| Description |
At the Volunteers of America (VOA) Adult Detoxification Center in Utah individuals across multiple disciplines unite together to form substance abuse treatment teams that coordinate the medical and psychosocial care of clients withdrawing from alcohol. These professionals have different training, education, communication styles, professional languages, theories that guide clinical practice, and expectations in regards to substance abuse treatment. Therefore, communication between team members can be challenging. When health care professionals do not communicate effectively, patient safety is at risk. Critical information can be misinterpreted, missing, or overlooked and orders, particularly over the telephone, may be unclear. Therefore, the purpose of this project was to design an assessment algorithm for VOA staff that aimed to help them rapidly and correctly identify and communicate dangerous symptoms of alcohol withdrawal syndrome (AWS) to their supervisors and the appropriate interdisciplinary team members affiliated with the VOA Adult Detoxification Center. The purpose of the algorithm was to facilitate adequate and appropriate resource utilization and treatment of withdrawal symptoms by enabling effective team communication. To date there is limited literature available that addresses the development, application, and evaluation of AWS assessment and communication algorithms/tools in the social detoxification setting. The review of literature includes information concerning AWS, detoxification models, current standards of care for AWS, and a discussion of the components of the algorithm including a focused medical history, vital signs, blood alcohol level, CIWA-AD score, and the SBAR communication tool. The objectives of my project were as follows: 1) develop an evidence based AWS assessment and communication algorithm; 2) train VOA staff about AWS and appropriate utilization of the algorithm; 3) implement the algorithm at the VOA's Adult Detoxification Center and; 4) submit a poster to the 2014 Snowbird Conference. To achieve my objectives I performed the following: 1) I identified research articles to support my algorithm; 2) I prepared a PowerPoint presentation that I delivered at a VOA staff meeting in March of 2014 that reviewed AWS, the SBAR communication tool, and instructions on how to use the algorithm; 3) I created a PowerPoint presentation that I gave to the 4th Street Clinic Director that reviewed VOA policy, procedures, and social model detoxification treatment principles; 4) I created a reference guide containing the AWS education materials, algorithm, and VOA and 4th Street Clinic policies, procedures, and treatment model principles; 5) I trained staff in the use of the algorithm at their March 2014 staff meeting; 6) After the staff training, I began the implementation process by incorporating the algorithm into the admission assessment and all other follow-up assessments associated with routine client care; and 7) I submitted a poster abstract to the 2014 Snowbird Conference. In order to evaluate the algorithm's ability to help staff assess AWS severity and improve interdisciplinary and inter-organizational communication, the VOA administration will administer and review a staff satisfaction questionnaire at the end of a two month trial period, which will continue until May of 2014. In summary, AWS can be unpredictable and dangerous. Social model detoxification is a safe, low-cost environment in which the majority of alcohol-dependent individuals can detoxify from alcohol; however, appropriate assessment, management, and communication concerning potentially dangerous withdrawal symptoms is necessary. |
