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Successful Implementation of an Alcohol-Withdrawal Pathway in a General Hospital

Received September 30, 2006; revised January 3, 2007; accepted January 11, 2007. From Massachusetts General Hospital, Boston, MA. Send correspondence and reprint requests to Jennifer Repper-DeLisi, APRN, BC, Dept. of Nursing, Massachusetts General Hospital, Blake 11, Boston, MA 02114. e-mail: jrepperdelisi{at}partners.org
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: Although alcohol use and abuse are common among general-hospital inpatients, many patients are inadequately assessed and treated for alcohol withdrawal. OBJECTIVE: The purpose of this study was to determine whether the implementation of a clinical pathway for the treatment of alcohol withdrawal in medical inpatients would result in improvements in clinical practice and patient outcomes. METHOD: Authors retrospectively reviewed 80 patient records (including 40 of those treated before the implementation of a pathway and 40 of those treated after pathway implementation). RESULTS: Assessment procedures and ordering patterns of physicians (medical house staff and staff physicians) shifted in a fashion consistent with the new treatment guidelines. Patient outcomes (e.g., length of stay and the incidence of delirium) improved for those patients who received benzodiazepines within the range of the pathway guidelines. CONCLUSIONS: Timely assessment and staff education can shift prescription patterns, increase patient monitoring, and reduce costs associated with alcohol withdrawal.

Key Words: Alcoholism • Withdrawal Treatment

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