz, Hovell, Lensing, & … Zhang, 2013).