Nov 4, 2015

RESEARCH: Alcohol Harm in Emergency Departments (AHED) Program

The AHED program conducts research into the extent and impact of alcohol harm in our EDs, is trialling initiatives to monitor and reduce alcohol and other drug harms, and advocates for alcohol policy reform. 

Below is an overview of some of their recent research:

1.     TWO SNAPSHOT SURVEYS

The first planned snapshot survey was conducted on 14 December 2013 at 2am – 107 hospitals in Australia and New Zealand took part. The Medical Journal of Australia published the findings from this survey on 17 November 2015.

This survey found that one in seven patients (14%) at 2am were in the emergency department because of alcohol.

The second snapshot survey was conducted on 6 December 2014 at 2am. Repeating the survey at this time point allowed a direct comparison of survey data.

In this second survey the percentage of alcohol-related presentations was 12% (one in eight patients).

The MJA paper can be accessed here: https://www.mja.com.au/journal/2014/201/10/survey-alcohol-related-presentations-australasian-emergency-departments

2.     SEVEN-DAY CONTINUOUS SURVEY

A seven-day continuous survey in six Australian EDs and two New Zealand EDs was conducted during the period 1-8 December 2015. This was a prospective survey in which the participating EDs attempted to screen all patients for alcohol. Approximately 10,500 patients presented to the eight EDs during this week. This survey was an attempt to gather in depth data on direct and indirect alcohol harms:

  • The quantity and types of alcohol-related presentations
  • The impact alcohol-affected patients have on the overall functioning of the ED.

Results will be officially released at ACEM’s Annual Scientific Meeting (22-26 November 2015) and in a journal paper to be submitted to the Lancet Journal in November 2015.

3.     STAFF PERCEPTIONS SURVEY

The aim of the survey was to obtain benchmark qualitative data from ED staff on their experiences of the effect of alcohol-related presentations on ED staff and the functioning of the ED.

The survey objectives were to:

  • Conduct the first large-scale survey of ED staff experiences of alcohol-related presentations
  • Quantify the scale of alcohol-related violence experienced by ED staff
  • Quantify ED staff perceptions of the effect alcohol-related presentations have on the functioning of the emergency department.

ED clinical staff were invited to participate in an online survey over a five week period (30 May – 7 July 2014). 2002 responses were received, which is the largest response rate for this kind of survey in Australasia.

Survey findings were presented at a public launch at St Vincent’s Hospital, Melbourne on 6 November 2014. More results will be released in a journal paper which has been submitted to the Medical Journal of Australia in July 2015.

A video to illustrate findings from the survey was also produced for the launch.

Results

ED clinicians reported:

  • 98% had experienced alcohol-related verbal aggression from patients in the last 12 months.
  • 92% had experienced alcohol-related physical violence or threats from patients in the last 12 months.
  • Over 94% said alcohol-related presentations in the ED had a negative or very negative effect on the workload of ED staff.
  • 87% said they had felt unsafe due to the presence of an alcohol-affected patient while working in their ED.
  • 88% said that the care of other patients was negatively or very negatively affected.