Evaluation of alcohol screening and brief intervention in routine practice of primary care nurses in Vhembe district, South Africa.

AIM To assess the implementation of the Alcohol Screening and Brief Intervention (SBI) strategy as part of a routine practice of nurses in 18 primary health care services in Vhembe district, South Africa. METHOD We performed a cross-sectional study to assess the success of implementation of the SBI in 18 primary health care services. We examined all anonymously completed questionnaires (n=2670) collected from all practices after a 6-month implementation period. Clinic managers were interviewed on SBI implementation after 4 months of implementation. The success of implementation was assessed on the basis of perceived benefits, beliefs, values, past history, current needs, competing priorities, complexity of innovation, trialability and observability, and feedback on SBI performance. RESULTS In the 6-month period, nurses screened 2670 patients and found that 648 (23.4%) patients (39.1% men and 13.8% women) were hazardous or harmful drinkers. Nine clinics had good and 9 poor SBI implementation. Factors discriminating the clinics with good or poor SBI implementation included the percentage of nurses trained in SBI, support visits, clinical workload, competing priorities, team work, innovation adoption curve, perceived complexity of innovation, compatibility beliefs, trialability, and observability of SBI. CONCLUSION To improve SBI implementation as a routine practice, more attention should be paid to training modalities, clinic organization, and changes in the attitudes of nurses.