Problem definition:There’s a
higher prevalence of preterm births in the USA associated with smoking.
· National Institute for Health and Clinical Excellence
o
National Institute for Health and
Clinical Excellence
§
Produce
public health guidance on interventions aimed at topping smoking in pregnancy
following childbirth
§
Indirect and
direct role
§
Working in:
local authorities, education and wider public, private, voluntary and community
sectors
§
Recommendations
on the basis of reviews of evidence, economic modeling, expert advice and
stakeholder comments
o
The Public Health Interventions
Advisory Committee (PHIAC)
§
Set up by the
NICE committee
o
Benefit from the intervention
§
are
planning a pregnancy
§
are
already pregnant
§
have
an infant aged under 12 months.
o
How do they determine and recommend these
interventions to those:
§
Carbon
Monoxide content: Some suggest a CO level as low as 3 parts per million (ppm),
others use a cut-off point of 6–10 ppm.
§
Take
action: midwives
·
CO
test and explain its physical measure or her smoking and her exposure
·
Provide
information about the risk to the unborn child of smoking while pregnant
·
Health
benefits of stopping
·
Normal
practice to refer all women who smoke for help to quit
·
Refer
to all women who smoke or have stopped smoking within the last two weeks, to
NHS Stop Smoking Services
·
Help
the partner’s that live in the household and second hand smoking
·
If
women declines referral, leave the offer to help still
§
Take
action: action
for others in the public, community and voluntary sectors
·
Target:
o
GPs,
practice nurses, health visitors and family nurses.
o
Obstetricians,
pediatricians, sonographers and other members of the maternity team (apart from
midwives).
o
Those
working in youth and teenage pregnancy services, children's centers and social
services.
o
Those
working in fertility clinics, dental practices, community pharmacies and
voluntary and community organizations.
o
Follow up interventions are effective
in helping women who are pregnant to quit smoking
§
Cognitive
behavior therapy
§
Motivational
interviewing
§
Structured
self help and support from NHS Stop Smoking Services
· Prenatal care staff
o
Ensure services
are delivered in n impartial, client centered manner
o
Sensitive to
their circumstances.
o
Involve thee
women in planning and development of services
o
Ensure flexible
and coordinated services and take place in locations and times that are easy to
access and be tailored to meet individual needs
o
Collaborate with
the family nurse partnership and outreach schemes to identify additional
support
o
Work in
partnership with agencies that support women who have complex social and
emotional needs.
· Partners and other in the household who smoke
o
Clear advice about
the danger that other people’s tobacco smoke poses t the pregnant women and
babe before and after
o
Not smoking
around pregnant woman, mother or baby
o
Multi component
interventions that
§
Contra-indications
and the potential for adverse effects from pharmacotherapies such as NRT
§
The
likelihood that they will follow the course of treatment
§
Their
previous experience of smoking cessation aids.
· The Tobacco Companies
o
Tobacco/cigarretes
taxes to increase
o
Might lose
business
o
They don’t take
advantage of this at all, they will lose customers and promotions as well
o
The issue of
second hand smoking that can also affect pregnant women is an issue
· The pharmaceutical companies
o
The
use of NRT and other pharmacological supply = BAD
o
The use of this
o
Advise pregnant
women who are using nicotine patches to remove them before going to bed
o
Neither
vareniciline or bupropion should be offered to pregnant or breastfeeding women
Work Cited:
Good list of stakeholders.
ReplyDeleteThink of the pregnant women too.
Am not sure what some of the acronyms in your blog mean - like NICE, NRT
Remember to write what these stand for when working on your paper.
I found it hard to follow the bullet points under some of the stakeholders.
Perhaps mentioning the concerns of each stakeholder separately from the interventions would help the reader follow what each bullet point is focused on.
For prenatal staff, how would you involve women in planning services?
For their smoking partners, how would you pass on the advise about the danger of smoking?
Which stakeholders would oppose your interventions? How would you address their concerns?
Great and really organized entry! There are so many stakeholders to mention when dealing with your issue and you mentioned a lot more than I thought of. My only question is if NICE works well as a stakeholder for preterm births in the USA due to smoking as NICE is a UK based organization. I'm not sure if that has any immediate impact on the research but may be worth looking into.
ReplyDelete