BACKGROUND: Alcohol use disorder in the United States is increasing. Alcohol is the second most commonly abused drug worldwide, resulting in acute hospitalizations related to alcohol use and alcohol withdrawal syndrome. Management of alcohol withdrawal syndrome relies on screening tools to determine the need for treatment. The most commonly used tool is the Clinical Institute Withdrawal Assessment for Alcohol Scale-Revised (CIWA-Ar), which has not been validated for use in critical care units.
OBJECTIVE: To evaluate whether the modified Minnesota Detoxification Scale (mMINDS) is more effective than the CIWA-Ar for evaluating acute withdrawal symptoms in patients in intensive care units.
METHODS: This integrative review used the framework of Whittemore and Knafl. The literature was searched for studies related to mMINDS, neurocritical care, and critical care.
RESULTS: Nine articles were included in the review. The review revealed 3 outcomes: nurses preferred the mMINDS over the CIWA-Ar, assessments with the mMINDS tool was more accurate for patients with CIWA-Ar scores greater than 10, and patient outcomes were improved with use of the mMINDS. The mMINDS is preferred over the CIWA-Ar for managing alcohol withdrawal syndrome in patients in intensive care units because it is associated with shorter stays, less benzodiazepine use, and a decrease in delirium tremens.
CONCLUSION: The findings regarding mMINDS can apply to both critical care and non-critical care settings. The mMINDS is preferred by nurses and results in more positive patient outcomes. The mMINDS is effective and should be used in critical care areas.
