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Across the Continuum….. Managing the Inpatient

Published byAlyson Austin Modified over 6 years ago

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Presentation on theme: "Across the Continuum….. Managing the Inpatient"— Presentation transcript:

1 Across the Continuum….. Managing the Inpatient

2 Today’s Panel Participants
Maureen L. Small, RN, BSN Trauma Program Manager Laura Gartner MS, BSN, RN Clinical Informatics Specialist Michael Sangirardi, MSN, RN Associate Director 3 Buerger Outpatient Observation Karen Fithian, LCSW Crisis Coordinator Danielle Schulingkamp, RPh, BCPS, BCCCP Clinical Specialist Critical Care/Surgical Trauma

3 Objectives Describe treatment of inpatient addiction issues
Explain the challenges of the stigma of addiction Develop a system of discussion around the issues surrounding addiction

4 Substance Withdrawal Committee
Multidisciplinary Psychiatry Pharmacy Nursing Informatics Trauma Safety Crisis

5 7% Statistics Adult National Alcoholism Rate

6 Statistics 17 million adults
2.6 million with alcohol plus other substance addiction

7 Alcohol/DT admission = 103
Statistics Community Alcohol/DT admission = 103

8 Delirium Tremens Symptoms: Delirium Tremulousness Agitation
Tachycardia Hypertension Diaphoresis Mortality: <5% with treatment Down from 35% without treatment Complications of Alcohol Withdrawal: Pathophysiological Insights pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf

9 Patient Case Mr.K is a 40yo man admitted to the ER with alcohol intoxication Other symptoms include dizziness and lightheadedness History includes Alcoholism Cirrhosis Depression Labs: Abnormal LFTs ETOH level = 444

10 Screening Tool Audit-C Standardized tool Screen on admission
Alert to contact MD Facilitate monitoring/treatment

11 Screening Tool Scores >3 Requires further assessment
Physician notification

12 Audit-C

13

14 Inpatient Screen In past 6 months, out of 2,879 screenings:
30% of patients scored >4 7% of these patients had score of 12

15 Patient Case Audit-C = 12 on admission

16 Monitoring Tool Clinical Institute Withdrawal Assessment (CIWA-Ar)
Series of questions/observations Detects progression

17 Patient Case CIWA range of 10-20

18 Treatment Algorithm Computerized order set Nursing driven
Decision support Ancillary orders Nursing driven

19 Treatment Algorithm

20 Patient Case

21 Counseling Referral Discharge Resources

22 Patient Case Mr.K opted for inpatient management
Placement into treatment facility

23 Future Goals Committee expansion Address ALL Substance Withdrawal
Guidance Increased resources

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