Hazardous alcohol use interventions with emergency patients: Self-reported practices of nurses, and predictors of behaviour

Toby Freeman, Ann M Roche, Paul Williamson, Ken Pidd
Emergency Medicine Australasia: EMA 2011, 23 (4): 479-89

OBJECTIVES: The present study examined Australian ED nurses' practices in asking patients about alcohol and assisting them to manage their alcohol consumption. It also investigated strategies to support ED nurses in these interventions.

METHODS: A two-stage survey was administered to ED nurses. The first questionnaire measured theoretical and organizational predictors of behaviour, and underlying beliefs, and the subsequent questionnaire explored rates of asking and assisting patients.

RESULTS: A total of 125 nurses returned the first questionnaire. Participants held generally positive attitudes, perceived norms, feelings of legitimacy and perceived ability to ask about and intervene for alcohol, but lower role adequacy. The 71 ED nurses who completed the second questionnaire had intervened with almost 500 patients concerning alcohol in the previous week. Participants asked approximately one in four patients about alcohol (median = 26.3% of patients, 1095/4279 total patients asked). The Theory of Planned Behaviour did not predict rates of asking or assisting patients. Several strategies were identified that might increase rates: identify environmental factors that prevent nurses acting on their intentions to ask and intervene, raise confidence and skills, make asking about alcohol part of routine assessment, make supports such as drug and alcohol units or nurses available, and implement organizational policies on alcohol.

CONCLUSIONS: Nurses appear positively disposed to engage with patients in regard to alcohol. However, greater support is needed to achieve the considerable significant public health benefits from this engagement. The findings point to several practical strategies that could be pursued to provide this support.

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