Utilisation of a purpose-designed chart for the nursing management of acute alcohol withdrawal in the hospital setting

Abstract

Summary Objective To describe nursing utilisation of a purpose-designed alcohol withdrawal management chart in terms of completeness of recording assessment measures, and use of recommended dose of diazepam and observation intervals. A secondary objective was to compare utilisation between the emergency department short stay ward and hospital wards. Methods A retrospective review was performed on data collected on a standardised chart for management of alcohol withdrawal. The convenience sample was 200 consecutive patients admitted through the emergency department from October till December 2007 and placed on the alcohol withdrawal chart. Assessment items, drug doses, observation intervals and admitting ward were recorded. Deviations from recommendations were calculated. Results A total of 3096 assessments were recorded. There was 85% compliance in completing assessment items and 84% compliance with recommended dose of diazepam. Incomplete assessments were mainly due to the patient being sleeping or because the patient's temperature was not recorded. There was similar performance between the short stay ward and hospital wards. Compliance with observation intervals was much lower at 49%, with observations being made early as well as late. Conclusions High compliance was achieved with the assessment tool and dosing regime, but not with recommended observation intervals. High compliance may be related to the brevity and standardisation of assessment and use of a single page format but requires further study.