Successful Implementation of an Alcohol- Withdrawal Pathway in a General Hospital

Background Although alcohol use and abuse are common among general-hospital inpatients, many patients are inadequately assessed and treated for alcohol withdrawal. Objective The purpose of this study was to determine whether the implementation of a clinical pathway for the treatment of alcohol withd...

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Bibliographic Details
Published in:Psychosomatics (Washington, D.C.) D.C.), 2008-07, Vol.49 (4), p.292-299
Main Authors: Repper-Delisi, Jennifer, APRN, BC, Stern, Theodore A., M.D, Mitchell, Monique, APRN, BC, Lussier-Cushing, Mary, APRN, BC, Lakatos, Barbara, APRN, BC, Fricchione, Gregory L., M.D, Quinlan, Joan, M.P.A, Kane, Martha, Ph.D, Berube, Rhodes, M.P.H, Blais, Mark, Psy.D, Capasso, Virginia, Ph.D., APRN, BC, Pathan, Firdosh, R.Ph., M.S, Karson, Andrew, M.D., M.P.H, Bierer, Michael, M.D., M.P.H
Format: Article
Language:English
Subjects:
Alcoholism - rehabilitation
Anti-Anxiety Agents - therapeutic use
Benzodiazepines - therapeutic use
Biological and medical sciences
Desintoxication. Drug withdrawal
Ethanol - adverse effects
Female
Health Status
Hospitalization
Hospitals, General
Humans
Institution therapy. Inpatient treatment
Internal Medicine
Male
Mass Screening
Medical sciences
Middle Aged
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Retrospective Studies
Substance Withdrawal Syndrome - drug therapy
Substance Withdrawal Syndrome - etiology
Substance Withdrawal Syndrome - rehabilitation
Treatments
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Summary:Background Although alcohol use and abuse are common among general-hospital inpatients, many patients are inadequately assessed and treated for alcohol withdrawal. Objective The purpose of this study was to determine whether the implementation of a clinical pathway for the treatment of alcohol withdrawal in medical inpatients would result in improvements in clinical practice and patient outcomes. Method Authors retrospectively reviewed 80 patient records (including 40 of those treated before the implementation of a pathway and 40 of those treated after pathway implementation). Results Assessment procedures and ordering patterns of physicians (medical house staff and staff physicians) shifted in a fashion consistent with the new treatment guidelines. Patient outcomes (e.g., length of stay and the incidence of delirium) improved for those patients who received benzodiazepines within the range of the pathway guidelines. Conclusions Timely assessment and staff education can shift prescription patterns, increase patient monitoring, and reduce costs associated with alcohol withdrawal.
ISSN:0033-3182
1545-7206
DOI:10.1176/appi.psy.49.4.292