Graduate student contributes
to alcohol withdrawal study
at Christiana Care
Statistics show that 20 percent of hospitalized adults have a history of
alcohol problems, and of those, six percent will experience alcohol
withdrawal symptoms while hospitalized. That's what a research team
at Christiana Care Health System found out when they started
studying the problem of how to identify the patients who are at risk
of developing the most serious complications of alcohol withdrawal.
Despite being the largest acute care provider in Delaware, prior to
2009, Christiana Care did not have a standardized screening
methodology for identifying alcohol withdrawal risk of hospitalized
individuals. Often, patients remained unidentified until serious
symptoms arose, including delirium tremens or DT, the most severe
complication of alcohol withdrawal.
As a practicing RN in the University of Delaware's Master of Science
in Nursing (MSN) program, Jim McWilliams completed his
graduate clinical internship at Christiana Hospital, and played a
contributing role in the study.
[Photo by Eric Crossan]
The research effort was multidisciplinary. The principal study author
was a family nurse practitioner at Christiana Care hospital, and the
team included Christiana Care physicians, pharmacists, nurses, UD
undergraduate nursing students, and other hospital staff.
McWilliams' primary contribution to the research was to analyze data
accumulated by the team. "The opportunity to work collaboratively
with other disciplines and departments in a setting that encouraged
teamwork was very personally rewarding for me. Every professional
I reached out to was eager to help and add another piece to the puzzle."
UD's Clinical Nurse Specialist program includes a strong clinical
practice component. The program's capstone course, NURS 686
Clinical Nurse Specialist Role Integration, requires students to
complete a clinical project in cooperation with the health agency in
which they are serving their clinical practicum.
"The clinical projects are intended to offer graduate nursing students
the opportunity to contribute to the improvement of patient care,"
said UD's Erlinda Wheeler, associate professor and graduate program
coordinator in the School of Nursing. "They learn to assess a
particular problem in the clinical setting with the help of their
clinical preceptor, learning to function as advanced practice nurses by
completing a project that will be useful in improving quality care in
the health care institution where they do their clinical experiences."
"Our whole team was impressed with Jim's contribution to the
project," noted Ruth Mooney, Nursing Research Facilitator at
Christiana Care, and McWilliams' clinical preceptor. "Team members
commented on the importance of collaborating with graduate
students in a research environment. The team benefited from Jim's
current knowledge through his graduate coursework at UD."
Dr. Mooney added, "Participating as a team member in an actual
case study like this does help to solidify your research technique in
a real-life health care setting."McWilliams described his graduate
coursework in statistics and research as invaluable to his
participation: "I worked with a lot of data, and there were some
challenges in presenting the data in a way that was logical and
meaningful, as well as drawing conclusions from the data in a way
that translated to bedside clinical practice."
As a result of implementing the protocol for identifying and treating alcohol withdrawal, the study found an increased number of Christiana Care patients proactively being diagnosed with and treated for alcohol withdrawal, and a decreased percentage of patients who actually developed DT. Hospital staff have widely praised the protocol for its interdisciplinary focus and successful implementation, and the study has continued to receive attention at Christiana Care and in the larger health care community.
"Many of UD's graduate nursing students are now leaders in their
field of practice as managers, chief nursing officers, clinical nurse
specialists, and directors of health clinics," noted Dr. Wheeler. "The
clinical project gives them hands-on experience in working with a team of health care personnel. These are the same kind of problems
that they will encounter as they work in their chosen fields."
McWilliams completed UD's Master of Science in Nursing (MSN)
in 2010 as a Clinical Nurse Specialist with a concentration in adult
health. Currently, he is pursuing a post-master's degree program at
the University of Arkansas for Medical Sciences and is completing
a pediatric rotation in the Family Nurse Practitioner program.
"Western Arkansas is a medically under-served area. I hope to
establish myself in family practice, as well as serving as a parish
nurse working with Hispanic immigrants and their families," said
McWilliams. "I plan to maintain dual credentialing as a Clinical
Nurse Specialist and Nurse Practitioner, and would like to conduct
research and publish on topics that are population focused,
especially the rural poor and immigrant agricultural workers."
As an RN for 16 years following a decade in the U.S. Navy,
McWilliams also worked as an RN at Jennersville Regional
Hospital in West Grove, Pa., while a graduate student at UD. "I
enjoy being part of the change processes that occur in health care.
I see nursing becoming more rooted in science than earlier in my
career and advanced practice nurses are in a very good position to
be the facilitators of evidence-based practice."
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