published

Smoking in Pregnancy Project Report: June 2012
2.2.6 Queen Alexandra Hospital, Portsmouth
Finally, as part of its programme of work, the NCSCT was also testing an alternative electronic
referral system designed for use within secondary care settings. This system allocated patients
to the most suitable stop smoking service based upon the patient’s postcode. Within this
pilot the maternity inpatients ward at the pilot hospital, Queen Alexandra Hospital in
Portsmouth, were included. The maternity ward itself was not originally identified as a
setting to include within the project; however it became apparent that many of the midwives
had voluntarily completed the online very brief advice (VBA) training as part of the pilot and
were keen to become involved. According to the local protocol, it was already policy on the
ward to identify smokers upon admission and automatically refer pregnant smokers to the
local stop smoking service unless they specifically requested that this did not happen.
Following discussions with the Deputy Head of Midwifery, it was agreed that an action plan
would be developed to support implementation. This involved:
1. Identifying an administrative member of staff who could access the relevant functions
on the hospital system (PAS)
2. All ward staff accessing the VBA training. Information about the VBA training was
cascaded to all ward staff via their management teams
3. Implementing supportive resources such as the referral labels that were affixed to the
patient’s paperwork to indicate to the administrator that a referral was required
The referral process was first discussed with maternity in November 2011. However, the
pilot did not go ‘live’ in the maternity unit until 16 January 2012, as there was a delay with
accessing the internal IT training required to use the hospital’s electronic system.
2.2.6.1 CO testing at time of delivery
CO testing was not included within the Streamlined Secondary Care System however so,
the maternity wards including the labour ward, were also asked to capture CO levels from
women upon admission. This was included to reflect NICE guidance and to also briefly test
the use of CO to support greater accuracy of smoking at time of delivery (SATOD) reporting,
the intention being to suggest whether more detailed testing in this area could be recommended.
Information about the monitoring process was provided (see example guidelines in annex
C) and following discussions with the senior midwifery manager, a simple monitoring form
was developed to support the collection of the data required for the pilot. Additional
guidance and demonstrations regarding CO monitoring were provided to staff during
handover meetings and shifts. Ward visits were repeated throughout the pilot to collect the
monitoring forms and to show any outstanding members of staff how to use the monitors.
This element of the pilot ran from 16 January to 31 March.
2.2.6.2 Pilot adaptations
Due to a shortage of administrative staff, a member of staff from a different area within
maternity had to be used to input referrals on behalf on the in-patient unit.
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