Implementation and clinical audit of alcohol detoxification guidelines.

This article describes the implementation and clinical audit of alcohol detoxification guidelines at the Royal Cornwall Hospital. The progress in developing a hospital alcohol strategy as recommended by the Royal College of Physicians (2001) is also reviewed. The Clinical Institute Withdrawal Assessment for Alcohol (revised) (Sullivan et al, 1989) is used to assess the alcohol-dependent patient's baseline requirement for their detoxification regimen in the first 24 hours of their care. The prevention and treatment of Wernicke's encephalopathy by parenteral and oral vitamin supplementation is also given a high priority in the guidelines. The clinical audit demonstrates high levels of compliance with the guidelines that were used effectively by the nursing and medical staff in their care of patients with alcohol withdrawal, with high levels of referral to the psychiatric liaison nurse service for brief intervention alcohol counselling and referral to community alcohol services.