1. Substance Misuse Nurse Team Lead Acute Division
Pauline Izat
Substance Misuse Nurse
Team Lead
Acute Division

2. An update to Alcohol Misuse in Scotland Trends and Costs( Scottish Executive,October 2001)
A & E attendances,the 10.5 million sum
utilises a cost per A & E attendance of 57
(ISD, 2003), and attributes 12% of A & E
attendances as being alcohol-related (Pirohamed et al, 2000).

3. Challenges
Strategic
Education of Public and Staff regarding the role of Accident and Emergency within Healthcare
Clinical Activity

4. STRATEGIC HEAT 4 Partnership working with key ADP agencies
Local press involvement

5. Nae Bother Campaign Strathclyde Police June 2010

6. Education Health promotion events FAST screening
Challenging of cultural attitudes

7. St Aidans High School Pour Yerself a Drink!

8. Clinical Activity Identification of Top 20 attenders
Development day facilitated by LEAN methodology to support partnership working across statutory agencies
A/E clinic

9. James Identified as a regular attender of our
A/E department. 35 year old man, married
with 2 children. Employed.
First attended our department in 2008 with a
minor injury. Not referred to this service until
his first admission. Did not manage to engage with
appointments at this time but attended on several
occasions thereafter asking for detox. No referral
made until his last admission.

10. Attendances to Emergency Department TOTAL NUMBER OF ATTENDANCES 41 WITHIN 9 MONTH PERIOD !

11. Hours spent in Emergency Department Oct Oct 2009 TOTAL HOURS SPENT 61.6 HOURS BREACH OF 4 HOUR TARGET!

12. TOTAL NUMBER OF IN PATIENT DAYS -14 ON 4 OCCASIONS!

13. James
During this time James was brought to hospital in an ambulance on 12 occasions. He was also brought by Police twice.
He separated from his wife and lost access to his 2 children
He became homeless following the death of his mother

14. Substance Misuse Nurse Service
Saw James on 12 occasions to support him with his ongoing alcohol detox following discharge from hospital
Initiated on going support with local services
Re established links with GP
Re established links with family
Arranged support via mutual support group
Supported tenancy application

15. James No attendances to A/E since June 2009! Remains abstinent
Now in permanent accommodation
Has regular access to children
Has returned to work

16. If we always do things the same things will always stay the same!