A Quality Improvement Project for Nurses Caring for Patients with Alcohol Withdrawal Syndrome
Nature and scope of the project
The health consequences of Alcohol Use Disorder (AUD) are associated with a high number of emergency department (ED) visits and inpatient hospital admissions. Individuals with AUD who suddenly stop drinking are at increased risk for alcohol withdrawal syndrome (AWS) and life-threatening consequences. Nursing management of these patients can be challenging, especially when stigmatizing attitudes and a lack of knowledge exist. This quality improvement project aims to expand nursing knowledge and skills in caring for patients with AUD, improve adherence to the Alcohol Detoxification Protocol, and improve attitudes toward patients with AUD.
Synthesis and analysis of supporting literature
Alcohol use disorder is a leading cause of disease burden and can lead to AWS, a potentially life-threatening condition requiring timely and effective management by healthcare providers. The stigma associated with alcohol use can impact the attitudes of nursing staff and can negatively affect the care of these patients. Education on AWS and associated protocols can improve patient outcomes, decrease healthcare costs, and improve nurses’ knowledge and satisfaction.
Project implementation
This project will take place at Northwest Community Hospital (NCH) on the neurology unit, the primary placement for patients with AWS. Staff nurses will attend a 30-minute live educational session reviewing symptoms of AWS, the accuracy, and timeliness of assessments and medication administration, and the terms to avoid with patients with AUD. Nurse champions and resource materials will be available to assist in reinforcement of content.
Evaluation criteria
The evaluation of this project will include three parts: knowledge, skills, and attitudes. Knowledge will be determined by analyzing the results of pre and post-test scores. Nursing attitudes will be evaluated by comparing the before and after Alcohol and Alcohol Problems Perceptions Questionnaire (AAPPQ) overall scores. Finally, skills will be assessed by reviewing adherence to the Clinical Institute Withdrawal Assessment-Alcohol Revised (CIWA-Ar) protocol in the Electronic Medical Record (EMR). The data from the EMR to measure protocol adherence will be the timeliness of assessments, appropriate medication administration, and initiation of the Phenobarbital protocol.
Outcomes
Evaluation data will be compared to the pre-intervention tools and EMR data points.
Recommendations
This project may guide future educational programs for nurses caring for patients with AWS.
A Quality Improvement Project for Nurses Caring for Patients with Alcohol Withdrawal Syndrome