title: Evaluation of a pilot training program in alcohol screening, brief intervention, and referral to treatment for nurses in inpatient settings.
abstract: Alcohol screening, brief intervention, and referral to treatment (SBIRT) is a set of clinical strategies for reducing the burden of alcohol-related injury, disease, and disability. SBIRT is typically considered a physician responsibility but calls for interdisciplinary involvement requiring basic SBIRT knowledge and skills training for all healthcare disciplines. The purpose of this pilot study was to design, implement, and evaluate a theory-driven SBIRT training program for nurses in inpatient settings (RN-SBIRT) that was developed through an interdisciplinary collaboration of nursing, medical, and public health professionals and tailored for registered nurses in the inpatient setting. In this three-phase study, we evaluated (1) RN-SBIRT's effectiveness for changing nurses' alcohol-related knowledge, clinical practice, and attitudes and (2) the feasibility of implementing the inpatient curriculum. In a quasi-experimental design, two general medical units at our facility were randomized to receive RN-SBIRT or a self-directed Web site on alcohol-related care. We performed a formative evaluation of RN-SBIRT, guided by the RE-AIM implementation framework. After training, nurses in the experimental condition had significant increases in Role Adequacy for working with drinkers and reported increased performance and increased competence for a greater number of SBIRT care tasks. Despite some scheduling challenges for the nurses to attend RN-SBIRT, nurse stakeholders were highly satisfied with RN-SBIRT. Results suggest that with adequate training and ongoing role support, nurses in inpatient settings could play active roles in interdisciplinary initiatives to address unhealthy alcohol use among hospitalized patients.
authors.affiliation: Lauren M. Broyles, PhD, RN, and Adam J. Gordon, MD, MPH, Center for Health Equity Research and Promotion and Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, and Division of General Internal Medicine, Department of Medicine, School of Medicine, and Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania. Keri L. Rodriguez, PhD, Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, and Division of General Internal Medicine, Department of Medicine, School of Medicine, and Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania. Barbara H. Hanusa, PhD, Center for Health Equity Research and Promotion and Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. Caroline Kengor, MPH, Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. Kevin L. Kraemer, MD, MSc, Division of General Internal Medicine, Department of Medicine, School of Medicine, and Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Broyles
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Gordon
authors.forename: Keri L
authors.initials: KL
authors.lastname: Rodriguez
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Hanusa
authors.forename: Caroline
authors.initials: C
authors.lastname: Kengor
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kraemer
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000451:nursing* / Q000628:therapy; D004509:Education, Nursing, Continuing / Q000379:methods / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D024802:Nurse's Role; D010348:Patient Care Team; D010865:Pilot Projects; D015397:Program Evaluation; D012017:Referral and Consultation; D015813:Substance Abuse Detection / Q000451:nursing