Implementation of Alcohol Withdrawal Program in a Medical-Surgical Setting: Improving Patient Outcomes

Abstract

Nurses in all settings care for patients who have underlying alcohol dependencies. Approximately 18-20% of patients in ambulatory settings have alcohol abuse or dependency problems, and 30-50% of all hospital admissions are related to the effects of alcohol abuse. Yet clinicians practicing in hospitals frequently have minimal training in the field of chemical dependency. Nurses practicing in general acute care facilities must assess for and intervene with the withdrawal process when alcohol-dependent patients are hospitalized for medical or surgical treatment. This study hypothesized that, if an alcohol withdrawal program were instituted in a medical surgical setting, patient outcomes might be improved. An alcohol program was developed and instituted at a large urban, teaching, community hospital. Variables were compared between the alcohol abusiveldependent populations preprogram and postprogram implementation. The results demonstrated a 78% reduction in the occurrence of delirium tremens, a 67% reduction in the need for restraints and/or sitters, a 21% reduction in the against-medical-advice discharge rate, a decrease in average length of stay of 1.1 days, and a 4% improvement in offering psychosocial interventions between the preprogram and the postprogram populations.