Hospital patients have high acceptability of and comfort with nurse-delivered alcohol screening, brief intervention and referral to treatment, according to a study.

In discussing why they conducted the study, the authors noted that The Joint Commission recently approved new hospital accreditation measures related to SBIRT for all hospitalized patients, but little is known about the effectiveness of brief interventions or inpatient acceptability of SBIRT performed by healthcare professionals other than physicians.

"SBIRT is a brief conversation, about 10 to 15 minutes, about hazardous alcohol consumption," study coauthor Deborah S. Finnell, RN, DNS, APRN-BC, CARN-AP, a research nurse scientist at the VA Western New York Healthcare System and associate professor of nursing at the University at Buffalo, said in a news release.

"Healthcare team members could easily deliver SBIRT, assuming they are qualified. Since nurses provide 24-hour care in hospitals, nurses are most likely to have contact with patients compared with other healthcare team members, such as physicians and social workers."

The study is scheduled for publication in the April issue of Alcoholism: Clinical & Experimental Research.

Corresponding author Lauren M. Broyles, RN, PhD, a research health scientist at the VA Pittsburgh Healthcare System and assistant professor of medicine at the University of Pittsburgh, and colleagues conducted a cross-sectional study of 342 males and 13 females in the med-surg unit at a large university-affiliated medical center that is part of the U.S. Department of Veterans Affairs.

Results indicated acceptability for nurse-delivered SBIRT was high. Patient acceptability for eight out of 10 individual nurse-delivered SBIRT tasks was greater than 84%. Roughly 20% of the patients reported some degree of personal discomfort with the discussions; in general these individuals had a lower belief in their ability to reduce their drinking risk, were older than 60, had a positive alcohol screening and were of non-black race.

"We found, in general, that acceptability for nurse-delivered SBIRT tasks was associated with how people perceived their own alcohol-related risks," Broyles said. "Patients had higher acceptability if they felt they were able to determine and reduce their own alcohol-related health risks, and if they had expressed concern about their own alcohol use.

"Conversely, roughly 20% of the patients expressed annoyance or embarrassment with the questions while also showing high levels of acceptability. While this might seem contradictory, patients might feel embarrassed or uncomfortable with the topic or discussion even though they see the discussions as a legitimate, necessary and acceptable part of the nurse's role."

Finnell said the study emphasizes the importance of being patient-centered.

"Patients are accepting of receiving information from nurses about changing their alcohol use and about self-help groups," she said. "Specifically, when patients can make the connection between their alcohol use and health risks, they may be more accepting of having the conversation with the nurse and decreasing the amount of alcohol they consume. Additionally, nurses providing patient-centered care will be sensitive to signs that the patient is uncomfortable during the conversation."

Both Broyles and Finnell emphasized the need for appropriate training, practice, support and pragmatic strategies for incorporating alcohol SBIRT into existing clinical practices and routines.

"Our findings suggest that once trained in SBIRT and motivational interviewing techniques, providers can proceed with greater confidence in alcohol-related risk assessment and risk-reduction conversations with patients," Broyles said.