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Factors associated with nurses’ readiness to provide alcohol-related care for inpatients

Broyles LM, Kraemer KL, Hanusa BH, Luther JL, Gordon AJ. Factors associated with nurses’ readiness to provide alcohol-related care for inpatients. Paper presented at: Association for Medical Education and Research in Substance Abuse Annual Meeting; 2010 Nov 6; Bethesda, MD.


Background: While alcohol misuse is common among hospital inpatients, routine alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) is infrequently performed in hospital settings. Inpatient settings may provide an ideal opportunity for nurse-led SBIRT, however, inpatient nurses' professional readiness to conduct alcohol screening and intervention is unknown. Objective: The primary aim of this study was to describe six dimensions of inpatient nurses' professional readiness to work with drinkers: Role Adequacy, Role Legitimacy, Role Support, Motivation, Satisfaction, and Task-Specific Self-esteem. Methods: We conducted a survey of 368 registered nurses (RNs) across 15 inpatient units at a large VA medical center. Appropriate descriptive and bivariate analyses were used to describe the sample and examine relationships between dimensions of readiness and various sociodemographic, knowledge, attitudinal and clinical practice factors. Results: The 134 responding RNs were 77% female, 81% Caucasian, and 50% Bachelor's-prepared, with an average of 13 years of RN experience. Nurses recognize the prevalence of alcohol use disorders and primarily perform alcohol-related care tasks associated with screening and acute withdrawal management. Nurses also report limited competence in assessing and discussing readiness to change drinking behavior, and referring patients to treatment or self-help programs. Years as an RN was inversely associated with Motivation (r = - 0.29, p < .05) and Satisfaction (r = - 0.19, p < .05) for working with drinkers. Similarly, duration of VA tenure was inversely associated with Motivation (r = - 0.33), Task-specific Self-esteem (r = - 0.24), Role Adequacy (r = - 0.20), and Satisfaction (r = -0.19) for working with drinkers (all p < .05). Receipt of alcohol-related continuing education, prior mental health experience, and clinical subspecialty were also associated with dimensions of professional readiness. Conclusions: Results identify areas for nurse continuing education and role development, support inter-disciplinary approaches to alcohol misuse, and inform potential responses to SBIRT-related hospital accreditation measures currently undergoing pilot-testing by the Joint Commission on the Accreditation of Healthcare Organizations.

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