Implementing an Evidence-Based Practice Change for Alcohol Withdrawal in an Acute Care Hospital

Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality. PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the occurrence of patient deterioration for acute alcohol withdrawal symptoms (O) within an eight week timeframe (T)? Intervention: The PAWSS tool was utilized to screen all patients admitted to the progressive care unit. Patients identified at moderate to severe risk by a score of ≥4 were treated according to the standard facility practice with included CIWA-Ar monitoring and medication management with benzodiazepine medication. Outcome: The project was able to demonstrate a significant decrease in the mean LOS for those patients identified at risk and treated for AWS, with an average decrease of 50 hours in length of stay for those patients treated during the project implementation. Conclusion: Early recognition of patients at risk for AWS is an important component of effective management and treatment. Further study is needed into best practices for treatment of patients at risk, and internal compliance measures within the organization.