Year of Publication

2018

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sheila Melander

Clinical Mentor

Dr. Rifaat El-Mallakh

Committee Member

Dr. Peggy El-Mallakh

Abstract

Abstract

PURPOSE: The purpose of this study was to assess provider adherence of an initial alcohol withdrawal protocol among adult inpatients, correlate outcome variables with protocol initiation, and examine the factors influencing provider decisions to implement all parts of the protocol.

METHODS: This multi-center descriptive evaluation utilized a retrospective medical record review and qualitative survey. A convenience sample of 313 inpatients represented 395 separate admissions between January and June 2018 in the four adult hospitals of a large health care system. Twenty-four providers participated in an anonymous online survey.

RESULTS: The protocol was implemented in its entirety three times (1%) out of 395 admissions during the study period. The survey revealed 37.5% of providers responded as alwaysordering the entire protocol and data analysis indicated labs and consults (41.2%) were the most commonly omitted components. No correlation existed between protocol initiation and mortality (p= .28) or hospital length of stay (p= .09). A statistically significant positive relationship existed between protocol implementation and intensive care unit transfers (p=

CONCLUSION: Provider adherence for the entire initial alcohol withdrawal protocol was low among the adult hospitals. Despite the goal of standardizing care for inpatients with alcohol use disorders, adherence rates and outcomes varied at each hospital with discovery of unexpected correlations to protocol initiation. Further research is recommended to thoroughly examine outcome variables as they correlate to the protocol. An educational needs assessment is also recommended to develop more robust education for nursing staff and providers. Open communication and collaboration among providers will assist the system toward more cohesive practice.

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