Effectiveness of a nurse-led alcohol liaison service in a secondary care medical unit

Alcohol misuse is a common reason for hospital admission. While there is considerable evidence from other areas that provision of specialised alcohol services can reduce alcohol intake, there is currently less evidence for medical departments in an acute hospital setting. Nottingham hospitals initiated such a service in 2002-3 based around two nurse specialists who provided input to inpatients with alcohol-related physical disease and provided links to community-based services for alcohol misuse. This service assessed 3632 patients over five years and has seen a reduction in hospital admissions, violent incidents against staff and primary care attendances. It is believed that this model of care is an effective means of intervening in people with alcohol-related problems.

An evaluation of alcohol dependence prevention measures at a Japanese newspaper company

Alcohol dependence prevention measures were implemented at a Japanese newspaper company, a company undergoing restructuring. An occupational health nurse interviewed each employee twice a year, providing guidance about reducing daily alcohol consumption and binge drinking. These nursing interventions were evaluated through individual employee health examinations conducted in 2000 and 2007. The examinations revealed that fewer employees drank alcohol in 2007 than in 2000 (8.4% and 11.6%, respectively). Employees who drank at least 1,500 milliliters of alcohol daily decreased from 13.7% to 7.0% (p = .004). By gathering case studies, the effectiveness of the occupational health nursing interventions was made clear.

Randomized controlled trial of a cognitive-behavioral therapy for at-risk Korean male adolescents

This study examined the effects of cognitive behavioral therapy (CBT) aimed at enhancing the resilience of high-risk adolescents with alcohol-dependent parents in Suwon, South Korea. The study used a randomized control group pretest and posttest design. The experimental group participated in 10 sessions of CBT, and the scores on resilience increased significantly after the intervention, whereas the scores of self-concept and depression did not change. In the control group, none of the scores of outcome variables changed significantly after the intervention period. The results indicate that the developed CBT program might be effective for improving the resilience of adolescents with alcohol-dependent parents.

Alcohol brief interventions: exploring perceptions and training needs

One of the main thrusts of contemporary alcohol misuse policies is that early intervention can make a real difference to patterns of problem drinking, as long as healthcare professionals are given the right skills. However, healthcare professionals themselves suggest that they are often unsure of how to raise issues, and feel that they lack the skills or knowledge to do this effectively. This study investigates the perceptions and training needs of health visitors, school nurses, nursery nurses and practice nurses in relation to alcohol misuse primary prevention and the delivery of brief interventions in their day-to-day work. The findings indicate a variation in the need for training, which is reflected by the level of knowledge, skills and confidence of the different professional groups. This may help to facilitate the provision of needs-led alcohol training, and promote the effective delivery of support and brief interventions to individuals, families, schools and communities.

Drink a little; take a few drugs: do nurses have knowledge to identify and manage in-patients at risk of drugs and alcohol?

INTRODUCTION AND AIMS

The widespread use of alcohol and other drugs poses particular problems during hospitalisation. Although nurses have been identified as an appropriate group to screen patients and provide acute and ongoing management to people with drug and alcohol-related problems, rates of screening are low. The aims of this study were to identify current practices for screening by nurses working in medical and surgical wards, determine their knowledge relating to problems associated with substance use and identify their self-reported skills in managing patients with drug- and alcohol-related problems.

DESIGN AND METHODS

A chart audit of medical records was completed and a survey was distributed to nurses working in the study wards.

RESULTS

Screening for alcohol and drug use was documented on only 22/79 medical records, and detailed information about quantity and duration of use was recorded in only nine. Overall, the nurses reported that they had little knowledge about substance use problems, and felt that they lacked skills to care adequately for these patients.

DISCUSSION AND CONCLUSIONS

The results of this study suggest a need for a comprehensive training and education to ensure that nurses are familiar with policies and protocols for management of patients and to assist nurses to provide evidence-based care and make appropriate referrals to specialist services.

Increasing practice nurse access to alcohol training

Policy makers have repeatedly placed emphasis on the role of primary care in screening for at-risk alcohol consumption and delivering public health messages to the general population. Research has pointed to primary care staff holding negative attitudes towards alcohol misusing patients. Training has traditionally been seen as the key to increasing the capacity of the medical field to engage with alcohol misusing patients but little work has been undertaken to examine the potential barriers to training take up. Consequently, the aim of this study was to explore the willingness of practice nurses to be trained in alcohol screening and brief intervention, and whether identifiable barriers to training exist and how they may be overcome. All practice nurses (n = 82) in an outer London (UK) Health Authority Area were twice mailed an invitation to an alcohol training seminar and a telephone invitation was made to all of those who did not reply to the mailings. Those who did not attend (n = 66) were contacted to take part in a short structured telephone interview - 89% (59/66) were contacted successfully and interviewed. Respondents were experienced in primary care and viewed health promotional activity as a valid part of their role. Few had undertaken previous alcohol training and as a group they were highly active in attending training events with training undertaken tending to be related directly to perceived practice needs and priorities: thus this group could not be characterized as unwilling to be trained. Barriers to training at alcohol events were found to be either personal or work-related, with most nurses interested in receiving further training or information. These data imply that the ways in which training is organized and delivered require sensitivity to identifiable barriers if it is to reach and effect changing practice among practice nurses successfully. A range of possibilities are identified as alternative approaches to the provision of elective training events which may be more acceptable to the target population of health-care staff.

[What nurses with a bachelor of nursing degree know about the effects of alcohol on blood pressure and risk of arterial hypertension]

INTRODUCTION

Alcohol abuse is one of the main causes of arterial hypertension. Alcohol is responsible for a few to more than ten percent of all cases of primary hypertension, particularly in persons consuming more than 20-30 g of alcohol per day. The aim of this study was to find out what Bachelor of Nursing degree holders know about alcohol consumption styles and the effects of alcohol on blood pressure, as well as on the risk of arterial hypertension in adults.

MATERIAL AND METHODS

The study group comprised 116 qualified nurses (112 females, 4 males; age 21-50 years; work seniority 0-29 years). The study was done between June 2007 and January 2008 with the use of the diagnostic poll technique based on a questionnaire developed by the authors.

RESULTS

We found that 8.62% of participants were informed about screening tools used for evaluating styles of alcohol consumption while 41.38% gave the correct definition of the standard portion of alcohol. The alcohol consumption threshold above which the risk of hypertension becomes significant was known to 58.62% of respondents. The influence of alcohol (drunk directly before blood pressure measurement) on blood pressure was known to 89.66% of the nurses. We observed a statistically significant effect of work experience (p = 0.002), place of work (p < 0.001), and position held (p < 0.001) on the number of correct answers. No statistically significant differences depending on age, place of residence, family status or type of postgraduate education were noted.

CONCLUSION

It is necessary to increase awareness among nurses regarding the risk of arterial hypertension associated with alcohol consumption and to improve the effectiveness of undergraduate and postgraduate education aimed at early recognition of problems caused by alcohol consumption which are important for the prevention of arterial hypertension.