Alcohol identification and intervention in English emergency departments

Two UK researchers have conducted a national survey of English EDs to determine current practice regarding alcohol identification and provision of brief advice, and to compare changes in activity to a previous National Survey (conducted in 2011). 

on-the-street-2713688_1920Abstract

Aims
In the ED, alcohol identification and brief advice is an effective method of reducing consumption and related harms. Our objective was to conduct a national survey of English EDs to determine current practice regarding alcohol identification and provision of brief advice and to compare changes in activity to a previous National Survey conducted in 2011.

Methods
This was a cross-sectional survey of all consultant-led EDs in England.

Results
Of 180 departments, 147 (81.6%) responded. All departments may question adult patients about their alcohol consumption, with many (63.6%) asking all patients aged over 18 years as part routine care and using a formal screening tool (61.4%).

The majority of departments asked young people (aged 11–17 years) about their consumption (83.8%), but only 11.6% did so as a part of routine practice. Compared with the 2011 survey, there have been significant increases in routine screening among adults , general practitioners being informed about patients’alcohol-related presentations and access to an alcohol health worker or a clinical nurse specialist. Modest (non-significant) changes were also found in access to training on brief advice (9.7%) and the use of formal screening questions on adult patients (9.7%).

Conclusion Alcohol screening together with referral or intervention is becoming part of routine practice in England. Compared with our previous national survey, increases in alcohol screening and intervention activity are demonstrated, with improvements in routine questioning (among adults), the number of general practitioners being informed about alcohol-related attendances, provision of training, access to specialist services and the use of formal screening tools.

Full reference: Patton, R. & Green, G. | Alcohol identification and intervention in English emergency departments | Emerg Med J | 2018 | 35 |p. 75- 78 | doi http://dx.doi.org/10.1136/emermed-2016-206467

Full text article available from the EMJ here 

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Educating Emergency Department Registered Nurses in Screening, Brief Intervention and Referral to Treatment

Mitchel, A.M. et al. International Emergency Nursing. Published online: December 17 2016

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Highlights

  • SBIRT has been shown to be effective in reducing risky alcohol consumption.
  • Patients trust nurses, underscoring nurses’ ability to have a positive impact.
  • EDRNs can increase their knowledge and attitudes to routinely screen patients for risky substance use.
  • SBIRT training and educational reinforcement is key for continued implementation.

Read the full abstract here

EMERGENCY DEPARTMENT SURVEY OF ALCOHOL IDENTIFICATION AND INTERVENTION ACTIVITY

Alcohol Research UK. Published online: 4 May 2016.

New research published today (4 May) by Alcohol Research UK shows that while more adults are being routinely screened for alcohol-related problems in Emergency Departments in England more specialist support is needed to help young people and the vulnerable.

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Image source: Alcohol Research UK

A new study by researchers based at the University of Surrey, funded by Alcohol Research UK, shows that Emergency Departments in England have increased the level of alcohol screening for adults – with the offer of specialist support for those attending with alcohol-related health problems and for those who frequently attend.

However, while most Emergency Departments attending to under-18s ask them about their drinking few do so routinely. This needs to improve to ensure young people considered to be at risk of developing drink-related ill health receive the specialist support they need.

Key findings from the study show that:

  • Almost two-thirds (63.6%) of adults are routinely questioned about alcohol use (compared to 47.7% in 2011).
  • Routine questioning about alcohol use among under-18s remains limited, with 11.6% being routinely asked about their drinking (up from 8.9% in 2011).
  • Access to Alcohol Health Workers or Clinical Nurse Specialists has increased by 13.4% since 2011 to 85.2% for adults displaying alcohol-related problems.
  • Forty per cent of emergency departments have ‘assertive outreach’ strategies in place to tackle frequent attendance by adult patients affected by alcohol-related problems.
  • Improved communication between Emergency Departments and GPs about alcohol-related attendance highlights a move towards multidisciplinary care, with 85% (compared to 74.8% in 2011) of GPs now routinely informed.

Read the full commentary here

Read the original research report here