A systematic nurse-led approach to withdrawal risk screening, prevention and treatment among inpatients with an alcohol use disorder in an ear, nose, throat and jaw surgery department-A formative evaluation

Substance Use Screening Protocol: Implementation of a System for Patients With Cancer

BACKGROUND

Substance use by patients with a cancer diagnosis may have a detrimental effect on short- and long-term outcomes. Screening, brief intervention, and referral to treatment (SBIRT) has been recommended for all patients in primary care and emergency medicine.

OBJECTIVES

The purpose of this quality improvement project was to train clinical providers and to implement an effective SBIRT program in a radiation oncology clinic in a comprehensive cancer center.

METHODS

An interprofessional task force developed a staff training protocol that incorporated oncology-specific content. The team then piloted an SBIRT program in the outpatient clinic.

FINDINGS

Staff training results were mixed, with only a few evaluation items showing significant improvement. Despite these results, staff training and the implementation of an SBIRT may be valuable in improving substance use screening in this vulnerable population.

Improving Care Provision to Older Adults with Dual Diagnosis: Recommendations from a Mixed-Methods Study

Older adults with dual diagnosis remain an under-diagnosed population in mental health services, with complex needs and high rates of medical comorbidity. Dual diagnosis is a significant challenge to contemporary mental health services, with recognition of the increased rate of relapse and costs of care of poorly managed dual diagnosis identified through comprehensive research. Unfortunately, the research attention paid to those with dual diagnosis in younger age groups has not been replicated in the older adult cohort, with few studies specifically exploring the treatment needs of these individuals. Of the studies that do exist, many identify poor screening and assessment, clinician frustration and a lack of cohesive treatment for co-occurring alcohol and other drug use disorders for older adults. We draw from a mixed methods exploratory study conducted in an inner Melbourne community older adult mental health service providing care to consumers with dual diagnosis to formulate recommendations to improve the care provision to this cohort. We discuss changes to the way older adult mental health services operate that are essential to improve the care and response to consumers presenting with dual diagnosis. Ultimately, we aim to discuss how older adult mental health services can improve to provide timely, responsive care to those with dual diagnosis.