Examining the feasibility of integrating an alcohol detoxification protocol within primary care
Date of Publication
Project Advisor: Christina Harlow DNP, FNP-BC; Agency Mentor: Victoria Roudabush, RN
Purpose: Medically supervised, in-home alcohol detoxification is safe, efficacious, cost-effective, and satisfying for patients. However, it remains underutilized within primary care practices. This feasibility study aimed to examine clinician perceptions of adopting a standardized outpatient alcohol detoxification protocol at a rural primary care clinic where no internal protocol exists.
Methods: An ambulatory alcohol detoxification protocol was created using the American Society of Addiction Medicine guideline on alcohol withdrawal management and presented to 38 providers and 11 nurses. Twelve participants (six providers and six nurses) completed a modified version of the Implementation Process Assessment Tool. The instrument measured stakeholder perceptions of the protocol within the domains of individual stages for behavioral change, individual activities and perceived support, collective readiness and support, and perceived effectiveness of the intervention. Average sub-domain scores were analyzed using the one-sample t-test.
Results: Meaningful increases in average IPAT scores were noted for individual stages for behavioral change among nurses (25.33, p <0.05) and the total cohort (24.4, p <0.01), and for perceived effectiveness of the intervention among nurses (18.33, p <0.05), providers (21, p <0.05), and the total cohort (19.4, p <0.01).
Conclusions: Stakeholders viewed the protocol favorably in terms of perceived effectiveness and openness to change. Neutral ratings related to perceived support and individual/collective readiness highlighted a need to tailor implementation strategies before trialing the protocol. This study was limited by its small sample size and nonresponse bias. Structured stakeholder interviewing and replication with a refined sampling methodology are recommended.
Miller, DNPc, BSN, RN, Emily A., "Examining the feasibility of integrating an alcohol detoxification protocol within primary care" (2023). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 131.
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The author has no conflicts of interest to disclose. This author receives funding from the Foundation for Healthy Communities to improve care delivery aimed at alcohol and substance use disorders within primary care clinics throughout the Dartmouth-Hitchcock Health network.