Implementing an Updated Alcohol Withdrawal Symptom Management Order Set Focused on Patient Safety.

Area of Science:

• Clinical Pharmacy
• Psychiatric Nursing
• Quality Improvement

Background:

• Inpatient mental health units frequently manage patients with alcohol withdrawal.
• Registered nurses identified concerns with the existing alcohol withdrawal symptom management order set.
• A multidisciplinary team (nurses, psychiatrists, pharmacists) was assembled to address these concerns.

Purpose of the Study:

• To review and revise the current alcohol withdrawal order set.
• To implement updated protocols and educate healthcare staff.
• To evaluate the outcomes of the revised order set and implementation process.

Main Methods:

• The Plan-Do-Study-Act (PDSA) quality improvement framework guided the project.
• Key phases included a nurse survey, practice evaluation, order set revision, and staff education via simulation.
• Patient records were analyzed for adverse events post-implementation.

Main Results:

• Diazepam was adopted as the primary medication, with a front-loading protocol introduced.
• The revised order set demonstrated improved clarity, boosting nursing staff confidence in using the Clinical Institute Withdrawal Assessment Alcohol Scale Revised (CIWA-Ar).
• No adverse patient events were recorded following the implementation of the revised order set.

Conclusions:

• The updated alcohol withdrawal order set aligns with current evidence and ensures patient safety.
• Healthcare professionals found the revised order set clear and easy to follow, with satisfaction reported by nurses, pharmacists, and physicians.
• Multidisciplinary collaboration, adequate resources, and continuous monitoring are crucial for effective alcohol withdrawal symptom management.