Alcohol problems in a general hospital

Determinants of Nurses' Attitudes toward the Care of Patients with Alcohol Problems

Nurses (n = 49, age = 39 ± 11 y) from an Australian metropolitan hospital completed the Marcus Alcoholism, Seaman Mannello Nurses' Attitudes toward Alcoholism, and the shortened Alcohol and Alcohol Problems Perception Questionnaires. The majority had personal (73%) and/or professional (93%) experience with people with alcohol problems. Not one reported receiving drug and alcohol training. On average, nurses held neutral to positive attitudes toward alcohol problems; however, 14.3% completely disagreed with the statement "I want to work with drinkers," and 12.5% completely disagreed that they were likely to find working with people with alcohol problems rewarding. Attitudes to care were significantly influenced by age, personal drinking habits, and beliefs about whether patients can be helped, whether alcoholism is a character defect, and the relationship between alcoholism and social status. Negative attitudes towards patient care persist and are influenced by age, personal drinking habits, and beliefs about alcoholism. Specific training in this area may be beneficial.

From data to evidence, to action: findings from a systematic review of hospital screening studies for high risk alcohol consumption

OBJECTIVE

To conduct a systematic review of hospital alcohol screening studies to identify effective and efficient evidence-based strategies.

METHOD

Sixty-five studies (N=100,980) of alcohol problem prevalence amongst hospital patients were reviewed.

RESULTS

Prevalence of positive alcohol screens varied according to hospital location, screening tool and patient characteristics. BAC measures (26%) were nearly twice as likely (OR=1.92, p<.001) to reveal positive screens in the ED than self-reports (16%). No difference was found in prevalence of self-report positive screens between ED (16%) and ward settings (17%). Males were two to four times more likely than females to screen positive (BAC: OR=2.37, p<.001, ED self-report: OR=3.07, p<.001, ward self-report: OR=4.30, p<.001). ED patients aged 20-40 years and ward patients aged 30-50 years had the highest prevalence of positive screens.

CONCLUSIONS

Prevalence of risky or problematic drinking among hospital patients is high and warrants systematic screening and intervention. Many hospitals lack sufficient resources to undertake widespread screening programs. For optimum return on resources, it is recommended to screen males in the ED using BAC measures. Established protocols applying priority criteria and staff training can increase screening accuracy and effectiveness.