Alcohol Withdrawal Assessment Instruments in Acute Care: An Integrative Review

Alcohol withdrawal is a prevalent challenge to manage in the hospital setting, and left undetected, can lead to life-threatening outcomes. Early identification and intervention are critical to improve morbidity and mortality. Nurses are the primary users of withdrawal assessment instruments in the hospital setting, and recommendations are needed regarding assessment tools that are psychometrically sound and usable.

The purpose of this integrative review was to evaluate and summarize the evidence related to the psychometric testing and usability of alcohol withdrawal assessment tools used in the hospital setting.

The Whittemore & Knafl method was used to conduct the review including the following stages: problem identification, literature search, data evaluation, data analysis and presentation of findings. Inclusion criteria were (a) developed/tested in an English-speaking country, (b) used in an adult population, (c) used in a hospital environment, (d) designed to screen or assess for alcohol withdrawal, and (e) tested for reliability, validity, and/or usability.

A total of 17 articles were identified that tested 14 instruments, ranging from 1 to 18 items. Studies were conducted in the United States (n = 7), Europe (n = 4), Canada (n =4), and Australia (n = 1). Validity was evaluated in the highest number of studies (n = 14), followed by reliability (n = 9), and usability (n = 9).

This review comprehensively examined reliability, validity, and usability findings of 14 instruments used for the assessment of alcohol withdrawal in the hospital setting. Findings can be used to help inform instrument selection based on psychometric properties and clinical application.