Abstract

Objectives: It is recommended that all patients clerked during A&E assessment should be asked for alcohol consumption history and positive cases should be identified at same time. This study explored about percentage of patients who are missed for alcohol consumption history and indirectly do not get support for alcohol cut-down. We suggested at the end of this Audit, that old AUDIT-C forms printed in A/E clerking forms should be replaced by new AUDIT C forms, and should be filled by patients rather than junior doctors. Design: We handed over newly printed AUDIT C forms to admitted patients in various wards of hospital and once returned to us we compared the alcohol consumption score with the score mentioned in old AUDIT-C forms which are part of A/E clerking forms. Setting • 06 wards in Princess Alexandra Hospital, Harlow. • Participants • 51 admitted patients. • Main outcome measures To find the number of patients, positive for excessive alcohol consumption and how many of those were diagnosed and offered help during A/E clerking. Results: We screened fifty one patients admitted in 6 wards randomly, through this audit, 21/51 (41%) patients were AUDIT_C positive. Almost half of these positive cases were neither clerked for their alcohol history nor offered help for alcohol cut-down. These patients, although, were admitted with different diagnosis but still at high risk for alcohol related disorders e.g. Alcoholic liver disease etc. Conclusion: We found that number of positive cases during this audit (41%), were significantly high when comparing to those in 2017(31%) and 2016(27%) audits. Despite such high rise in number of positive cases, the half of patients remained no clerked during A/E presentation. Data obtained from this audit were used to guide operational changes to improve the process of alcohol history recording in A/E pro forma.

Highlights

  • Used A&E clerking pro forma have printed AUDIT C form included in them which is supposed to be completed in A&E by junior doctors during initial history taking

  • It is recommended that all patients clerked during A&E assessment should be asked for alcohol consumption history and positive cases should be identified at same time

  • We suggested at the end of this Audit, that old AUDIT-C forms printed in A/E clerking forms should be replaced by new AUDIT C forms, and should be filled by patients rather than junior doctors

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Summary

Introduction

Used A&E clerking pro forma have printed AUDIT C form included in them which is supposed to be completed in A&E by junior doctors during initial history taking. It has been noted on various occasions that these forms go unfilled till the end of hospital admission course and most of patients are never clerked for this important social history section. There was a total score of 12 for these questions and anyone with score of 5 or above was taken as positive for excessive alcohol consumption These forms were different from conventional forms used in A&E because in new forms we included pictures of filled glass, bottle and cup etc.

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