UCLA

Purpose. The purpose of this study was to assess preliminary efficacy of screening for alcohol use and brief interventions (BIs) on patients who present to the emergency department (ED) at-risk for alcohol use disorder (AUD) utilizing established nurse navigators. This is the first study to assess the initial efficacy of a BI to reduce alcohol use in at-risk patients utilizing nurse navigators in the ED who were not bedside nurses.

Theoretical Framework. The theoretical framework guiding this study is based on the Health Belief Model (HBM) and the Transtheoretical Model and is the first study to assess the HBM constructs for patients with AUD in the ED.

Methods. A pilot, non-equivalent, two-group quasi-experimental study assessed the preliminary effectiveness of a registered nurse-led BI to reduce alcohol consumption and dependency, improve readiness to change alcohol use, lower depressive symptoms, decrease perceived barriers, and improve the perceived susceptibility, seriousness, and benefits among individuals presenting to the ED who were at-risk for AUD. Two groups were enrolled: an intervention group and a usual-care comparison group.

Results. At 3-month follow-up, the intervention group had a significant decrease in standard drinks on a typical day and the construct of perceived seriousness was significantly higher in the intervention group than in the comparison group. Within groups significance was found at the 3-month follow-up for both the intervention and comparison groups for most outcome variables. The Patient Health Questionnaire (PHQ-9) scores for depression were significantly greater at baseline for participants who did not return for follow-up.

Conclusion. This pilot study examined the feasibility of a nurse navigator-administered BI in the ED for patients at-risk for AUD and may be beneficial for future randomized control trials to assess the efficacy of a nurse navigator-led BI in the ED.

Implications. Nurses should be screening patients on admission for alcohol use based on current evidenced-based practice tools. They should be planning interventions with their patients at risk for alcohol use disorder. They should be assisting with referrals to treatment in the community and offering options to the patient who is ready to change their alcohol use. Electronic health records can be utilized to alert nurse navigators for consult to provide the BI and refer patients to treatment.