Introduction The 2013 NCEPOD report1 identified that care was ‘less than good` in more than half of cases reviewed for patients admitted with alcoholic liver related deaths, and that opportunities for diagnosis were missed on previous admissions. It was recommended that patients should be screened for hazardous drinking on admission with access to full assessment and brief intervention within 24 hours.
This is an audit of screening on admission, the implementation of a pathway and a reaudit.
The Wessex Academic Health Sciences Network (AHSN) funded this audit as part of a pathway improvement project for alcohol related liver disease.
Method All patients admitted 1st January-31s March 2015, for at least 24 hours, coded with liver disease. The notes were reviewed for:
• Documentation of alcohol unit consumption,
• AUDIT – C use, if higher risk (AUDIT C>8), referral to the Alcohol Intervention Team (AIT)
• Reviewed by AIT
• Discharge support offered/referral to community services
• First or subsequent admission to hospital
• GP Communication/discharge summary
Following the first audit, an alcohol pathway was implemented, including an AIT electronic referral system, and supported by a Trust wide education programme, led by the AIT to improve alcohol history taking, and use of AUDIT-C.
The audit was repeated one year later 01/01/2016-31/03/2016.
Conclusion Trustwide training was effective in the use of AUDIT-C for screening for alcohol intake, with increased referrals to the AIT. Similar numbers of patients were seen by the AIT in both audits. Post discharge care was markedly improved in the 2016 audit. Ongoing training of staff is required with onward referral for those identified with harmful drinking. This audit has been repeated in other hospitals across Wessex and has been a springboard for change and improvement across the region
. National confidential enquiry into patient outcome and death, 2013, Alcohol Related Liver Disease: Measuring the Units (2013)
Disclosure of Interest H Phillips Conflict with: Wessex AHSN, J. Sinclair: None Declared, L. Grellier: None Declared, H. Gordon: None Declared
- Alcohol Screening