Limitations
In addition to the convenience sample and the small sample size, there are a number of factors that should be considered in the interpretation of these findings. Without a comparison group, we are unable to confirm if the improvement in the frequency of nurses’ interventions was due to attendance at the educational program or other factors. The nurses who attended these programs and completed the surveys may have been more interested in tobacco control than nurses who did not participate, and thus provided more positive responses. The sample size did not allow for subgroup analysis such as the comparison of never, former, and current smokers. Although each nurse faculty who led the workshop was provided with a packet of educational materials, we were not able to guarantee the fidelity of the delivery of the program at each of the hospitals. This study did not assess increases in knowledge per se, or link nurses’ self-reported frequency of cessation interventions with changes in the number of smokers who received interventions. Similar to the protocol by Katz et al. (2012), future studies might consider providing a direct feedback loop to nurses about their performance. Including smoking cessation interventions as a core part of day-to-day nursing care may be a role change for nurses in the Czech Republic, with competing demands on nurses’ time. In order to attend the program, nurses
needed to be released from patient care, which might have limited the reach of the program. Additionally, although reported in other studies, validation of the nursing education on patient outcomes in terms of actual quit attempts and abstinence with biochemical verification is warranted.