NURS6640: CIWA Managing Alcohol Withdrawl Assessment Answer

CIWA Assessment: A Comprehensive Guide to Managing Alcohol Withdrawal

The primary focus of this teaching session is to assist the healthcare professionals in comprehending and analyzing the essentiality of Clinical Institute Withdrawal Assessment (CIWA) scale.

Audience: The audience may be medical professionals including practitioners, nursing staff, social service staff or  professionals involved in caring for patients with alcohol disorder.

Proposed location: Ideal location can be a training room facility within the healthcare setup

Length: A session of 45 minutes , thrice a week for 2 weeks can be ideal.

Methodology: Virtual presentation regarding introduction, administration, assessment and interpretation of the CIWA scale.

Resources: Handouts containing information regarding the CIWA assessment along with CIWA tools for practise

CIWA Tool for Alcohol Withdrawal

• The alcohol withdrawal syndrome starts usually 6-24 hours post alcohol intake in the patients with alcohol use disorder (Pribék et al., 2021).
• The CIWA tool is employed by the medical professionals with the aim to assess and diagnose the severity of  alcohol withdrawal (American Addiction Centers, 2023).
• This scale assist the healthcare professionals to measure in total 10 of the withdrawal symptoms on a scale of 0-7 indicate mild,
• Healthcare professionals administer the CIWA assessment at regular intervals to monitor changes in symptom severity over time (Steel et al., 2021).

Learning Outcomes

LO1: By incorporating knowledge regarding the CIWA scale, adequate management of the people with AWS can procure (Thompson et al., 2019).

LO2:  It can assist in determining the severity of of the withdrawal symptoms and aids in guiding the intensity of the treatment

LO3: Assisting in monitoring the progress of the patients (Foulser et al., 2017).

LO4: Identification and segregation of the patients with milder risks with that of patients with severe risk.

LO5: Mitigating the harm to the patient

LO6: Provides a consistent way to measure the level of withdrawal

Management of AWS by Employing CIWA

• This tool grades the withdrawal symptoms .
• The scale measures symptoms such as nausea, tremor, visual disturbances, headache, paroxysmal sweats and disorientation (Carter et al., 2020).
• It promotes in management of the AWS by to prescribe the addition and titration of depressants of central nervous system (CNS) such as benzodiazepines.
• The CIWA aids in the assessment of the levels of deterioration which can promote in choosing the ideal course of treatment alternative
• The tool can assist in deciding the course of action i.e medical therapy that can assist in uplifting the condition of the patient

Mode of Treatment

• The CIWA tool aid in in firstly determining the condition , secondly appropriate pharmacological or non -pharmacological treatment option.
• The pharmacological management of alcohol is determined on the basis of scores obtained by CIWA scale.
• Pharmacological alternatives such as benzodiazepines (e.g., diazepam, lorazepam) are commonly used to alleviate withdrawal symptoms and prevent complications ( AAC, 2023).

CIWA Tool in Mitigating the Harm

The CIWA tool can mitigate the harm to the patients by :

Comprehension of the symptoms severity: This tool assist in measurement of the severity of the symptoms in order to mitigate the harm (Melkonian et al., 2019).

Comprehensive evaluation and  determination of treatment plan: Following the comprehensive evaluation, the CIWA alo assist in development of treatment plans.

Mitigating complication: CIWA tool to monitor symptom severity can aid  healthcare professionals can intervene promptly to prevent or minimize the complications.

Regulation of progress:  Attaining knowledge about this tool may allow healthcare professionals to monitor the patient's progress throughout the withdrawal process.

Evaluation of the sessions

In order to evaluate the effectiveness of the session or to comprehend whether the professionals have attained the session objective , various things can be done.

• By taking their assessments via employing varied tools such as Competency Performance Assessments (CPAs); Competency Performance Examinations (CPEs) etc.
• By employing into taking written test or questionnaires to assess their level of cognitive learning

References

AAC. (2023). CIWA-AR Assessment for alcohol withdrawal. https://americanaddictioncenters.org/alcoholism-treatment/ciwa-ar-alcohol-assessment

Pribek, I. K., Kovacs, I., Kadar, B. K., Kovacs, C. S., Richman, M. J., Janka, Z., ... & Lazar, B. A. (2021). Evaluation of the course and treatment of Alcohol Withdrawal Syndrome with the Clinical Institute Withdrawal Assessment for Alcohol–Revised: A systematic review-based meta-analysis. Drug and Alcohol Dependence, 220, 108536. https://doi.org/10.1016/j.drugalcdep.2021.108536

Steel, T. L., Giovanni, S. P., Katsandres, S. C., Cohen, S. M., Stephenson, K. B., Murray, B., ... & Williams, E. C. (2021). Should the CIWA-Ar be the standard monitoring strategy for alcohol withdrawal syndrome in the intensive care unit?. Addiction Science & Clinical Practice, 16(1), 1-6.https://doi.org/10.1186/s13722-021-00226-w

Thompson, C., McLeod, S. L., Perelman, V., Lee, S., Carver, S., Dear, T., & Borgundvaag, B. (2019). Evaluation of a web‐based educational program to teach the identification and management of alcohol withdrawal in the emergency department. AEM Education and Training, 3(1), 50-57.https://doi.org/10.1002/aet2.10202

Foulser, P., Everett, L., Parsons, M., & Cheent, K. (2017). Evaluating the benefits of using a scoring system to aid management of alcohol withdrawal at an NHS district general hospital. Clinical Medicine, 17(Suppl 3), s26. https://doi.org/10.7861/clinmedicine.17-3s-s26

Carter, W., Truong, P., Sima, A. P., Hupe, J., Newman, J., & Ebadi, A. (2021). Impact of traumatic brain injury on clinical Institute withdrawal assessment use in trauma patients: a descriptive study. PM&R, 13(2), 159-165..  https://doi.org/10.1002/pmrj.12385

AAC.(2023). Medications to Treat Alcohol Withdrawal. https://alcohol.org/medication/

Melkonian, A., Patel, R., Magh, A., Ferm, S., & Hwang, C. (2019). Assessment of a hospital-wide CIWA-Ar protocol for management of alcohol withdrawal syndrome. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 3(3), 344-349.https://doi.org/10.1016/j.mayocpiqo.2019.06.005

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