Clinical use of a shortened XXXX withdrawal scale in a general hospital.

@entity167 @entity1
BACKGROUND: Multi-item scales for monitoring @entity167 withdrawal reactions have been used since the 1970s, and since 1985 we have used a modified version of the Clinical Institute Withdrawal Assessment (CIWA) in our general hospitals. This study was conducted to determine whether a shorter version of the scale would prove easier to use without loss of accuracy. METHODS: A simultaneous 'crossover' clinical audit using two hospitals. The shortened scale was developed from the existing one, and had 10 items as opposed to the previous 18. The @entity1 were followed throughout their course and the incidences of complication, the frequency of sedation, the delay in initiating monitoring and the ease of use were recorded. RESULTS: There were 106 @entity1 managed with the old scale and 96 with the new. The rate of complication was not different, being 16% in @entity1 managed using the old scale and 14.5% using the new scale; the rates of sedation were 49 and 48%, respectively. @entity1 managed with the new scale had a shorter course with a median duration of 27.6 h compared with 40 h. The time from admission to first recording of a score was 5.4 h for the new scale and 4.8 h for the old, which is not a significant difference. Both scores were used according to instructions, but staff reported that the shortened scale was easier to use. CONCLUSIONS: We conclude that a shortened form of the CIWA @entity167 withdrawal scale works as well as the original and is simple to use.
