title: Tobacco-Cessation Interventions and Attributes of Individual and Organizational Excellence in Acute Care.
abstract: Despite years of reducing tobacco use, few studies describe to what extent evidence-based tobacco-cessation interventions are a standard of acute and critical care nursing practice using the US Public Health Service 5 A's framework: ask, advise, assess, assist, and arrange.
  
  
  
  To identify relationships between the 5 A's framework, attributes of individual and organizational excellence, and intention to integrate tobacco-cessation interventions as a standard of daily practice among nurses.
  
  
  
  Nurses attending the American Association of Critical-Care Nurses National Teaching Institute were invited to complete a 21-item survey. Data were gathered in Boston, Orlando, and Chicago in a 3-year period. Descriptive statistics and logistic regression were used for data analysis.
  
  
  
  Among 1773 completed surveys, nurses from organizations with standing orders for tobacco dependence were 5 times more likely to have high confidence in their 5 A's skills (odds ratio, 5.037; 95% CI, 3.429-7.400; P < .001) and 3.4 times more likely to have high intentions to integrate tobacco cessation into their daily practice (odds ratio, 3.421; 95% CI, 1.765-6.628; P < .001). Nurses with certifications were more likely to want to learn how to integrate tobacco-cessation interventions (odds ratio, 1.676; 95% CI, 0.990-2.836; P = .05).
  
  
  
  Opportunities abound to create strategies leveraging attributes of nursing and organizational excellence to promote evidence-based approaches to improve health outcomes in acutely and critically ill tobacco-dependent populations.
authors.affiliation: is dean and Warwick Professor of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky. Karen M. Butler is an associate professor, an assistant dean, and a faculty associate for BREATHE, University of Kentucky College of Nursing. Joel G. Anderson is an assistant professor, University of Tennessee College of Nursing, Knoxville, Tennessee. Sarah Craig is an assistant professor, University of Virginia School of Nursing. Claudia Barone is a professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Jeannette O. Andrews is dean and professor of nursing, University of South Carolina, Columbia, South Carolina. Jheath@uky.edu.
authors.forename: Janie
authors.initials: J
authors.lastname: Heath
authors.affiliation: is dean and Warwick Professor of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky. Karen M. Butler is an associate professor, an assistant dean, and a faculty associate for BREATHE, University of Kentucky College of Nursing. Joel G. Anderson is an assistant professor, University of Tennessee College of Nursing, Knoxville, Tennessee. Sarah Craig is an assistant professor, University of Virginia School of Nursing. Claudia Barone is a professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Jeannette O. Andrews is dean and professor of nursing, University of South Carolina, Columbia, South Carolina.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Butler
authors.affiliation: is dean and Warwick Professor of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky. Karen M. Butler is an associate professor, an assistant dean, and a faculty associate for BREATHE, University of Kentucky College of Nursing. Joel G. Anderson is an assistant professor, University of Tennessee College of Nursing, Knoxville, Tennessee. Sarah Craig is an assistant professor, University of Virginia School of Nursing. Claudia Barone is a professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Jeannette O. Andrews is dean and professor of nursing, University of South Carolina, Columbia, South Carolina.
authors.forename: Joel G
authors.initials: JG
authors.lastname: Anderson
authors.affiliation: is dean and Warwick Professor of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky. Karen M. Butler is an associate professor, an assistant dean, and a faculty associate for BREATHE, University of Kentucky College of Nursing. Joel G. Anderson is an assistant professor, University of Tennessee College of Nursing, Knoxville, Tennessee. Sarah Craig is an assistant professor, University of Virginia School of Nursing. Claudia Barone is a professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Jeannette O. Andrews is dean and professor of nursing, University of South Carolina, Columbia, South Carolina.
authors.forename: Sarah
authors.initials: S
authors.lastname: Craig
authors.affiliation: is dean and Warwick Professor of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky. Karen M. Butler is an associate professor, an assistant dean, and a faculty associate for BREATHE, University of Kentucky College of Nursing. Joel G. Anderson is an assistant professor, University of Tennessee College of Nursing, Knoxville, Tennessee. Sarah Craig is an assistant professor, University of Virginia School of Nursing. Claudia Barone is a professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Jeannette O. Andrews is dean and professor of nursing, University of South Carolina, Columbia, South Carolina.
authors.forename: Claudia
authors.initials: C
authors.lastname: Barone
authors.affiliation: is dean and Warwick Professor of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky. Karen M. Butler is an associate professor, an assistant dean, and a faculty associate for BREATHE, University of Kentucky College of Nursing. Joel G. Anderson is an assistant professor, University of Tennessee College of Nursing, Knoxville, Tennessee. Sarah Craig is an assistant professor, University of Virginia School of Nursing. Claudia Barone is a professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Jeannette O. Andrews is dean and professor of nursing, University of South Carolina, Columbia, South Carolina.
authors.forename: Jeannette O
authors.initials: JO
authors.lastname: Andrews
mesh_terms: D000328:Adult; D000368:Aged; D002568:Certification / Q000592:standards; D002983:Clinical Competence; D003422:Critical Care / Q000379:methods*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000592:standards; D016017:Odds Ratio; D009937:Organizational Objectives; D017410:Practice Guidelines as Topic; D016540:Smoking Cessation / Q000379:methods*