title: Successful implementation of an alcohol-withdrawal pathway in a general hospital.
abstract: BACKGROUND
  Although alcohol use and abuse are common among general-hospital inpatients, many patients are inadequately assessed and treated for alcohol withdrawal.
  
  
  OBJECTIVE
  The purpose of this study was to determine whether the implementation of a clinical pathway for the treatment of alcohol withdrawal in medical inpatients would result in improvements in clinical practice and patient outcomes.
  
  
  METHODS
  Authors retrospectively reviewed 80 patient records (including 40 of those treated before the implementation of a pathway and 40 of those treated after pathway implementation).
  
  
  RESULTS
  Assessment procedures and ordering patterns of physicians (medical house staff and staff physicians) shifted in a fashion consistent with the new treatment guidelines. Patient outcomes (e.g., length of stay and the incidence of delirium) improved for those patients who received benzodiazepines within the range of the pathway guidelines.
  
  
  CONCLUSIONS
  Timely assessment and staff education can shift prescription patterns, increase patient monitoring, and reduce costs associated with alcohol withdrawal.
authors.affiliation: Dept. of Nursing, Massachusetts General Hospital, Blake 11, Boston, MA 02114, USA. jrepperdelisi@partners.org
authors.forename: Jennifer
authors.initials: J
authors.lastname: Repper-DeLisi
authors.forename: Theodore A
authors.initials: TA
authors.lastname: Stern
authors.forename: Monique
authors.initials: M
authors.lastname: Mitchell
authors.forename: Mary
authors.initials: M
authors.lastname: Lussier-Cushing
authors.forename: Barbara
authors.initials: B
authors.lastname: Lakatos
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Fricchione
authors.forename: Joan
authors.initials: J
authors.lastname: Quinlan
authors.forename: Martha
authors.initials: M
authors.lastname: Kane
authors.forename: Rhodes
authors.initials: R
authors.lastname: Berube
authors.forename: Mark
authors.initials: M
authors.lastname: Blais
authors.forename: Virginia
authors.initials: V
authors.lastname: Capasso
authors.forename: Firdosh
authors.initials: F
authors.lastname: Pathan
authors.forename: Andrew
authors.initials: A
authors.lastname: Karson
authors.forename: Michael
authors.initials: M
authors.lastname: Bierer
mesh_terms: D000437:Alcoholism / Q000534:rehabilitation*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000534:rehabilitation*
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines; D000431:Ethanol