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ALCOHOL RELATED ATTENDANCES IN CHILDREN

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ALCOHOL RELATED ATTENDANCES IN CHILDREN. KIM WILLIAMS LEAD NURSE, EMERGENCY DEPARTMENT Alder Hey Children’s NHS Foundation TRUST. BACKGROUND . Total 60,000 new attendances year 0-16 years 150 – 200 patients a day. Background. Childrens NSF National Alcohol Harm Reduction Strategy

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alcohol related attendances in children

ALCOHOL RELATED ATTENDANCES IN CHILDREN

KIM WILLIAMS

LEAD NURSE, EMERGENCY DEPARTMENT

Alder Hey Children’s NHS Foundation TRUST

background
BACKGROUND
  • Total 60,000 new attendances year
  • 0-16 years
  • 150 – 200 patients a day
background3
Background
  • Childrens NSF
  • National Alcohol Harm Reduction Strategy
  • Every Child Matters
  • Local Concerns
background4
BACKGROUND
  • Increasing number of alcohol related attendances Audit 2004
  • Inconsistent management
  • Poor follow up & support
what could we do6
WHAT COULD WE DO?
  • Clinical care pathway
  • Standardise medical assessment/treatment
  • Standardise information given to patients
  • Offer Brief intervention clinic follow up
  • Establish links with existing support services
what could we do8
WHAT COULD WE DO?
  • Links with education
    • School nurses
    • Identify high use schools
    • Healthy schools co-ordinator
  • Links with police
    • Hot spots of activity
    • Alcohol suppliers
  • Links with MRAS
brief intervention clinic
Brief intervention clinic
  • Nurse Led
  • Training – motivational interviewing
  • Once only – 30 -40 mins
  • Information pack prior to attendance
  • Seen within a week of event
slide11
BIC
  • ‘Its all about you’- social history
  • Reflection – Morning after leaflet
  • Explore knowledge
  • Personal safety
  • Risk taking behaviours
  • Screening tool – young people at risk
  • Referral as appropriate.
desired outcomes
DESIRED OUTCOMES
  • Change in behaviour
  • No re-attendance to AED
  • Early identification of substance misuse
  • Referrals to specialist services in appropriate areas
  • Collaborative working with schools
  • Collaborative working with police
  • Data collection to add to national database
pathway audit
Pathway Audit

Jan 05 to May 09

743 alcohol related attendances

67% Female

70% aged 14 – 16yrs

18% admitted to hospital.

age range alcohol
AGE RANGE - ALCOHOL

120

100

80

60

No of patients

40

20

0

Under

11

12

13

14

15

16

Over

10

16

Age

alcohol audit
Alcohol audit
  • About half are drinking in streets/parks
  • With friends, few alone
  • Alcohol bought from shops (20%)
  • Co-ingestion in 15%
    • Paracetamol, cannabis, caffeine
    • Ecstacy, amphetamines, cocaine and heroin
  • 17% found by Police/Stranger
  • 40% associated injuries
is this the first time
Is this the first time?
  • Sometimes - 38%
  • Regular - 16%
  • Never - 14%
  • Not recorded - 32%
case 2 what lies beneath
Case 2What lies beneath
  • 14yr old girl
  • Hand laceration – day after
  • Fallen whilst drunk
  • Admitted to drinking Vodka Friday nights
  • Alcohol from off license
  • Drinks with 1 friend mostly
slide19
BIC
  • Drinks half bottle of vodka and cider
  • Has been drinking for 2 yrs
  • Has events that she can’t remember
  • Truants from school
  • Trouble with the police once
  • Father died tragically 3yrs previous
  • No bereavement counselling
  • Visits grave almost every day
slide20
BIC
  • Recognised problem
  • Wanted to give up
  • Referral to specialist services
group therapy
Group Therapy
  • 13yr old girl, drinking vodka in park
  • 5 friends + group of boys
  • Vodka obtained by boys
  • 2 ‘drunk’ 2 sober 1 semi conscious
  • Explored event from different perspectives
  • Feelings/concerns/shared experience
group therapy22
Group Therapy
  • Discussion
  • Risk taking
  • Future strategies
  • Experimentation
what effect are we having
WHAT EFFECT ARE WE HAVING?
  • Early referral to appropriate services
  • Recognition of vulnerability of these young people
  • Opportunity for exploration of underlying issues – depression/anxiety/anger
what we have learned
What we have learned?
  • Local alcohol and substance misuse services
    • Lots around at Tier 2 and 3
    • Real need at Tier 1 provision
  • Need for “joined up working”
    • Education, Social Care and other Healthcare providers
  • Adolescent issues
thank you
Thank you

If you are young and you drink a great deal it will spoil your health, slow your mind, make you fat

- in other words, turn you into an adult.

P.J. O\'Rourke

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