Development of a Flowchart-Based Algorithm for Alcohol Screening, Brief Intervention, and Referral to Treatment in a Womens’ Healthcare Setting

Alcohol is the most frequently used and misused substance in the United States and is attributable to more deaths each year than the opioid epidemic. Historically, studies have shown that males are more likely than females to drink alcohol and to drink more heavily than females; however, this gender gap is closing, with emerging research showing women are the fastest growing segment of alcohol consumers in the United States. Compared with men, at-risk alcohol use by women has a disproportionate effect on their health and lives including more rapid progression to alcohol related problems and alcohol use disorders, and harms to reproductive function and pregnancy outcomes. The U.S. Preventative Services Task Force (2018) recommended that all U.S. adults, including pregnant women, be screened for alcohol abuse and a brief intervention provided for those drinking at risky or hazardous levels. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based, integrated public health approach to identify and intervene with individuals who might be at risk for negative alcohol related consequences. The purpose of this Doctor of Nursing Practice scholarly project was to develop a flowchart algorithm for screening, brief intervention, and referral to treatment for harmful alcohol use to be utilized by advanced practice providers in the women’s healthcare setting to improve population health. The following research question guided this project: Q1 How can current evidence and feedback from a panel of subject matter expert clinicians be integrated to develop an algorithm to guide the routine alcohol screening, brief intervention, and referral to treatment (SBIRT) in the women’s healthcare setting? Utilizing current evidence from the literature and expert clinical feedback, a flowchart-based algorithm unique to women was developed and validated for use by advanced practice providers in the women’s health care setting through electronic survey. The Stetler (2001) model was the conceptual framework used to guide this DNP scholarly project.