Evaluation of clinical practice improvement programs for nurses for the management of alcohol withdrawal in hospitals
Michelle Daly
North Coast Area Health Service, Riverlands Drug & Alcohol Centre, Lismore NSW
Stephen Kermode
School of Health and Human Sciences, Southern Cross University, Lismore NSW
David Reilly
Clinical Psychologist; Former Area Manager Drug and Alcohol Services, North Coast Area Health Service, Riverlands Drug & Alcohol Centre, Lismore NSW
PP: 98 - 107
Abstract
The most common alcohol-related chronic condition for hospitalisation is alcohol dependence which can lead to an alcohol withdrawal syndrome (AWS). The aim of this paper is to report on a quality improvement program in an Australian rural area health service for the screening and management of alcohol withdrawal and the effect of two types of nursing education and training approaches: a self-directed competency training package and a more traditional in-service program.
The measure of improvement was compliance to nine clinical standards or core competencies for the assessment and treatment of the AWS derived from the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) scale and the NSW drug and alcohol withdrawal clinical practice guidelines. An audit of medical records using a standardised protocol for the nine standards was conducted at baseline (n=100) and follow-up (n=340) across eleven hospitals in the area.
Results indicated that in three hospitals, where 70 nurses completed the self-directed competency training, there was a higher total compliance score across the nine standards compared to eight hospitals where 238 nurses received the in-service program. The self-directed competency program was also rated highly by nurses who participated in the program.
The benefits of self-directed competency training are discussed as well as future recommendations for improving nurse education strategies for managing alcohol withdrawal.
Keywords
nursing, education, alcohol withdrawal, alcohol-related hospital admissions
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