Smoking cessation reduces the risk of death, improves recovery, and reduces the risk of hospital readmission. Evidence and policy support hospital admission as an ideal time to deliver smoking-cessation interventions. However, this is not well implemented in practice. In this systematic review, the authors summarize the literature on smoking-cessation implementation strategies and evaluate their success to guide the implementation of best-practice smoking interventions into hospital settings. The CINAHL Complete, Embase, MEDLINE Complete, and PsycInfo databases were searched using terms associated with the following topics: smoking cessation, hospitals, and implementation. In total, 14,287 original records were identified and screened, resulting in 63 eligible articles from 56 studies. Data were extracted on the study characteristics, implementation strategies, and implementation outcomes. Implementation outcomes were guided by Proctor and colleagues' framework and included acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. The findings demonstrate that studies predominantly focused on the training of staff to achieve implementation. Brief implementation approaches using a small number of implementation strategies were less successful and poorly sustained compared with well resourced and multicomponent approaches. Although brief implementation approaches may be viewed as advantageous because they are less resource-intensive, their capacity to change practice in a sustained way lacks evidence. Attempts to change clinician behavior or introduce new models of care are challenging in a short time frame, and implementation efforts should be designed for long-term success. There is a need to embrace strategic, well planned implementation approaches to embed smoking-cessation interventions into hospitals and to reap and sustain the benefits for people who smoke.

中文翻译：

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医院如何改变实践以更好地实施戒烟干预措施？系统评价

戒烟可降低死亡风险、促进康复并降低再次入院的风险。证据和政策支持住院是实施戒烟干预措施的理想时机。然而，这在实践中并没有得到很好的实施。在这篇系统评价中，作者总结了有关戒烟实施策略的文献，并评估了它们在指导医院环境中实施最佳吸烟干预措施方面的成功。使用与以下主题相关的术语搜索 CINAHL Complete、Embase、MEDLINE Complete 和 PsycInfo 数据库：戒烟、医院和实施. 总共识别和筛选了 14,287 条原始记录，从 56 项研究中筛选出 63 篇符合条件的文章。提取了关于研究特征、实施策略和实施结果的数据。实施结果以 Proctor 及其同事的框架为指导，包括可接受性、采用、适当性、成本、可行性、保真度、渗透性和可持续性。调查结果表明，研究主要侧重于培训员工以实现实施。与资源充足和多组件方法相比，使用少量实施策略的简短实施方法不太成功且持续性较差。虽然简短的实施方法可能被视为有利的，因为它们资源密集度较低，他们持续改变实践的能力缺乏证据。改变临床医生行为或引入新的护理模式的尝试在短时间内具有挑战性，实施工作应着眼于长期成功。有必要采用战略性的、精心策划的实施方法，将戒烟干预措施嵌入医院，并为吸烟者获得和维持利益。