The views of nurses to the conduct of a randomised controlled trial of problem drinkers in an accident and emergency department
Section snippets
Background
Excessive intake of alcohol can lead to many public health problems including premature mortality (Gronbaek et al., 1995), physical and psychological ill-health, marriage and family breakdown (Buchan et al., 1981) and child neglect and abuse (Bijur et al., 1992). Drinkers are also known to have a higher number of health problems and accordingly consult general practitioners frequently (Buchan et al., 1981).
However, in the context of this report it is important to note that those attending
Objectives of the study
- 1.
To demonstrate that problem drinkers could be routinely identified through screening by triage nurses in an AandE department.
- 2.
To assess the outcome of brief intervention for problem drinkers subsequently referred to a clinical nurse specialist following opportunistic screening in an AandE department.
- 3.
To examine the attitudes of nurses, working in an AandE department, to problem drinkers following a short training which included use of an appropriate screening instrument.
Screening by the triage nurse
All patients presenting at
Screening attendees in the AandE department
Over the 6 month period of the study a total of 16 654 adults attended the AandE department of whom 28% (n=4663) were recorded, i.e. a screening form was prepared. Of this group, 25% (1162) were judged unable to complete the questionnaire although a reason for this was not generally given. Thus, only 20% of all adult attendees were screened (3398/16 654) by triage nurses. 19% (n=645) of this smaller subsample screened positive inasmuch as they either drank in excess of government guidelines or
Discussion
This study was funded to examine the impact of screening for alcohol problems in a population of AandE attendees. Nurses were trained to play a key role in the research through the provision of screening and feedback at triage. Furthermore, the efficacy of brief intervention provided by clinical nurse specialists was to have been examined in a randomised controlled trial for those identified through screening as problem drinkers.
Although the research team planned this research in an energetic
Acknowledgements
We are grateful to NHS-Executive, Trent who funded this study and who encouraged us to persist with the research despite the difficulties.
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