Improving the Identification and Management of Alcohol Withdrawal in a Psychiatric Hospital

Quality Improvement Poster Download

Background & Problem

Studies of acute psychiatric inpatients suggest that 50% have an alcohol use disorder and over 20% are alcohol dependent. This compares to the general population, where 6% of males and 2% of females are alcohol dependent. Despite this, alcohol withdrawal is poorly identified and managed on psychiatric wards.

Aim

75% of new psychiatric admissions to be properly assessed for risk of alcohol withdrawal within 24 hours and treated appropriately.

Method

We did an initial audit looking at the alcohol history of new admissions to both Charlton Lane and Wotton Lawn hospitals. We looked at whether those at risk of alcohol withdrawal were identified and if they were appropriately put on a detox regime. After gathering our initial results from 56 admissions, we adapted the clerking proforma to include questions relating specifically to alcohol history and a prompt reminding people what to do if the patient was identified as being at an increased risk of alcohol withdrawal. We collected post-intervention results to look for an improvement in the identification and management of alcohol withdrawal.

Results

Our initial results showed that 27% (15/56) had no documented alcohol history. Only 1 of the 56 patients had their alcohol consumption quantified in units. No patients were formally detoxed. We continue to be in the process of collecting our post-intervention results.

Implications

We hope that our results will show that using a simple prompt has helped to ensure that alcohol dependence is identified and managed appropriately.