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Hospitalized Patients’ Acceptability of Nurse-Delivered Screening, Brief Intervention, and Referral to Treatment

Authors

  • Lauren M. Broyles,

    1. From the Center for Health Equity Research & Promotion (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; VISN4 Mental Illness Research Education, and Clinical Center (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Division of General Internal Medicine (LMB, KLK, AJG), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Center for Research on Healthcare (LMB, KLK, AJG), University of Pittsburgh, Pittsburgh, Pennsylvania; and University of Pittsburgh, School of Medicine (ER), Pittsburgh, Pennsylvania.
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  • Emily Rosenberger,

    1. From the Center for Health Equity Research & Promotion (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; VISN4 Mental Illness Research Education, and Clinical Center (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Division of General Internal Medicine (LMB, KLK, AJG), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Center for Research on Healthcare (LMB, KLK, AJG), University of Pittsburgh, Pittsburgh, Pennsylvania; and University of Pittsburgh, School of Medicine (ER), Pittsburgh, Pennsylvania.
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  • Barbara H. Hanusa,

    1. From the Center for Health Equity Research & Promotion (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; VISN4 Mental Illness Research Education, and Clinical Center (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Division of General Internal Medicine (LMB, KLK, AJG), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Center for Research on Healthcare (LMB, KLK, AJG), University of Pittsburgh, Pittsburgh, Pennsylvania; and University of Pittsburgh, School of Medicine (ER), Pittsburgh, Pennsylvania.
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  • Kevin L. Kraemer,

    1. From the Center for Health Equity Research & Promotion (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; VISN4 Mental Illness Research Education, and Clinical Center (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Division of General Internal Medicine (LMB, KLK, AJG), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Center for Research on Healthcare (LMB, KLK, AJG), University of Pittsburgh, Pittsburgh, Pennsylvania; and University of Pittsburgh, School of Medicine (ER), Pittsburgh, Pennsylvania.
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  • Adam J. Gordon

    1. From the Center for Health Equity Research & Promotion (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; VISN4 Mental Illness Research Education, and Clinical Center (LMB, BHH, AJG), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Division of General Internal Medicine (LMB, KLK, AJG), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Center for Research on Healthcare (LMB, KLK, AJG), University of Pittsburgh, Pittsburgh, Pennsylvania; and University of Pittsburgh, School of Medicine (ER), Pittsburgh, Pennsylvania.
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Reprint requests: Lauren M. Broyles, PhD, RN, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, 7180 Highland Drive (151C-H), Pittsburgh, PA 15206; Tel.: 412-954-5269; Fax: 412-954-5265; E-mail: Lauren.Broyles@va.gov

Abstract

Background:  Inpatient healthcare providers in the United States may soon be required to offer alcohol screening, brief intervention, and referral to treatment (SBIRT) for hospital accreditation, but little is known about inpatient acceptability for SBIRT, particularly when performed by nonphysician providers such as nurses. The purpose of this study was to assess patient acceptability for and comfort with nurse-delivered SBIRT care among hospitalized patients and to identify factors associated with SBIRT acceptability.

Methods:  We conducted a cross-sectional survey of 370 hospitalized medical–surgical patients at a large university-affiliated medical center, which is part of the U.S. Department of Veterans Affairs.

Results:  Patient acceptability for 8 of 10 individual nurse-delivered SBIRT tasks was >84%. Patients were more accepting of SBIRT tasks if they felt able to determine their alcohol risk, able to reduce alcohol-related health risks, and expressed some degree of concern about their own use of alcohol. Approximately 20% of patients reported some degree of personal discomfort with alcohol-related discussions. Patients who were less comfortable with these discussions had lower perceived ability to reduce alcohol-related health risk, were >60 years old, had a positive AUDIT-C screening, and were of nonblack race.

Conclusions:  Among hospitalized patients, patient acceptability for nurse-delivered SBIRT is high, and alcohol-related risk perceptions appear to be important factors associated with acceptability for SBIRT tasks. Providers can proceed with greater confidence in SBIRT-related discussions with most hospitalized patients but may need particular sensitivity and skill addressing alcohol with patient subgroups such as older patients and those with positive alcohol screenings.

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