ED NASD Alcohol Education Project

Boston University Medical Campus, Boston MA

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): Among Americans aged 18 and older, around 5% or 10 million are dependent drinkers, 20% or 40 million are at-risk drinkers, and more than 107,000 alcohol related deaths are reported yearly. Emergency Departments (EDs) offer a concentrated opportunity or "teachable moment" to screen, perform a brief intervention and refer to treatment (SBIRT). A recent controlled trial of ED resident education in SBIRT provides good evidence that ED physicians, with training and institutional support, can use brief motivational intervention with at-risk or dependent drinking. Yet nationwide, ED physicians miss many opportunities for SBIRT. In an ED study using the saliva alcohol test and CAGE to identify patients who would benefit from SBIRT, only one of five patients who screened positive for at risk or dependent drinking was counseled or referred. Factors that contribute to low levels of screening by ED physicians and nurses may include: 1) lack of a knowledge base in addiction (the rationale for treatment); 2) lack of exposure to standardized clinical screening instruments; 3) lack of exposure to and skill in motivational interviewing; and 4) lack of familiarity with referral resources. This ED National Alcohol Screening Day (NASD) Alcohol Education Project is designed to promote the adoption of SBIRT among ED clinicians in accordance with the Healthy People 2010 Objective 26-22, which recommends that ED providers identify and refer patients with alcohol problems. During a one year period from November 2003 to October 2004, we intend to develop a SBIRT curriculum for the ED setting, and use innovative, interactive methods, including video-streaming, to deliver this curriculum and a self-assessment tool to ED providers nationwide via links to the websites for the major professional organizations in Emergency Medicine (the Society for Academic Emergency Medicine, the American College of Emergency Physicians, and the Emergency Nurses Association) and their 47,000 members. In addition, at 13 local sites across the country, we will conduct workshops and a follow-up video-conference in preparation for ED practitioner participation in NASD 2004. In these 13 sites we will recruit and enroll 390 ED physicians, nurses, and physicians' assistants, survey them prior to training about alcohol knowledge, beliefs and practices, train them intensively in SBIRT using ED based case studies, exercises and didactic materials, record their participation in interventions over a two week period beginning with NASD, and then at three months post-NASD re-survey them to assess changes in perceived barriers to SBIRT, and evaluate the impact of education for and participation in NASD events on ED providers' satisfaction with and adoption of SBIRT.