In a perfect world Emergency Department Screening and Brief Interventions for heavy and hazardous use of substances : a feasibility study
Travers, Kylie A.
Citation:Travers, K. A. (2016). In a perfect world Emergency Department Screening and Brief Interventions for heavy and hazardous use of substances: A feasibility study. [An unpublished thesis submitted as] part of the requirement for the degree of Master of Applied Practice (Health Science), Unitec Institute of Technology, New Zealand.
Permanent link to Research Bank record:http://hdl.handle.net/10652/3590
Screening and Brief Intervention (SBI) is an evidence based technique for reducing heavy and harmful consumption of alcohol and other drugs. There is significant evidence for both the efficacy and the effectiveness of SBI. SBI has been shown to be effective in emergency departments (EDs) in a variety of different countries. The feasibility of SBI in the ED, however, remains contentious and no studies have been done on this area in a New Zealand ED. For this feasibility study, eight experienced ED nurses attempted to provide SBI to as many of their patients as possible over a one month period, using the ASSIST-Lite screening tool (Ali, Meena, Eastwood, Richards, & Marsden, 2013). The patient’s charts were audited to see how many actually received the SBI. Of 390 eligible patients only 46 (41 screened plus five who declined) were given the opportunity to participate, equating to 11.79% of the patients who were in the care of the participating nurses. Thirteen of these patients screened positive and received a formal Brief Intervention, and another patient received information about Community Alcohol and Drug Services. There was an inverse correlation between the number of patients presenting to the ED and the average number of screenings undertaken by each nurse participant per day. Following the data collection period the nurse participants were interviewed about their experience. Semi-structured interviews with the nurse participants revealed three main themes: 1) the nurses attitudes towards SBI, 2) Working conditions, and 3) the ED environment. It was concluded that high patient numbers compared to the number of nursing staff in the ED currently precludes nurses from providing consistent SBI to all eligible patients in the ED, however, the benefits of SBI are recognised by them. With higher staffing levels, ED SBI may be feasible and of benefit to individuals, to the ED and to society.