Spotlight: Johnny Woodard, MSN, RN-BC
Manager, VPH Patient Care Services
Vanderbilt Psychiatric Hospital
Type of project: Randomized controlled trial
Title of project: Optimizing Nicotine Replacement Therapy for the Inpatient Psychiatric Patient
Description of project: A control and intervention group was utilized in order to compare the management of nicotine withdrawal symptoms for voluntary inpatients hospitalized with a primary diagnosis of a substance-use disorder. The control group received standard treatment (a daily transdermal 21mg. nicotine patch). The intervention group received standard treatment, plus the availability of 2mg. nicotine gum every two hours for nicotine withdrawal symptom and craving management.
Why you chose this project: Psychiatric patients are 70 percent more likely to use tobacco than the general population. Given this prevalence, and that abrupt nicotine withdrawal may compound symptoms and frustration for the psychiatric inpatient, this project was designed in order to compare the withdrawal symptom management of tailored nicotine replacement therapy vs. monotherapy.
Presentation and publication as a result of this project (poster, podium or publications):
Optimizing Nicotine Replacement Therapy for the Inpatient Psychiatric Patient. Poster presented at the American Psychiatric Nurses Association’s conference in Hartford, Connecticut (October, 2016).
Implications of findings for nurses or recommendations for future research:
Although statistical significance was not realized, perhaps due to the small sample size, feasibility and clinical significance was demonstrated. Combination NRT was described by study participants as instrumental in managing symptoms associated with nicotine withdrawal.
Staff responses to the availability of combination NRT were positive. Staff were inquisitive as to the potential for changing NRT practice.
Significant patient responses included:
- “It’s so hard to come into the hospital for addiction treatment in the first place, then, when you smoke as much as I do, that’s just one more thing to battle.”
- “I’ve left against medical advice many times before. The gum and the patch helped me feel like I wasn’t climbing the wall wanting a cigarette.”
Johnny Woodard, MSN, RN-BC
Manager, VPH Patient Care Services
Vanderbilt Psychiatric Hospital
615-327-7085