1 / 12

Dr Tina Alwyn, Dr Bev John & Elisabeth Zabel

“Why are we babysitting binge drinkers – Why are we not dealing with the consequences?” The Impact of Alcohol Related Admissions on Accident and Emergency (A&E) Departments in Wales. Dr Tina Alwyn, Dr Bev John & Elisabeth Zabel.

Mercy
Télécharger la présentation

Dr Tina Alwyn, Dr Bev John & Elisabeth Zabel

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. “Why are we babysitting binge drinkers – Why are we not dealing with the consequences?”The Impact of Alcohol Related Admissions on Accident and Emergency (A&E) Departments in Wales. Dr Tina Alwyn, Dr Bev John & Elisabeth Zabel

  2. Just another Friday night in Accident and Emergency. An 18-year-old is passed out after drinking at one of the city's bars all night(BBC, 2008).

  3. What we know • Hospital admissions as a result of excessive alcohol consumption are now higher than at any time in the past two decades (Dept of Health, 2008). • According to the Alcohol Misuse in Wales subgroup (2007) about 35% of people presenting for treatment at A&E departments have alcohol related conditions. • Anecdotal evidence suggests these figures are conservative

  4. Our earlier findings • John et al(2002) • Confirmed the detrimental impact of alcohol on A&E departments in England and Wales • Found that although nurses and doctors reported high levels of alcohol related admissions, they were reluctant to code and record alcohol related admissions. • Staff felt that A&E departments could implement screening and deliver appropriate brief interventions if resources were available.

  5. Has anything changed over the last decade?Impact of alcohol in Cardiff over the previous ten years • Developments in response to excessive alcohol use in the city • Field hospitals • Flip flops • Traffic re-organisation • Taxi stewards • Police resources

  6. Developments in A&E over the last decade? • Specialist alcohol nurses in only a few hospitals • Havard et al (2008) • interventions are effective in reducing alcohol-related injuries • evidence that brief interventions in A&E reduce alcohol consumption is not convincing • need further evaluation research and improved reporting of results

  7. Mapping the current situation in Wales • Aim: • To map and evaluate the current prevalence of alcohol related attendances • Objectives: • To evaluate current procedures in place to record alcohol related admissions • To evaluate procedures for referral • To look for evidence of good practice in identification and processing of alcohol related admissions • To evaluate the feasibility of implementing nurse training in screening and brief interventions to reduce alcohol related harm

  8. Method • Qualitative semi-structured interviews to explore issues surrounding the key objectives • 16 Nurses and Doctors in 9 of the 12 A&E departments throughout Wales

  9. Findings • Alcohol related admissions were reported to be “anything up to 50%” of the total admissions on a Friday and Saturday evening in a rural area, and from other A&E departments “95% after 10pm”. • increase in alcohol attendances throughout the day • increase in attendances by younger populations • more young children being admitted with alcohol related problems particularly problematic in University towns • High impact on A&E staff time and resources and also affects other patients (bed space) • Problems with referral of known drinkers: “if patients are drunk, psychiatrists wont touch them till their blood alcohol levels are lower” and “we have to keep them till they sober up”.

  10. Differences in staff perceptions over the last 10 years? • The majority of doctors and nurses who participated agreed that screening and brief interventions would be beneficial: “Ideally this is a good place to screen” and “we should be doing that (screening and brief interventions)”. • However there was an acknowledgement that in the majority of A&E departments there is not enough time and resources to facilitate this: “We are an absolutely over stretched service – under resourced and understaffed”. • Changes in attitudes include increase pressure to meet patient through-put to meet government targets • Attitudes toward binge drinking, particularly with certain populations are much more negative

  11. Barriers • A&E not appropriate place for brief interventions: “interventions should be done elsewhere” • Staff ambivalence • Chronic drinkers • Disruptive binge drinkers • “people like us” • Personal values and attitudes “people should not feel as if they are being interrogated or judged” • Due to high level of problems relating to alcohol related attendances nurses reported that “it is not always easy to sympathetic” • Lack of training in screening and brief interventions • Lack of resources • Organisations not taking responsibility for alcohol related attendances: “we are not policing people we are nursing people”

  12. Conclusions and Recommendations • Alcohol related issues are a resource and management problems for A&E departments • There are many barriers to a proactive role for A&E staff (practical, psychological and policy driven) • Training needs • Screening can be initiated in A&E but interventions done elsewhere

More Related