None listed
Conditions
Brief summary
The misuse of substances (alcohol and other drugs) is a major health issue in New Zealand. In 2007/8 5.4% of all deaths in persons aged less than 80 years old were attributed to alcohol consumption. The use of other drugs is also a substantial problem with harmful effects including addiction, physical and mental health problems and financial and social harm. The use of substances brings people repeatedly to the emergency Department (ED) however usually nothing is done to address the problem. Screening and brief intervention (SBI) is the process of asking screening questions about substance use then if indicated providing motivational counselling aimed at reducing use. SBI has been shown by many studies to reduce substance use and to be effective in the (adult) Emergency Department. No research has been done on the feasibility of providing SBI in an NZ ED, and the proposed research aims to investigate this. Eight Registered Nurses (RNs) will be trained to provide SBI, and for a period of one month all their patients between ages 18 and 80 (who fit medical inclusion criteria) will be given a written screening form and if indicated receive a brief intervention (counselling) from the RN. After the trial period, the charts will be reviewed to see how often the components of SBI were done, and the nurses will be interviewed about their experience. If SBI can be provided using existing staff it could be a cost effective health measure, and reduce ED utilisation.
Interventions
Administering a screening for substance use and if patient screens at high risk of substance use disorder a nurse administers a 3-10 minute counselling session.
The questionnaire is an independently validated existing tool called Alcohol Smoking and Substance Involvement Screening Test (ASSIST) in a shortened version most appropriate for the busy Emergency Department (ED) setting, called ASSIST-Lite. Questions are about use of selected substances within the past 3 months. ASSIST-Lite is a on
Administering a screening for substance use and if patient screens at high risk of substance use disorder a nurse administers a 3-10 minute counselling session. The questionnaire is an independently validated existing tool called Alcohol Smoking and Substance Involvement Screening Test (ASSIST) in a shortened version most appropriate for the busy Emergency Department (ED) setting, called ASSIST-Lite. Questions are about use of selected substances within the past 3 months. ASSIST-Lite is a one page written questionnaire that the patient can fill out themselves. It will be handed out and collected by a Registered Nurse (RN). The counselling is motivational interviewing aimed at reducing use, it is a single stand alone session requiring no follow up for the patient.
Sponsors
Kylie Travers
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Patients at Waitakere hospital Emergency Dept in Waiting, Consults, Acutes and Monitored areas who are medically fit in the professional opinion of RN, Doctor or Mental Health Nurse as appropriate. Ages 18-80. There are 2 participant groups: nurses and patients. Nurses are volunteers, selected to give a cross section of ED staff but must have at least 1 yr ED experience. Patients are a convenience sample of eligible patients who present and are cared for by a participating nurse and who agree to participate.
Exclusion criteria
Emotional distress, Mentally unwell (unless MH nurse/doctor thinks it is in the best interest of the patient), chest pain, shortness of breath, life threatening condition, severe or moderate pain, cognitive impairment, any condition that makes patient unable to give informed consent. Language barrier.
Outcome results
None listed