Year of Publication

2017

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Lynne A. Jensen

Clinical Mentor

Dr. Kristin Pickerell

Committee Member

Dr. Elizabeth Tovar

Abstract

Purpose: The purpose of this practice inquiry project was to examine current screening practices for alcohol misuse within a primary care clinic. The United States Preventive Services Task Force (USPSTF) guidelines state that alcohol misuse screening should be performed on adults aged 18 years or older using one of three standardized screening tools: Alcohol Use Disorders Identification Test (AUDIT), the abbreviated AUDIT-Consumption (AUDIT-C), or a single-question screening. If indicated, providers should provide a brief intervention and/or referral to treatment through the process known as SBIRT (screening, brief intervention, referral to treatment).

Methods: A retrospective chart review was conducted to examine current screening practices within Norton Healthcare and to determine the percentage of patients being seen for a new patient visit or an annual wellness exam who were being screened for alcohol misuse. Demographic data, comorbidities, and who performed the screening were assessed. The charts were also examined to determine if a standardized screening tool was used to assess for alcohol misuse.

Results: While 97% of patients in the examined population were asked about whether or not they used alcohol using a yes or no question, there was no evidence of a standardized screening tool being used to evaluate alcohol misuse. There was no evidence of a screening bias with regard to patient characteristics such as age, gender or health problems.

Conclusion: No standardized tool for screening for alcohol misuse is currently in use within Norton Healthcare. Though 97% of patients were asked about their alcohol use, current practice does not adhere to the recommendations of the USPSTF. A toolkit has been developed to provide the foundation for provider education in the Norton Healthcare System. Provider education regarding the SBIRT process and using standardized tools may help to increase adherence to national guidelines and to facilitate practice change.

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