Inclusion of SBIRT strategies related to substance use on hospital nursing assessment forms

Purpose: In partnership with the Substance Abuse and Mental Health Services Administration (SAMSHA) the Joint Commission piloted four performance measures related to Screening, brief intervention and referral to treatment (SBIRT) for substance use. In 2012 hospitals could select these measures to meet their four core measure set accreditation requirement. The purpose of this study was to determine the degree to which SBIRT components were included on nursing admission documents in acute care settings   Methods:  This was a cross-sectional study with the nursing assessment form as the unit of analysis. Chief nursing officers from acute care hospitals in Baltimore and Cincinnati metropolitan statistical areas were asked to submit copies of nursing assessment forms. The assessment forms were reviewed to see if they included items related to alcohol and other drug consumption, and the four elements of SBIRT. Data were extracted and descriptive statistics were calculated. Results: Of the 55 acute care hospitals contacted 16 provided a total of 24 different assessment forms. None of the forms included the full complement of SBIRT components. Only one form included an alcohol screening tool, the CAGE, and none included a tool to screen for drug use. None of the forms included brief intervention and three included referral for treatment for alcohol use. Six included prompts for further assessment of substance use. Conclusion: There are compelling reasons for hospitals to include SBIRT strategies to help meet Joint Commission accreditation requirements.  Improvement in standardizing inpatient nursing admission forms will help to support the use of SBIRT.