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Alcohol abuse screening/brief interventions in community hospital emergency department
Date:8/24/2009

e project was divided into two phases over a year. The first phase involved meeting with key stakeholders to gather information and feedback on the SBI delivery model design and implementation. The feedback was then used to adapt the proposed SBI model design for the community hospital and train the staff. Phase two focused on the implementation and adoption of the SBI into the ED setting in the community hospital over a 6-month period. The research study design team included ED physicians, a clinical psychologist, experimental psychologist and project coordinator, along with a research assistant who was present in the ED to record the extent of adoption into the ED's practice.

Mello says, "Our research identified numerous barriers, with key stakeholders expressing concern over potential disruption to the clinical practice and patient flow; the burden of SBI on staff time, particularly nurses; the willingness of nursing and physician staff to accept the SBI; and staff reluctance to speak to patients about alcohol-related issues when not directly related to a patient's chief complaint. These are all understandable concerns."

As a result, the SBI model was modified to address the concerns. The implementation was limited to an area of the ED for non-critical patients, active participation was limited to physicians only who would evaluate using the screening tool and then refer patients screening positive to a research assistant who would then perform the 5- to 10-minute brief intervention.

Prior to the adoption of the SBI model in the community hospital ED, a medical record review revealed that alcohol screening only occurred in 50 percent of patients, and of those, only 23 percent of the positive screens were referred for an alcohol intervention. In the study, during the time period when the research assistant was present in the ED, 90 percent of eligible patients were screened, and 71 percent of those patients were then evaluated by ED s
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Contact: Nancy Cawley Jean
njean@lifespan.org
Lifespan
Source:Eurekalert

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