An evidence based alcohol screening, brief intervention and referral to treatment (SBIRT) curriculum for emergency department (ED) providers improves skills and utilization.
An evidence based alcohol screening, brief intervention and referral to treatment (SBIRT) curriculum for emergency department (ED) providers improves skills and utilization.
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DOI：
10.1300/j465v28n04_01
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发表时间：
2007-01-01
期刊：
影响因子：
3.5
通讯作者：
Owens, Patricia
中科院分区：
文献类型：
--
作者：
Bernstein, Edward;Bernstein, Judith;Owens, Patricia
目的：急诊科（ED）提供了一个机会，通过教学人员进行筛查，进行简短的干预和参考治疗（SBIRT），改善对有风险和依赖性饮酒患者的护理。我们在这里描述的实施在14个学术ED的结构化SBIRT课程，以确定这种学习经验，提高供应商的信念和practices.METHODS：艾德教师，居民，护士，医生扩展，社会工作者，和紧急医疗技术人员（EMT）进行了调查，然后参加两个小时的互动研讨会与案例模拟，或基于网络的程序（www.ed.bmc.org/sbirt）。前后重复测量设计评估的变化，在提供者的信念和做法，在3个月和12个月后exposing.Results：在402艾德供应商，74%的报告< 10小时以前的专业酒精相关的教育和78%有< 2小时的曝光在过去的一年。在3个月的随访中，自我报告的能力信心、干预责任和实际使用SBIRT技能的得分都比基线显著提高。12个月时，增益略有下降，但仍高于基线。在实践中的时间长度与SBIRT利用率呈正相关，控制性别，种族和职业类型。持续的障碍包括时间限制和缺乏转介resources.CONCLUSIONS：艾德供应商积极响应SBIRT。使用的变化是实质性的，在暴露于标准化课程后三个月，但12个月后不太明显。可能需要加强会议、经过培训的助理和基础设施支助，以便在较长时期内维持变革。
OBJECTIVE: Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience improves provider beliefs and practices.METHODS: ED faculty, residents, nurses, physician extenders, social workers, and Emergency Medical Technicians (EMTs) were surveyed prior to participating in either a two hour interactive workshops with case simulations, or a web-based program (www.ed.bmc.org/sbirt). A pre-post repeated measures design assessed changes in provider beliefs and practices at three and 12 months post-exposure.RESULTS: Among 402 ED providers, 74% reported < 10 hours of prior professional alcohol-related education and 78% had < 2 hours exposure in the previous year. At 3-month follow-up, scores for self-reported confidence in ability, responsibility to intervene, and actual utilization of SBIRT skills all improved significantly over baseline. Gains decreased somewhat at 12 months, but remained above baseline. Length of time in practice was positively associated with SBIRT utilization, controlling for gender, race and type of profession. Persistent barriers included time limitations and lack of referral resources.CONCLUSIONS: ED providers respond favorably to SBIRT. Changes in utilization were substantial at three months post-exposure to a standardized curriculum, but less apparent after 12 months. Booster sessions, trained assistants and infrastructure supports may be needed to sustain changes over the longer term.