title: Development of a Tobacco Cessation Clinical Decision Support System for Pediatric Emergency Nurses.
abstract: Almost 50% of children who visit the pediatric emergency department are exposed to tobacco smoke. However, pediatric emergency nurses do not routinely address this issue. The incorporation of a clinical decision support system into the electronic health record may improve the rates of tobacco exposure screening and interventions. We used a mixed-methods design to develop, refine, and implement an evidence-based clinical decision support system to help nurses screen, educate, and assist caregivers to quit smoking. We included an advisory panel of emergency department experts and leaders and focus and user groups of nurses. The prompts include the following: (1) "Ask" about child smoke exposure and caregiver smoking; (2) "Advise" caregivers to reduce their child's smoke exposure by quitting smoking; (3) "Assess" interest; and (4) "Assist" caregivers to quit. The clinical decision support system was created to reflect nurses' suggestions and was implemented in five busy urgent care settings with 38 nurses. The nurses reported that the system was easy to use and helped them to address caregiver smoking. The use of this innovative tool may create a sustainable and disseminable model for prompting nurses to provide evidence-based tobacco cessation treatment.
authors.affiliation: Author Affiliations: Division of Emergency Medicine (Drs Mahabee-Gittens and Dexheimer); Department of Biomedical Informatics and Department of Pediatrics (Dr Dexheimer), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Ohio; and Department of Family and Community Medicine, University of Arizona, Tucson, Arizona (Dr Gordon).
authors.forename: E Melinda
authors.initials: EM
authors.lastname: Mahabee-Gittens
authors.forename: Judith W
authors.initials: JW
authors.lastname: Dexheimer
authors.forename: Judith S
authors.initials: JS
authors.lastname: Gordon
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D020000:Decision Support Systems, Clinical; D004636:Emergency Service, Hospital; D005260:Female; D017144:Focus Groups; D006801:Humans; D010290:Parents; D010353:Patient Education as Topic; D010371:Pediatric Nursing / Q000379:methods*; D011795:Surveys and Questionnaires; D020340:Tobacco Use Cessation