Alcohol and injury
Up to half of all trauma patients are drunk when they're injured, which is why the American College of Surgeons requires designated trauma centers to assess for substance abuse and refer for treatment. Many hospitals use SBIRT — Screening, Brief Intervention and Referral to Treatment. JPS went further, assigning SBIRT to chaplains, who have offered counseling and follow-up visits at 3 months, 6 months and 12 months post-discharge.
"Patients inherently trust chaplains, and chaplains are trained to listen and guide our patients," writes Tiffany Overton, trauma research coordinator at JPS, in an article published online in the Journal of Emergency Nursing. "Our chaplains are able to take advantage of a teachable moment by helping patients make connections between drinking and their injuries, if such a connection exists."
Trauma research has documented positive results from approaching patients about risky behavior immediately after they’ve been hurt. For some, like a 45-year-old man described in Overton's report, it’s a wake-up call. "It sure woke me up, that's for sure," the patient told a chaplain six months after being assaulted while intoxicated. "I had to let my fiancé go. She had too many boyfriends …. I don’t drink no more …. Too much drama and trouble."
Recent changes in Medicaid policy have necessitated turning SBIRT over to trained case workers at Trinity Springs Pavilion, who will be incorporating lessons learned from the chaplains' experience.
Overton's co-authors are Gary Williams, Raj Gandhi, MD, PhD, and Shahid Shafi, MD, MPH.