A nurse-led intervention to identify and manage patients with alcohol-related brain injury

This project from Royal Liverpool and Broadgreen University Hospitals NHS Trust aimed to identify and better support patients with alcohol-related brain injury (ARBI) through a specially developed nurse-led pathway of care.  

The pathway enabled the identification of patients referred to the Trust’s alcohol care team who were at risk of ARBI, facilitating their assessment and onward referral. This enabled patients to be diagnosed at the earliest opportunity and to be offered a bespoke package of care designed to maximise abstinence from alcohol and limit or reverse cognitive impairment.

During the project, 210 patients (approximately 10% of referrals to the alcohol care team) met the criteria for screening and assessment by the ARBI specialist nurse. Ongoing electronic data collection for each patient, including information on hospital admissions and diagnosis coding, enabled the project team to monitor and evaluate their progress.

Analysis revealed that the pathway helped to identify at-risk patients and led to a reduction in hospital and emergency department attendances. Importantly, significant improvements in cognitive function were demonstrated for patients who avoided alcohol for three months. Families and patients valued the opportunity to screen for cognitive problems and staff gained a better understanding of patients’ behaviour.

The project team learned that reliance on the specialist nurse’s availability to attend screening was a major limitation to implementation, and plan to integrate this role into the usual clinical assessment carried out by nurses in the alcohol care team, to ensure sustainability. Their plans for dissemination and spread include advising on the identification of ARBI in acute care and raising awareness of the condition across wider health and social care settings.

Contact information

For more information about this project, please contact Dr Paul Richardson, Consultant Hepatologist, Royal Liverpool and Broadgreen University Hospitals NHS Trust.