Abstract
Objective:To explore the effect of education and training on the delivery of alcohol screening and brief intervention and referral to high‐risk patients in a hospital setting. Main outcome measures included; delivery of training; practice change in relation to staff performing alcohol screening, brief intervention and referrals. Methods:Observational study design using mixed methods set in a tertiary referral hospital. Pre‐post assessment of medical records and semi‐structured interviews with key informants. Results:Routine screening for substance misuse (9% pre / 71.4% post) and wellbeing concerns (6.6% pre / 15 % post) was more frequent following the introduction of resources and staff participation in educational workshops. There was no evidence of a concomitant increase in delivery of brief intervention or referrals to services. Implementation challenges, including time constraints and staff attitudes, and enablers such as collaboration and visible pathways, were identified. Conclusion:Rates of patient screening increased, however barriers to delivery of brief intervention and referrals remained. Implementation strategies targeting specific barriers and enablers to introducing interventions are both required to improve the application of secondary prevention for patients in acute settings. Implications:Educational training, formalised liaison between services, systematised early intervention protocols, and continuous quality improvement processes will progress service delivery in this area.
Highlights
Routine screening for substance misuse (9% pre / 71.4% post) and wellbeing concerns (6.6% pre / 15 % post) was more frequent following the introduction of resources and staff participation in educational workshops
This paper reports on the effect of promoting primary care interventions on the delivery of alcohol SBI and referral to high-risk patients with alcohol-related injuries in a hospital setting
This study’s findings support the assertion that the incidence of alcohol-related injury and subsequent hospital admission caused by assault is high among facial trauma patients at RDH, among young Indigenous men
Summary
Most patients identified as Indigenous at baseline and follow-up. Indigenous men, on average, were more at risk of sustaining a facial injury than their non-Indigenous counterparts. Injury secondary to assault was the most common cause for admission, and alcohol was a contributing factor in the majority of cases. Informal screening for AOD issues, reflected in the recording of an AOD concern in patient files, increased significantly from 57% to 84%. NB: Percentages calculated to 2 decimal places a. Indigenous: Aboriginal and/or Torres Strait Islander b.
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