Date of Award

Spring 2024

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



Committee Chairperson

Jackie Owens DNP, CRNP, FNP-BC

Committee Member

Amy Callahan, DNP


Alcohol use disorder (AUD) is a prevalent condition and is a leading cause of death for adults aged 20 to 64 (Esser et al., 2022). Patients with AUD who present to acute care hospitals seeking medical treatment are at risk for alcohol withdrawal. Undertreated alcohol withdrawal can progress to delirium tremens, which can result in increased transfers to ICU level of care, increased need for sedative medications, and has been shown to prolong hospital length of stay. Early screening with the validated Predictors of Alcohol Withdrawal Severity Scale (PAWSS) tool has been shown to be both reliable and effective for identifying patients at risk for developing severe alcohol withdrawal syndrome (Maldonado et al., 2015). Therefore, this quality improvement project evaluated the impact of early screening for severe alcohol withdrawal on patient centered outcomes including delirium tremens and hospital length of stay. The quality improvement project utilized a retrospective chart review design. The population included adults aged 18 and older who were medically admitted to a large urban hospital with crisis services embedded in the ED. There were no statistically significant differences in demographic variables between the control and intervention groups with the exception of two co-morbidities, hypertension (p = 0.007) and mood disorder (p = 0.002). Early screening using the PAWSS tool in the ED was shown to reduce average hospital LOS from 5.3 days to 3.8 days. The difference between median hospital LOS in days between the control (4.5) and intervention group (3) was statistically significant (p = 0.042).