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Children With Asthma: Risks Created by Smoking Parents


The available literature indicates that secondhand smoking (SHSE) from parents hurts children with asthma and other respiratory diseases causing various complications. The current practice of nursing has not been effective in enabling the parents to address the issue of SHSE. It is paramount to develop an effective approach that will facilitate nursing interventions to have a more significant impact on concerned parents.

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To ensure that the desired outcome related to the SHSE problem is resolved, this paper proposes to establish a psychosocial intervention. The activities that should be included in the intervention are counseling, peer support, health education, and also the provision of incentives for pregnant women. The health education component is critical as it enables the women to develop an understanding of the principles behind the need to institute the interventions for the SHSE. Using peer support has been shown to allow women to depend on each other to ensure that they can face the current challenges and share success stories. The counseling component of the intervention will make sure that the women are in a position to discuss the emerging challenges during the period of the intervention. The incentives are critical in enabling the mothers to have some extra motivation and be effective especially in regions where the SHSE cases involve the teenage mothers.

Change Plan

The “Johns Hopkins Nursing Evidence-Based Practice Model,” serves as a tool that facilitates nurse practitioners to incorporate the most recent research findings as well as the best practices into their care. Nurses need to consider using the Johns Hopkins EBP tool as it serves as a guide hence ensuring that they do not miss critical aspects of evidence-based care.

Practice Question

Recruitment of the Interprofessional Team

The psychosocial intervention that has been identified to manage the SHSE problem will require various stakeholders to address it adequately. The team members will include a nurse, a social worker, and a counselor.

Develop and Refine the EBP Question

The question will seek to identify how smoking reduction can be used to address the SHSE to ensure cessation and prevent relapse. The patients under this question are the children aged between 0-12 with asthma or other related respiratory conditions. The intervention aims at providing the postpartum reduction of smoking. Compared with the existing interventions, the current intervention will encourage cessation and prevent a relapse. The desired outcome is to make a decision on which strategy will be most effective in managing the patients.

Define the Scope of the EBP

SHSE is a growing healthcare problem with serious ramifications. SHSE results in the death of over 34,000 infants annually and results in health conditions such as lung disorders including cancer, heart disease, and stroke among the remaining population. The issue places a burden on the healthcare resources on a broader scale as more finances have to be allocated to deal with the emerging conditions that arise from the SHSE.

Determine the Responsibilities of Team Members

The nurse will be involved in identifying the patients during their visits to the hospital and recruiting them into the program. The nurse will also provide the health education component of the intervention. The social worker will facilitate peer support as well as the incentive components while the counselor will provide the required counseling for the patients.

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Conduct Internal/Eternal Search for Evidence and Appraisal of Evidence

To develop an effective EBP intervention, several studies were reviewed which contained both systematic reviews and also used quantitative and qualitative data. The research articles that were used in gathering the evidence were of high quality as they had been peer-reviewed and had identified gaps in their results which aided the process of translating the outcomes obtained.

Summarize the Evidence

For the SHSE related issues to be addressed adequately, the existing literature indicates that there is a need to establish a significant bond between the parent and the child (Rosen, Noach, Winickoff, & Hovell, 2012). Based on the available literature, regular smoking cessation interventions are crucial for the successful termination of the habit. The termination facilitates the recovery of the children with respiratory issues and helps in the management of the needs of the children with asthma (Brown, Luckett, Davidson & Giacomo, 2015). Self-reporting is a critical aspect of the intervention to prevent SHSE as it encourages the mothers to remain committed to the process of management. There is a need to address the issues related to the SHSE in a broader perspective which seeks to develop tools that are beyond the ones guiding the existing interventions (McDermott, Nicholson & Tyc, 2013).

Develop Recommendations for Change Based on Evidence

Based on the evidence obtained from the literature, providing the required education for the patients and facilitating them with the prerequisite social interventions is the most effective intervention that can be employed by the team. The health education session should begin within the first contact with the at-risk patients during the clinic visits. The social worker will ensure that they organize regular peer support sessions within the hospital as it is will ensure easy access to the clients and reduce defaulter rates. The counseling sessions will be individualized for each of the clients to ensure that it provides maximum support.


Action Plan

The following steps outline the implementation of the intervention in practice:

  1. Brief the team about the intervention and develop the goals of the project.
  2. Develop an educational plan on the impact of SHSE on the children.
  3. Lease with the hospital administration to allocate the space for project interventions.
  4. Allocate Monday, Wednesday, and Friday for the counseling sessions and peer meetings.
  5. Allocate the team to their duties in the project.
  6. Evaluate the outcomes of the project.

The evaluation of the intervention will be based on the number of self-reported cases of smoking cessation among the participants.

Evaluating Outcomes and Reporting Outcomes

The desired outcome is the increase in the number of women who stop smoking habits and avoid relapse. To estimate the outcome, the number of women who cease smoking and avoid relapse will be evaluated against the pre-intervention period to evaluate if there is a reduction.

Identify Next Steps

Once the intervention is identified as successful, the hospital administration will be contacted to allow it to be utilized as a standard process of care for the patients.

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Disseminate Findings

Within the hospital where the intervention will be taking place, the results will be disseminated using presentations and briefing reports. For the wider nursing community, the results will be disseminated through a peer-reviewed research article.


The problems presented by the SHSE are shown to be on the rise within the existing literature. Taking up an integrated approach that focuses on prenatal interventions will be beneficial in identifying if the strategy can be used to address the issue. It is a prerequisite that a reliable solution is identified using the EBP tools to eliminate the burden of the issue on the wider healthcare system.


Brown, N., Luckett, T., Davidson, P. M., & Giacomo, M. D. (2015). Interventions to reduce harm from smoking with families in infancy and early childhood: A systematic review. International Journal of Environmental Research and Public Health, 12(3), 3091-3119. Web.

McDermott, M. J., Nicholson, J. S., & Tyc, V. L. (2013). Accuracy and concordance in reporting for secondhand smoke exposure among adolescents undergoing treatment for cancer and their parents. Journal of Adolescent and Young Adult Oncology, 2(3), 125-129. Web.

Rosen, L. J., Noach, M. B., Winickoff, J. P., & Hovell, J. P. (2012). Parental smoking cessation to protect young children: A Systematic review and meta-analysis. Pediatrics, 129(1), 141-152. Web.

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