Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Future Healthcare Journal

  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Future Healthcare Journal

futurehosp Logo
  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Nicotine replacement therapy for COVID-19 patients – a quality improvement project to reduce nosocomial COVID-19 infection

Florence Douglas and Mark Shipley
Download PDF
DOI: https://doi.org/10.7861/fhj.9-2-s8
Future Healthc J July 2022
Florence Douglas
ASouth Tyneside and Sunderland NHS Foundation Trust, South Shields, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mark Shipley
Bjob title
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

Introduction

At the beginning of the COVID-19 pandemic there was much publicity and anxiety around nosocomial COVID-19 infections.1–3 While much has been written about preventing further transmission in hospitals,4 one issue that we believe could also be tackled is that of patient–patient spread while smoking outside the hospital.

With the recent introduction of effective vaccines, there are more patients with ‘incidental’ COVID-19 who do not require oxygen and therefore are often able to leave the ward independently. Nicotine replacement therapy (NRT) has been shown to increase the chance of smoking cessation as well as treating nicotine addiction.5 This may therefore encourage patients to remain isolated on inpatient wards. We suspected that NRT prescribing levels would be low and set out to improve this.

Materials and methods

The audit office at the Trust compiled a list of patients between March 2020 to April 2020 with COVID-19 and who were current smokers. Patients on intensive care units were excluded. Inpatient documentation and prescriptions were reviewed to see if NRT was discussed or prescribed.

A poster was created for the doctors’ office of the two COVID-19 wards in November 2021 highlighting the importance of NRT prescription and an order set that was available on the e-prescription system.

In January 2022, a further review was undertaken. Initially this was planned to look at patients over a 2-month period, but this was completed early due to high numbers of patients.

Results and discussion

The initial review comprised 20 patients and the subsequent review comprised 41 patients – all of whom were inpatients with COVID-19 and current smokers.

The results showed that following the intervention, rates of prescribing NRT increased from 15% to 27%. There was also an increase in documentation about offering NRT – from 25% to 49%. These results show a modest increase, although overall disappointing levels of NRT prescribing.

These results reveal high levels of patients declining NRT prescription – the reason for this is not clear.

The second review revealed an increased proportion of patients with ‘incidental’ COVID-19 such as patients with fractures, overdoses or falls. These patients had low levels of NRT discussion and prescribing. The intervention, when designed, had not targeted doctors from non-medical specialties. Many of these patients are more mobile than patients with symptomatic COVID-19 and therefore these patients, in particular, should have NRT prescribed.

Another difficulty encountered in this project was the high turnover of medical doctors on COVID-19 wards due to reliance on locum doctors. Levels of NRT prescription varied greatly depending on which doctor had seen the patient.

Conclusion

Preventing nosocomial infections remains an issue for UK hospitals and increasing NRT prescription rates for COVID-19 patients could be a simple and low-cost initiative. A small intervention has led to some increase in NRT prescriptions by the medical team at our trust. The rise of ‘incidental’ COVID-19 infection has led to an increase in numbers of COVID-19 patients being seen by non-medical doctors and as such further intervention and education for non-medical teams is required.

  • © Royal College of Physicians 2022. All rights reserved.

References

  1. ↵
    1. Wang D
    , Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323:1061.
    OpenUrlCrossRefPubMed
  2. ↵
    1. BBC News
    . Coronavirus caught in Staffordshire hospitals leads to 107 deaths. BBC News, 10 March 2021. www.bbc.co.uk/news/uk-england-stoke-staffordshire-56334292 [Accessed 10 February 2022].
  3. ↵
    1. Loader G
    . Wales Covid deaths: A quarter caught virus in hospital. BBC News, 5 July 2021. www.bbc.co.uk/news/uk-wales-57726939 [Accessed 10 February 2022].
  4. ↵
    1. Du Q
    , Zhang D, Hu W, et al. Nosocomial infection of COVID19: A new challenge for healthcare professionals. Int J Mol Med 2021;47:31.
    OpenUrl
  5. ↵
    1. Hartmann-Boyce J
    , Chepkin SC, Ye W, Bullen C, Lancaster T. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Syst Rev 2018;5:CD000146.
    OpenUrlPubMed
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Nicotine replacement therapy for COVID-19 patients – a quality improvement project to reduce nosocomial COVID-19 infection
Florence Douglas, Mark Shipley
Future Healthc J Jul 2022, 9 (Suppl 2) 8; DOI: 10.7861/fhj.9-2-s8

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Nicotine replacement therapy for COVID-19 patients – a quality improvement project to reduce nosocomial COVID-19 infection
Florence Douglas, Mark Shipley
Future Healthc J Jul 2022, 9 (Suppl 2) 8; DOI: 10.7861/fhj.9-2-s8
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Introduction
    • Materials and methods
    • Results and discussion
    • Conclusion
    • References
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Acute management of suspected vaccine induced thrombocytopenia and thrombosis
  • Pneumothorax and pneumomediastinum in COVID-19
  • An unusual case of superior vena cava syndrome
Show more COVID-19

Similar Articles

FAQs

  • Difficulty logging in.

There is currently no login required to access the journals. Please go to the home page and simply click on the edition that you wish to read. If you are still unable to access the content you require, please let us know through the 'Contact us' page.

  • Can't find the CME questionnaire.

The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. RCP members and fellows (using their login details for the main RCP website) are able to access the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from:  https://cme.rcplondon.ac.uk

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home

Other Services

  • Advertising
futurehosp Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians