Presenters: Assoc. Prof. Ping Yu Team: Wilf Yeo, David Reid, - PowerPoint PPT Presentation

Presenters: Assoc. Prof. Ping Yu Team: Wilf Yeo, David Reid, Barbara Sinclair, Xiaoqi Feng, Susan Bresnahan, Peter Lynch, Renee Brighton, Siyu Qian, Mudar Irani

Alcohol A Major Risk to Population Health Road and Liver other disease accidents Brain Domestic damage and public violence Family breakdown Crime Social dysfunction

To identify the gaps in effective identification, assessment and clinical Project Aim management of vulnerable patients with harmful alcohol use in Emergency presentations in Wollongong Hospital

Methods Medical records auditing Retrospectively identified and audited 210 patient records with a diagnosis of alcohol related problem in Nov 2016 to Jan 2017 Compare the management against clinical guidelines

Findings • Age: 14 to 90 years old – 60% of them between 40 and 70 years old 70% 30%

Findings Ideally, they should be identified E.g. intoxication Patients’ presentations E.g. directly abdominal related to alcohol pain Patients’ presentations 9% NOT directly related to alcohol 91%

At Which Point of Patient Journey Were Total Harmful Alcohol Use Identified? 79% ED assessment: 37% Ward: 23% Triage: 17% Waiting room: 2% Triage Waiting room Ward outside of ED Treatment Referral ED Assessment Registration

At Which Point of Patient Journey Were Total Harmful Alcohol Use Identified? 79% ED assessment: 37% 21% Ward: 23% Triage: 17% Waiting room: 2% Triage Waiting room Ward outside of ED Treatment Referral ED Assessment Registration

Patients with Detailed Alcohol Use History Total ED doctor: 55% 65% Ward staff: 7% ED nurse: 3% Triage Waiting room Ward outside of ED Treatment Referral ED Assessment Registration

Patients with Detailed Alcohol Use History Total ED doctor: 55% 65% 35% Ward staff: 7% ED nurse: 3% Triage Waiting room Ward outside of ED Treatment Referral ED Assessment Registration

Alcohol Withdrawal Management Total 57% After assessment: 37% Before assessment: 11% Ward: 9% Triage Waiting room Ward outside of ED Referral ED Assessment Treatment Registration

Alcohol Withdrawal Management Total 57% After assessment: 37% 43% Before assessment: 11% Ward: 9% Triage Waiting room Ward outside of ED Referral ED Assessment Treatment Registration

Thiamine • Medication Management 50% 50% Prescribed! No! Thiamine

Medication Management Benzodiazepine • 40% 60% Prescribed! No! Benzodiazepine

Referral to Drug and Alcohol Service 72% 28%

Summary 210 65% 50% 57% 79% 40% 28% patients Detailed Referred to alcohol AWS Benzodiazepine Drug and Identified Thiamine use history Alcohol Service

Summary 210 43% 21% 35% 50% 60% 72% patients Detailed Referred to alcohol AWS Benzodiazepine Drug and Identified Thiamine use history Alcohol Service

Acknowledgement • We are grateful for the support from – Global Challenges Program – Illawarra and Shoalhaven Local Health District – Illawarra Health and Medical Research Institute

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