Use of a quality improvement strategy to increase drug and alcohol consultation and care opportunities for mental health inpatients in rural and remote New South Wales.
Warren Kealy-Bateman, Namrata Christian, Rebecca Wetton and 3 others
PMID 34148275WHAT IT FOUND
Drug and alcohol consultations rose from 21% to 35.8% after a combined local effort of daily meetings, education, executive support, staff prompts from family reports, withdrawal signs and urine screens, and modelling that referrals fit existing resources.
Key findings
01Drug and alcohol consultations during mental health admission rose from 21% to 35.8% across 460 admissions.
02The audit reported a significant relationship between year and consultation.
03Auditors still found people with clear drug or alcohol problems who were not referred in 2019.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The audit compared 2018 with 2019 after a combined local effort, so it cannot show which part of the effort mattered. The intervention included daily meetings, education, executive support, referral prompts from family reports, withdrawal signs and urine screens, and resource modelling, so the contribution of any single component cannot be separated. Aboriginal status was known for each admission but was not reported for ethical reasons, despite high Aboriginal admission rates. Some patients with clear drug or alcohol problems still had no referral in 2019. The audit covered only two units at Dubbo Hospital in rural and remote New South Wales.
The easy way to misread this
Do not read the rise to 35.8% as proof that any one part of the local effort caused it. The audit changed daily meetings, education, executive support, referral prompts and resource modelling together, and it only compared 2018 with 2019 after the effort.