title: Could an advance practice nurse improve detection of alcohol misuse in the emergency department?
abstract: Alcohol misuse is a prevalent problem in New Zealand society, and one that exacts a considerable cost in terms of health, social cohesion, and economic productivity. Despite the burden of alcohol misuse, screening, brief assessment, and interventions for alcohol problems are frequently poorly performed within general health services. In this paper we explore the response to alcohol problems in a New Zealand emergency department and discuss difficulties encountered in improving rates of detection by emergency department personnel. We report the results of a clinical audit of alcohol screening and brief assessment and a staff education programme designed to improve practice in this area, but which met with limited success. The potential role for an advanced practice nurse providing a clinical consultation and liaison service to the emergency department staff is explored. We argue that such a role has potential to reduce the health and social costs of alcohol misuse, and to meet the national policy objective of providing a treatment response to people with alcohol-related problems in contact with health services.
authors.affiliation: School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Grafton, Auckland, New Zealand. a.obrien@auckland.ac.nz
authors.forename: Anthony
authors.initials: A
authors.lastname: O'Brien
authors.forename: Louise
authors.initials: L
authors.lastname: Leonard
authors.forename: Daryle
authors.initials: D
authors.lastname: Deering
mesh_terms: D000293:Adolescent; D000328:Adult; D057179:Advanced Practice Nursing / Q000193:education / Q000379:methods*; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D055815:Young Adult