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Beyond the blue line Evaluating Galway University Hospitals Tobacco-free Campus Initiative. Dr. David S. Evans Ms. Maria Faney Ms. Laura Mc Hugh Ms. Irene O Byrne Ms. Deirdre Goggin. Introduction. Leading cause of preventable death 5 million worldwide 5200 in Ireland
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Beyond the blue lineEvaluating Galway University Hospitals Tobacco-free Campus Initiative Dr. David S. Evans Ms. Maria Faney Ms. Laura Mc Hugh Ms. Irene O Byrne Ms. Deirdre Goggin
Introduction • Leading cause of preventable death • 5 million worldwide • 5200 in Ireland • Significant advances in last decade • 2004 smoking ban • Smoking prevalence reduced • Need to build on success • Smoking related death rates 9% higher than European average • Smoke pollution migrating into buildings
HSE Tobacco Control Framework 2010 • Health services and professionals have a fundamental role in reducing the impact of smoking • Acknowledged need to develop a HSE tobacco free policy • ensure healthy environment for all that use its facilities • Tobacco Free Policy developed from which GUH developed its own policy
GUH Tobacco Free Policy • Introduced February 2012 “…prohibits smoking anywhere on the campus including doorways, entrances, walkways, roads, car parks, cars parked on GUH grounds, bicycle sheds and bus shelters on GUH grounds.”
GUH Tobacco Free Policy (cont.) • All staff have a role in implementing • inform those who breach policy that they are not allowed to smoke and offer information on support services • security staff have specific role in ensuring compliance • Policy to be reviewed in 2013
Aims and objectives • Aim • Assess compliance with GUH Tobacco free Campus policy • Objectives • Undertake observation audit of compliance by staff, visitors, and patients • Undertake a count of cigarette butts at key locations outside GRH
Method • Observation audit • Key locations at each hospital campus (e.g. main and secondary entrances, outside seating areas, car parks) • 7 days over 2 week period at each hospital • 4 times per day • Visiting times, times when staff having break • Followed a pre determined route and at each location observed number of smokers classified by staff, patient, and visitor
Method (cont.) • Count of cigarette butts • Collected and counted at each location • Background information (e.g. weather conditions, presence of no smoking signs)
Results of observation audit • 11% of people within the hospital grounds were smoking. • 52% of all smokers were observed outside the perimeter entrance with 48% within the hospital grounds. • 57% of those smoking within the hospital grounds were visitors, 33% patients, 10% staff. • 68% of those smoking outside the hospital perimeter were staff, 31% visitors and 1% were patients. • Main and secondary entrances main areas where smoking was observed
Results of count of butts • 3674 butts over 14 days • 35 cigarette butts on average were collected within the hospital grounds during each observation period • An average of 28 butts were collected outside the hospital perimeter during each observation period. • Main and secondary entrances were the main areas within the perimeter of GRH hospitals where butts were collected
Comparing hospitals • The overall proportion of smokers observed on hospital grounds did not significantly differ between UHG (11%) and Merlin Park (10%) hospitals. • At the perimeter, significantly more people were observed and cigarette butts collected at UHG. • The average number of smokers observed outside the main entrance and at the perimeter entrance was significantly greater at UHG. • The issue of discarded cigarette butts outside hospital entrances and the main perimeter entrance is significantly greater at UHG.
Conclusions • 52% of those smoking whilst visiting GRH are compliant with the Tobacco Free Campus Policy • Positive yet also demonstrates scope for improvement in terms of making the GRH campuses completely smoke free.
Recommendations • Set compliance level targets and audit annually • Review enforcement systems • Proactive enforcement by key members of staff • Make role of security staff explicit • Feasibility of modifying existing and new employee contracts • Updating the GRH uniform policy • Examine current initiatives to raise awareness of the policy
Recommendations (cont.) • A system to provide safe access to hospital perimeter • Specific initiatives for UHG need to be developed • Review signage • Consider providing additional smoking areas along the perimeter of hospitals
Thank you Dr. David S. Evans Department of Public Health HSE West Tel +35391775200 david.evans@hse.ie