National survey of emergency department alcohol screening and intervention practices

Study objective: We describe current alcohol screening and brief intervention practices in emergency departments (EDs) at Level I and Level II trauma centers and characterize ED directors' attitudes and perceived barriers associated with these practices among injured patients in the ED.

Methods: ED directors at Level I and Level II trauma centers were surveyed about current alcohol screening and intervention practices in the ED, as well as knowledge, attitudes, and perceived barriers to these practices.

Results: Nearly half (46.0%) of ED directors surveyed responded. The majority (64.5%) reported using a serum alcohol level to routinely screen for unhealthy alcohol use; only 23.6% routinely use standardized instruments. Sixty-five percent of ED directors support screening and 70% support intervention among injured ED patients. Only 15% reported having formal screening and intervention policies in their ED, and 9% reported offering brief alcohol intervention by trained personnel. The most commonly perceived barriers to implementation are provider time (83%) and financial resources (55%). Of injured patients identified as exhibiting alcohol misuse, few (12%) receive brief intervention conducted by trained personnel.

Conclusion: Current alcohol screening and brief intervention practices are lagging behind national guidelines. Although the majority of ED directors support the idea of alcohol screening and intervention, these beliefs have not yet been translated to routine clinical care.