SHM Converge Scientific Abstract ePoster Gallery-Improving Identification and Management of Patients at Risk for Moderate to Severe Alcohol Withdrawal Syndrome

Pdf Summary

This quality improvement project addressed inconsistent screening and treatment of inpatient alcohol withdrawal syndrome (AWS) at UNC. Before the intervention, 30% of hospitalized patients with alcohol use disorder experienced severe withdrawal, and there was no standardized tool or protocol for risk assessment.<br /><br />The team implemented a PAWSS (Prediction of Alcohol Withdrawal Severity Scale) calculator reminder in Epic, along with an order set and standardized phenobarbital protocol for patients with PAWSS scores of 4 or higher, indicating risk for moderate-to-severe AWS. Educational sessions were also provided to clinicians. Patients admitted with AWS from July 2023 to September 2024 were evaluated for PAWSS use, phenobarbital and benzodiazepine prescribing, length of stay, and escalation of care.<br /><br />Results showed clear improvement after the intervention. Phenobarbital use increased three-fold, from 18% to 60%. PAWSS use by providers also increased. Benzodiazepine use initially decreased, though not consistently over time. Importantly, length of stay decreased, suggesting better management and possibly reduced resource use.<br /><br />The patient population was mostly male (73.8%), with a median age of 47 years and a median hospital stay of 4 days.<br /><br />Overall, the study suggests that combining standardized risk screening with a phenobarbital-based protocol can reduce variation in AWS care and improve outcomes. The authors recommend expanding the approach to the UNC emergency department and Chatham Hospital, with continued iterative improvement through PDSA cycles.

Asset Subtitle

Melissa Pabalan

Meta Tag

Author List Amy Dacillo-Curso, Ashmita Chatterjee, Carlton Moore, Melissa Pabalan

Category Research

Concept Alcohol Withdrawal

Concept PAWSS

Concept Phenobarbital

Concept Benzodiazepines

Concept Inpatient Screening

Distinguished Non-Finalist

Presenter Organization Unc

Presenting Author Melissa Pabalan

Track Quality Improvement

Keywords

alcohol withdrawal syndrome

PAWSS

phenobarbital protocol

inpatient screening

quality improvement

Epic reminder

benzodiazepine use

risk assessment

length of stay

standardized care

Alcohol Withdrawal

PAWSS

Phenobarbital

Benzodiazepines

Inpatient Screening