Désy Pierre M, Howard Patricia Kunz, Perhats Cydne, Li Suling
ENA Injury Prevention Institute/EN CARE, ENA, Des Plaines, IL 60016-6569, USA.
J Emerg Nurs. 2010 Nov;36(6):538-45. doi: 10.1016/j.jen.2009.09.011.
In a quasi-experimental study, control and intervention group outcomes were compared following implementation of alcohol screening, brief intervention, and referral to treatment (SBIRT) by emergency nurses. The primary hypothesis was: Trauma patients who participate in nurse-delivered ED SBIRT will have greater reductions in alcohol consumption and fewer alcohol-related incidents than those who do not.
Patients were screened for alcohol use and those with risky drinking were randomly assigned to either the intervention or usual care group. Those in the intervention group received a brief motivational intervention and referral to appropriate follow-up services. Using medical and driving history records, subjects' alcohol consumption, alcohol-related traffic incidents, repeat injuries, and repeat ED visits were compared between groups at baseline and three-month follow-up.
Alcohol consumption decreased by 70% in the intervention group compared to 20% in the usual care group. Drinking frequency also decreased in both groups. Fewer patients from the intervention group (20%) had recurring ED visits compared to patients in the usual care group (31%).
The SBIRT procedure can impact alcohol consumption and potentially reduce injuries and ED visits when successfully implemented by staff nurses in the emergency department environment. Further research is needed to improve follow-up methods in this hard to reach, mobile patient population.
在一项准实验研究中，比较了急诊护士实施酒精筛查、简短干预及转介治疗（SBIRT）后对照组和干预组的结果。主要假设为：参与护士主导的急诊SBIRT的创伤患者，与未参与者相比，饮酒量会有更大幅度的减少，且与酒精相关的事件会更少。
对患者进行酒精使用筛查，将有危险饮酒行为的患者随机分配至干预组或常规护理组。干预组患者接受简短的动机性干预并被转介至适当的后续服务。利用医疗和驾驶历史记录，在基线和三个月随访时比较两组患者的酒精摄入量、与酒精相关的交通事故、重复性损伤及再次急诊就诊情况。
干预组的酒精摄入量下降了70%，而常规护理组下降了20%。两组的饮酒频率也均有所下降。与常规护理组（31%）相比，干预组再次急诊就诊的患者较少（20%）。
当急诊室的护士成功实施SBIRT程序时，其可以影响酒精消费，并有可能减少损伤和急诊就诊次数。对于这个难以接触到的流动患者群体，需要进一步研究以改进随访方法。
