Vital alcohol role needs extra funds

Alcohol liaison nurses in hospitals need greater financial support, a report states.

A Power in Clinical Nursing Practice: Concept Analysis on Nursing Intuition

Growing evidence suggests intuition in nursing is an important part of effective clinical decision making that supports safe patient care. In this article, the concept of intuition as it relates to decision-making processes among novice nurses is analyzed.

Older people and alcohol use

The proportion of older people drinking alcohol above the recommended levels has been increasing in the UK. Alcohol dependency and misuse can lead to various physical and psychological problems for older people. A range of factors can influence alcohol dependency and misuse among older adults, which need careful consideration when interventions are being developed to reduce consumption. Interventions to reduce alcohol consumption among older people can include: home visits, telephone support, mentoring, one-to-one and group programmes, family and community engagement programmes, outreach programmes, and targeted support groups focused on education and social activities. There is a need for the training of community nurses focused on improving the detection (screening and assessment), treatment and service provision for older people.

Alcohol reduction starts here

Emma Dermody leads a hospital-based specialist nursing team working with patients who have alcohol-related problems. They aim to reduce admissions by early intervention.

A 'symptom-triggered' approach to alcohol withdrawal management

In acute hospital settings, alcohol withdrawal often causes significant management problems and complicates a wide variety of concurrent conditions, placing a huge burden on the NHS. A significant number of critical incidents around patients who were undergoing detoxification in a general hospital setting led to the need for a project to implement and evaluate an evidence-based approach to the management of alcohol detoxification-a project that included a pre-intervention case note audit, the implementation of an evidence-based symptom-triggered detoxification protocol, and a post-intervention case note audit. This change in practice resulted in an average reduction of almost 60% in length of hospital stay and a 66% reduction in the amount of chlordiazepoxide used in detoxification, as well as highlighting that 10% of the sample group did not display any signs of withdrawal and did not require any medication. Even with these reductions, no patient post-intervention developed any severe signs of withdrawal phenomena, such as seizures or delirium tremens. The savings to the trust (The Pennine Acute Hospital Trust) are obvious,but the development of a consistent, quality service will lead to fewer long-term negative effects for patients that can be caused by detoxification. This work is a project evaluation of a locally implemented strategy, which, it was hypothesised,would improve care by providing an individualised treatment plan for the management of alcohol withdrawal symptoms.

The role of community nursing in providing integrated care for older people with alcohol misuse

Alcohol misuse in older people is a growing problem for health and social care providers, but remains largely hidden from public view and therefore largely overlooked by commissioners. Many older people with alcohol misuse have a 'dual diagnosis' (alcohol misuse accompanying other mental disorders) rather than alcohol misuse alone, which requires specialist nursing expertise. Over the past 10 years, assessment of and interventions for the detection of alcohol misuse in older people have been developed within one London borough. This article details the background, strategy and outcomes of this service, which provides integrated care in a multi-disciplinary community mental health team covering an inner-city area with a high prevalence of alcohol misuse and dual diagnosis in older people.

The relationships of sexual identity, hazardous drinking, and drinking expectancies with risky sexual behaviors in a community sample of lesbian and bisexual women

This study examined the influence of demographic characteristics, sexual identity, hazardous drinking, and sexuality/intimacy enhancement alcohol expectancies on rates of risky sexual behaviors in a community sample of women who self-identified as lesbian, mostly lesbian, and bisexual (N = 349). Structured interview data were collected as part of a larger longitudinal study of sexual minority women's health, the Chicago Health and Life Experiences of Women study. We used structural equation modeling, controlling for demographic characteristics, to evaluate the influence of sexual identity, hazardous drinking, and alcohol-related sexuality/intimacy enhancement expectancies on sexual risk behaviors. Controlling for demographic characteristics and for sexual identity, higher levels of both hazardous drinking and sexuality/intimacy enhancement alcohol expectancies were associated with higher sexual risk scores. The final model predicted 36% of the variance in risky sexual behavior scores. Our findings regarding the central role of alcohol use and sexuality/intimacy enhancement expectancies in sexual risk behaviors among sexual minority women are consistent with previous research focusing on predominantly heterosexual women. Future efforts at sexual risk reduction in sexual minority women will need to address the influences of alcohol use and drinking-related expectancies on sexual behaviors and decision making.

[Support in addictology: hydrotherapy]

Hydrotherapy is a corporal mediation treatment used with patients with addictions by the Mayenne centre for addiction support therapy and prevention. A demonstration of the benefit of hydrotherapy for these patients through a patient's case.

[Outpatient withdrawal programme: advanced practice in addictology]

Advanced nursing practices are procedures enabling nurses to carry out, in a structured and predefined manner, tasks usually entrusted to doctors. Introduced in France by the Berland reports of 2003 and 2006, advanced nursing practices remain under-developed in the fields of psychiatry and addictology. In this context, Lille regional and university hospital has set up an outpatient programme for alcohol withdrawal, a scheme coordinated by a nurse, authorised to modifythe treatment dosage according to the patient's clinical state and who is supported by a network of caregivers during the period of medicalised withdrawal.

Expanded roles and responsibilities for nurses in screening, brief intervention, and referral to treatment (SBIRT) for alcohol use

It is the position of the International Nurses Society on Addictions and the Emergency Nurses Association that nurses in all practice settings be prepared to deliver screening, brief intervention, and referral to treatment, or SBIRT, to identify and effectively respond to alcohol use and related disorders across the lifespan.

Integrating procedural care with addiction support: an example from a PICC nurse

Alcohol-related problems are substantial in this society. In support of national health goals, increased effectiveness of hospital-provided care, and patient's well-being, hospital nurses are called to address the issue of addiction and recovery with patients and their families. SBIRT involve a set of strategies useful for this purpose. Nurse-led use of SBIRT strategies into hospital procedural care was demonstrated through the scenario. This technique is applicable to patient encounters during most direct-care inpatient procedures.