title: Clinical pathway effects on treatment of the alcohol withdrawal syndrome.
abstract: We investigated whether initiating a clinical pathway, that incorporated the use of an alcohol withdrawal assessment scale, would decrease length of stay (LOS) for and/or amount of benzodiazepine prescribed during uncomplicated alcohol detoxification. We retrospectively reviewed alcohol detoxification admissions on an inpatient unit: 66 admissions before, 56 after, and 75 admissions 1-year after initiation of the pathway. Admissions were grouped into completers and non-completers. Comparison of group means before and after pathway implementation demonstrated a significant decrease in LOS for completers of the detoxification service from 7.35 to 4.77 days, and from 6.67 to 4.31 days for all admissions. Similarly, total benzodiazepine exposure decreased to a third of the mg amount given per admission prior to the pathway. There were no increases in the "irregular" discharge rate or complication rate. These findings suggest that a clinical pathway, with an incorporated withdrawal assessment scale, can decrease LOS and benzodiazepine prescribing on an alcohol detoxification unit.
authors.affiliation: Dept of Psychiatry, Royal C. Johnson VAMC, Sioux Falls, SD, USA.
authors.forename: T
authors.initials: T
authors.lastname: Morgan
authors.forename: L
authors.initials: L
authors.lastname: Kofoed
authors.forename: D B
authors.initials: DB
authors.lastname: Petersen
mesh_terms: D000430:Alcohol Withdrawal Delirium / Q000517:prevention & control*; D000437:Alcoholism / Q000534:rehabilitation*; D001569:Benzodiazepines / Q000627:therapeutic use; D019091:Critical Pathways; D000431:Ethanol / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D011379:Prognosis; D015397:Program Evaluation; D012189:Retrospective Studies; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control
chemical_list: D001569:Benzodiazepines; D000431:Ethanol