Quality assurance in the management of alcohol withdrawal in a general hospital

We have shown previously that a standardized protocol is effective in the management of alcohol withdrawal in a general hospital. In this study a Quality Assurance (QA) approach was used to determine whether all patients at risk were detected and treated correctly in time. A total of 500 episodes were monitored, 82% of patients at risk were identified, and 89% of patients were seen within 24 h (median 4 h). The protocol was followed correctly in 86% of cases but was inappropriately applied in 7.2%. Medication was given in 242 cases, on 93% of occasions according to guidelines. In all, 11.8% of episodes became complicated by seizure, hallucinations or confusion and two patients had terminal respiratory failure which worsened after sedation. A standardized protocol for alcohol withdrawal can be used in a general hospital with high rates of detection of at risk patients, a high rate of compliance with treatment guidelines and a low rate of complications.