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Substance abuse among somatic patients: A strategy for treating harmful use of alcohol, intoxication and addiction in a somatic hospital setting

Contact person

name: Sverre Nesvåg
Phone: 0047 90837431
E-mail: [email protected]
Hospital: Stavanger Universitetssykehus
Network: Norwegian Network of HPH

Project details

Langugage of communication: English
Standard relation: Standard 1. Management Policy, Standard 2. Patient Assessment, Standard 3. Patient Information and Intervention, Standard 4. Promoting a Healthy Workplace, Standard 5. Continuity and cooperation
Date of last update: 10. November 2008

Background

The Administrative alcohol and drug treatment reform that was implemented in 2004 transferred responsibility for the treatment of problem alcohol and drug users from the county councils to the regional health authorities on behalf of the state. The regional health authorities’ responsibility is defined as “interdisciplinary, specialised treatment of drug and alcohol abuse”. It forms part of the specialist health services on a par with the somatic and psychiatric health services. The overriding objective of the Reform was to improve the treatment options for problem drug and alcohol users. This mean strengthening the health services for this patient group and improving cooperation between the specialist health services for problem drug and alcohol users who require services from different parts of the specialist health services.

Purpose and objectives

This is a presentation of a comprehensive strategy currently containing twelve defined activities. Each of these activities are to be registered in this activity data base. The purpose and objectives of the comprehensive strategy are as follows: 1.To improve the quality of treatment in regard to the diagnosis that patients are treated for in a somatic setting by identifying and intervene towards problem alcohol and drug users. 2.Using the opportunity a stay at the hospital is for identifying and intervening when it comes to alcohol and drug problems. 3.Improving patient pathways for patients in need of specialised treatment for drug and alcohol abuse. 4.Integrate the work in the existing HPH models and tools in practice. 5.To develop a research program connected to the clinical, educational and organizational issues involved in the implementation process.

Methodology and actions

Strategy: The enterprise is based on education of the health staff on alcohol and drugs health work. The education is adapted to the different challenges facing different divisions and departments. One important part of the education is to challenge attitudes like “it is difficult for the staff and for the patient if we start asking questions about alcohol use”. The project started out in the emergency ward and has gradually expanded to new divisions and departments at Stavanger University Hospital The enterprise builds on a model with different interventions levels: 1.Screening/Identification; implementation of procedures for identifying patients in the main target groups (acute intoxication, harmful use and dependence syndrome). 2.Written information/digital programs for lifestyle changes. 3.Advice from health staff regarding alcohol and/or drug use 4.Advice/counselling from specially trained health staff/follow up by alcohol and drug liaison service. 5.Collaboration with external health and social services 6.Referral of patient from the somatic setting to specialised treatment for drug and alcohol abuse. Activities: 1.Scandin.Alc: Development of an evidence-based alcohol education program for hazardous drinkers in surgical settings in Scandinavia. 2.Effect of alcohol intervention in surgical settings. 3.Health determinants in surgical patients and need for alcohol interventions in the surgical setting. 4.The effect of patient education program on the high alcohol consumption in patients operated for ankle fractures. 5.One year follow-up after patient education program on the high alcohol consumption in patients operated for ankle fractures 6.Health determinants among hospital patients and the need for health promoting activities in hospitals 7.Development and implementation of procedures for identification and intervention for alcohol intoxication and injuries among adolescents in emergency departments 8.Development and implementation of procedures for abstinence treatment among substance dependent patients in somatic hospital settings 9.Development and implementation of follow up procedures of substance dependent patients after discharge from treatment in somatic hospitals 10.Development and implementation of procedures and services for identification and intervention for alcohol patients in somatic hospital setting 11.Health service research project following the implementation of the strategy for treating harmful use of alcohol, intoxication and addiction in a somatic hospital setting 12.Testing the effect of an interactive digital intervention on alcohol use among hospital staff.

Main target groups

The main target groups in the project generally corresponds with the classification used in ICD 10 and the categories used to specify the clinical conditions; acute intoxication, harmful use and dependence syndrome.

Results and conclusions

This is a work in progress now involving the Division of Acute Care Medicine, Division of Internal Medicine and Division of General and Orthopedic Surgery. Each of the activities has their own defined outcome measures. Results concerning the intervention model will be presented at the 17 th International HPH conference.

Purpose and objectives

This is a presentation of a comprehensive strategy currently containing twelve defined activities. Each of these activities are to be registered in this activity data base. The purpose and objectives of the comprehensive strategy are as follows: 1.To improve the quality of treatment in regard to the diagnosis that patients are treated for in a somatic setting by identifying and intervene towards problem alcohol and drug users. 2.Using the opportunity a stay at the hospital is for identifying and intervening when it comes to alcohol and drug problems. 3.Improving patient pathways for patients in need of specialised treatment for drug and alcohol abuse. 4.Integrate the work in the existing HPH models and tools in practice. 5.To develop a research program connected to the clinical, educational and organizational issues involved in the implementation process.

Publications

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WHO-CC for Evidence Based Health Promotion in Hospitals
Clinical Unit of Health Promotion
Bispebjerg Hospital
DK-2400 Copenhagen NV, Denmark
Phone: +45 3531 6789
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