Does implementation of clinical practice guidelines change nurses' screening for alcohol and other substance use?
OBJECTIVE
To examine the effectiveness of the implementation of a clinical practice guideline on nurses screening patients for alcohol and other substance use, providing brief interventions, and referring patients at risk for treatment.


METHODS
Medical record audits were conducted in selected medical and surgical wards of two metropolitan hospitals in Sydney prior to and three months following the guideline implementation.


RESULTS
Seventy-nine (pre) and 84 (post) patient records were audited. There were no differences in screening rates for alcohol (28% and 29%), tobacco (29% and 23%) and illicit drug use (16% and 8%) before and after implementation of the guideline.


CONCLUSIONS
Factors which may have limited the effectiveness of the clinical practice guideline dissemination included design of the education program, existing level of nurses' knowledge and competence, and strategies in place to ensure sustainability of the program. We also provided suggestions for improvement of screening for alcohol and other substance use.
Tran
Duong Thuy
DT
Centre for Applied Nursing Research, Sydney South West Area Health Service, Sydney, NSW, Australia.
Stone
Andrea M
AM
Fernandez
Ritin S
RS
Griffiths
Rhonda D
RD
Johnson
Maree
M
D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D002983:Clinical Competence; D004059:Diffusion of Innovation; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D019983:Guideline Adherence / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000451:nursing / Q000706:statistics & numerical data*; D009517:New South Wales; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment; D009731:Nursing Audit; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education* / Q000458:organization & administration / Q000523:psychology; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000175:diagnosis*