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Smoking Cessation Drop in Clinics Protocol

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Smoking Cessation Drop in Clinics Protocol

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									                      Tees Startstopping Service

Protocol for Smoking Cessation Drop-In Clinics
                In Langbaurgh

1.      Clients who present at any Smoking Cessation Drop-In clinic
        will be greeted by a member of staff who has completed the
        Tees Startstopping Service Intermediate training.

2.      Patients for Zyban will be assessed, and referred back to
        GP.

        a) Those interested in using Zyban will be informed of any
           Contraindications, possible side effects and treatment
           regime. A clients Referral form or a Self Referral form
           should be completed and given to the client to inform the
           GP that a full assessment has been carried out using a
           white questionaire, (This should be returned to Tees
           Startstopping Service using a pre-addressed envelope).
           It is important that the client is aware that the final
           decision to prescribe will be the GP's, as any
           contraindications need to be discussed with the GP. The
           BNF also recommends that clients should have their BP
           checked before commencing Zyban and every two weeks
           during treatment. (Pre–prepared letter to be included).

3.      Clients who are pregnant will be assessed, and referred back
        to GP.

        a) Those who are pregnant should have a full assessment
           completed. The client should sign to confirm that she
           is aware of the risks and benefits of using Nicotine
           Replacement Therapy during pregnancy. Client details
           to be forwarded in a pre-addressed envelope to the
           Smoking Cessation Pregnancy Specialist Advisor for extra
           support using the blue questionaire. Client Referral form
           or a Self Referral form should be completed and given to
           the client to inform the GP that a full assessment has
           been carried out




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4.      Clients under 18 years of age will be assessed, and referred
        back to GP.

        a) The clients Referral form or a Self Referral form should be
           completed and given to the client to inform the GP that a
           full assessment has been carried out. ( Return completed
           white questionaire to Tees Startstopping Service using a
           pre-addressed envelope).

5.      Clients requesting Allen Carr Session to be referred to
        Smoking Cessation Service/Health Promotion.

6.      Excluding the above clients highlighted in numbers 2-5 all
        other clients will be given a Hand Held Record to complete.

        a)       Hand Held Record - To be completed in readiness for
                 the Nurse Prescriber. NB - please ensure that Ethnicity
                 Code and Post Codes are recorded.

        b)       The client should be informed that the Tees
                 Startstopping Service will be contacting them at regular
                 intervals throughout their quit attempt, and that they
                 can contact the service themselves for further help and
                 support. The client should then sign the front sheet of
                 the hand held record.

        c)       Drop-In venue to be inserted in box on front sheet, to
                 allow for correct monitoring data.

        d)       Any relevant Medical History and details of any current
                 medication should be noted. The Nurse Prescriber will
                 be responsible for checking medications for
                 interactions etc.

        e)       The Fagerstrom Score should be completed and
                 relevance to treatment discussed with client.

        f)       The motivational tools can be used to identify to the
                 client their motivation and confidence for change. This
                 will help them to highlight coping strategies.

        g)       Samples of each of the NRT products will be available
                 to aid assessment.

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        h)       Client will be informed of treatment regimes and any
                 possible side effects of each product.

        i)       Carbon Monoxide reading to be taken and recorded on
                 front page. Client to be informed of score and why the
                 level is of importance.

        j)       The nurse prescriber must sign and date the completed
                 assessment.

        k)       Nurse prescriber's are unable to prescribe more than
                 one product, other options should be discussed and
                 refer back to GP for further product using a pre-
                 prepared letter. (This is in line with the National
                 Institute of Clinical Excellence guidelines). It is
                 important to stress that the second product should only
                 be used as and when required and not as stated in the
                 product information.

        l)       After assessment by the Nurse Prescriber if there are
                 any contraindications, (See BNF), to prescribing
                 Nicotine Replacement Therapy the clients Referral
                 form or Self Referral form should be completed and the
                 client referred back to the GP, (using a pre-prepared
                 covering letter).

        m)       Client to be given Tees Startstopping Service booklet
                 "Top Tips" and “ NHS Giving Up For Life ”.

        n)       A two-week follow up appointment should be agreed
                 with the client and recorded in the Hand Held Record.

6.      All clients are to be seen and assessed by a Nurse
        Prescriber prior to each prescription.

7.      After initial assessment has been completed one copy of
        the front page should be placed in pre-addressed
        envelope and returned to Tees Startstopping Service.
                    * This is essential for data collection*

8.      The client will be given their Hand Held Record to take
        away. They will be given a list of all Drop-In clinics in


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        Langbaurgh and will be able to attend any Drop-In for
        further prescriptions or support.

9.      The Hand Held record contains sheets to be used by the
        Nurse Prescriber in place of the prescribing triplicate
        book. One copy to remain in Hand Held Record, one
        copy to GP surgery and one copy to be kept by
        prescriber.

10      After four weeks post quit date one copy of this
        completed page should be returned to Tees
        Startstopping Service using the pre-addressed
        envelopes. The clients CO reading should be 10ppm or
        below to justify further prescriptions of NRT.
                *This is essential for data collection*




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