Implementation of the Modified Minnesota Detoxification Scale in acute alcohol withdrawal patients in the intensive care unit

ABSTRACT

Background: Acute Alcohol Withdrawal Syndrome (AWS) is a severe disorder that affects many patients admitted to the Intensive Care Unit (ICU). Current treatments include the use of benzodiazepines and the Critical Institute Withdrawal Assessment tool (CIWA-Ar). Improper use of this assessment tool can lead to inappropriate dosing of medications leading to adverse patient outcomes. In recent years, a newer and more effective assessment tool has emerged. The Modified Minnesota Detoxification Scale (mMINDS) has shown a significant decrease in the usage of benzodiazepines and the incidence of respiratory distress, delirium, and decreased length of stay (LOS) in the ICU for AWS patients. Methods: The Promoting Action Research Implementation in Health Service (PARiHS) conception model and the Donabedian model for evaluation of health care were used to support the development and implementation of the intervention. After receiving education on the mMINDS assessment tool, nurses assessed AWS patients over one month and tracked their LOS in the ICU. This measurement was compared to the ICU length of stay for AWS patients treated with the CIWA-Ar assessment tool.Intervention Nurses assessed patients suffering from acute alcohol withdrawal using the mMINDS assessment tool. Pre- and post-intervention data was collected on the length of stay in the ICU for each patient. Simple statistical analysis compared the LOS in the ICU between the pre- and post-intervention groups. Results: Patients who were assessed with the mMINDS alcohol withdrawal assessment tool had a decreased LOS in the ICU by 12 hours or 0.5 days. However, the pre- and post-implementation data was analyzed using a paired sample t-test. The results from the mMINDS assessment tool were not statistically significant for a LOS in the ICU for patients with AWS. Conclusion: Patients assessed with mMINDS had a decreased LOS in the ICU. However, there were multiple limitations for this project, such as an implementation on one unit in one facility, a small sample size, limited implementation period, the COVID-19 pandemic, and the opening of a new inpatient treatment facility. (PsycInfo Database Record (c) 2023 APA, all rights reserved)