title: A 'symptom-triggered' approach to  alcohol withdrawal management.
abstract: In acute hospital settings, alcohol withdrawal often causes significant management problems and complicates a wide variety of concurrent conditions, placing a huge burden on the NHS. A significant number of critical incidents around patients who were undergoing detoxification in a general hospital setting led to the need for a project to implement and evaluate an evidence-based approach to the management of alcohol detoxification-a project that included a pre-intervention case note audit, the implementation of an evidence-based symptom-triggered detoxification protocol, and a post-intervention case note audit. This change in practice resulted in an average reduction of almost 60% in length of hospital stay and a 66% reduction in the amount of chlordiazepoxide used in detoxification, as well as highlighting that 10% of the sample group did not display any signs of withdrawal and did not require any medication. Even with these reductions, no patient post-intervention developed any severe signs of withdrawal phenomena, such as seizures or delirium tremens. The savings to the trust (The Pennine Acute Hospital Trust) are obvious,but the development of a consistent, quality service will lead to fewer long-term negative effects for patients that can be caused by detoxification. This work is a project evaluation of a locally implemented strategy, which, it was hypothesised,would improve care by providing an individualised treatment plan for the management of alcohol withdrawal symptoms.
authors.forename: Jay
authors.initials: J
authors.lastname: Murdoch
authors.forename: Janet
authors.initials: J
authors.lastname: Marsden
mesh_terms: D000328:Adult; D000430:Alcohol Withdrawal Delirium / Q000188:drug therapy* / Q000209:etiology* / Q000451:nursing; D000437:Alcoholism / Q000150:complications* / Q000451:nursing*; D002707:Chlordiazepoxide / Q000627:therapeutic use*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D055318:Evidence-Based Nursing / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom
chemical_list: D002707:Chlordiazepoxide