提升冠狀動脈心臟病住院病人之戒菸率

Increasing Smoking Cessation Rates in Hospitalized Patients With Coronary Artery Disease

背景：戒菸對冠狀動脈心臟病病人而言，不但可促進其疾病之預後，且可減少猝死的危險性，故戒菸對冠狀動脈心臟病住院病人是非常重要的。 目的：提升冠狀動脈心臟病住院病人之六個月戒菸率達45%以上。 解決方案 經現況分析後發現，冠狀動脈心臟病住院病人戒菸率非常低（0%），故制訂戒菸個案轉介機制、建立個案管理師工作規範及追蹤流程、制訂戒菸指引、增訂戒菸護理指導單張、建置戒菸個案管理資訊系統、醫護人員菸害防制宣導教育為本專案之解決方案。 結果：冠狀動脈心臟病住院病人之戒菸轉介率達100%；且六個月戒菸率達50%。 結論：本專案的實施不但推動跨科部合作提升冠狀動脈心臟病住院病人戒菸率外，也發揮戒菸個案管理師之獨特功能，藉系統性地追蹤病人，達勸導戒菸的成效。

Background & Problems: Smoking cessation improves disease prognoses and decreases the risk of sudden death in patients with coronary artery disease. Purpose: This study was designed to increase the six-month smoking cessation rate to more than 45% for hospitalized patients with coronary artery disease. Resolutions: Data analysis found a current smoking cessation rate of zero percent. Strategies to raise this rate significantly included implementing a referral system, regulating case managers and follow-up procedures, providing smoking cessation guidelines, distributing patient education handouts, setting up an information system to facilitate smoking cessation case management, and implementing smoking cessation education programs for health professionals. Results: The smoking cessation referral rate increased to 100% and the six-months smoking cessation rate rose to 50%. Conclusions: This project leveraged interdisciplinary cooperation to increase the rate of smoking cessation in hospitalized patients. It also introduced the unique function of case manager who is charged with systemically following up with patients to improve the effectiveness of smoking cessation programs.