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DNP - University Access Only
Doctor of Nursing Practice (DNP)
Polly A. Hulme,
alcohol withdrawal, alcohol withdrawal management, alcohol withdrawal tools, alcohol withdrawal treatment, symptom triggered, and CIWA-Ar.
Introduction: Current practices for managing and treating alcohol withdrawal (AW) have not been validated, which could be contributing to increased length of stays (LOS) and inappropriate benzodiazepine usage.
Methods: A literature review examined the effects of alcohol, the progression of AW, treatment and management options, and the impacts on hospitalized patients. Various tools were identified, and no gold standard exists. Each tool had positive and negative aspects, but the CIWA-Ar was most applicable to this project. Symptom triggered scales, such as the CIWA-Ar, can reduce LOS and total benzodiazepine usage.
Gaps: The current method lacks uniformity across the organization and inconsistencies for managing hospitalized patients with AW are present. When looking at validated scales for non-critical care patients, the most utilized and analyzed was the CIWA-Ar. Limited data exists regarding other scales. The main shortcoming of the CIWA-Ar is the lack of monitoring of objective data, which is used on different scales, but the research only supports these scales with more severe AW.
Recommendations: The most reliable process to assess and treat AW needs to be identified, which at this time appears to be the symptom triggered scale known as the CIWA-Ar implemented in a hospital setting.
Library of Congress Subject Headings
Alcoholism -- Treatment.
Outcome assessment (Medical care)
Number of Pages
South Dakota State University
Copyright © 2020 Brett Jahnke
Jahnke, Brett A., "Implementing the Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar)" (2020). Doctor of Nursing Practice (DNP) Practice Innovation Projects. 136.