Title slideWest Suffolk Hospital

Alcohol Project

Chris Hill – Senior Matron

Lou Bland – Alcohol Liver Disease Nurse Specialist

Mario Iannone – Alcohol Liaison Support Worker

Background

• No clear pathway for patients affected by alcohol

• No defined discharge plans

• Re-admission problems

• No health promotion/patient information

• Poor pro-active detox management of alcohol patients

Outline of the project

• A dedicated post holder based in A&E

• A specialist post holder working across our acute NHS Trust

• Alcohol project team – GPs, Psychiatry, Pharmacy, Medical Physicians, Specialist Nurses, Nutritional Specialists

Alcohol Liaison Support Worker

• Funding acquired from RARY

• Focus of this post holder to screen specific age group with alcohol problems who are attending A&E

• Screening tool – PAT

• Data collection looking at age, location, gender and discharge destination

Alcohol Liaison Support Worker

• Paddington Alcohol Tool used in A&E – one minute

• Brief intervention within A&E

• Health promotion and support for patients and relatives

• Sign posting to external agencies for support and advice

• Working with external partners including Police, voluntary sector, County Council

Alcohol Liver Disease Nurse Specialist

• Funded by grant from EoE office

• Based within the Medical Directorate within WSH

• Advising MDT on management plans for inpatients affected by alcohol

• Pro-active management

• Reviewing medical treatment for detox

• Advising MDT on discharge

• Support for patients and families• Working with external partners and support

agencies• Reducing length of stay• Working towards reducing re-admission

rates• Data collection regarding this client group• Development of robust clinical guideline

which reflects other acute NHS Trusts

Alcohol Liver Disease Nurse Specialist

Challenges

• No previous posts within the Trust

• Poor compliance with previous clinical guideline

• Currently no mechanism for follow-up – A&E attendees

• Inpatient attendees

• Four hour target

• No current provision for 24/7 service

Positive outcomes

• Support for patients and relatives

• Anecdotal patient feedback

• Support and training for staff in managing this group of patients

• Reduction in clinical incidents for this patient group

• Development of robust clinical guidelines and discharge plans

Patients screened using P.A.T.

• November 2009 to the end of April 2010

• Patients screened 1,925

• 454 patients P.A.T. positive

Age ranges

0

20

40

60

80

100

120

140

160

2009 2010 2010 2010 2010

Dec Jan Feb Mar Apr

Over 75

66-75

56-65

46-55

36-45

26-35

17-25

<16

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Contacts

Month Year

Age

Headlines

• 144 females• 310 males• 358 patients were brought in from home• 55 patients from a public place• 20 patients from RTCs• 19 patients unknown

Activity

Activity

Activity

Length of Stay

Activity

Home Locations of

Patients Seen

Number of Patients February March April

Home Locations of

Patients Seen

Number of Patients February March April

Acton 0 1 0 Langham 0 1 0

Brandon 6 9 4 Lavenham 4 2 0

Bury St Edmunds

14 19 9 Mendlesham 0 0 1

Clare 0 7 0 Mildenhall 0 5 4

Diss 3 0 2 Newmarket 0 10 0

Essex 0 0 1 Norton 0 0 1

Eye 0 0 3 Norwich 0 1 0

Glemsford 0 3 1 Rattlesden 1 2 0

Great Barton 2 0 2 Stanton 0 0 1

Great Cornard 1 0 0 Stowmarket 5 2 16

Great Waldingfield

0 4 0 Sudbury 5 1 5

Haverhill 1 1 2 Thetford 5 8 9

Icklingham 3 1 1 Thurston 0 2 0

Ipswich 0 1 1 Walsham Le Willows

0 0 2

Ixworth 0 1 0 Woolpit 3 0 0

Lakenheath 3 1 1  

Questions?