Implementation of a screening, brief intervention, and referral to treatment (SBIRT) program for alcohol use during pregnancy

Purpose of Project: Implement a screening, brief intervention, and referral to treatment (SBIRT) program for alcohol use during pregnancy for women in their first trimester.Methodology: A quality improvement project with a convenience sample of two physicians, three medical assistants, and one nurse practitioner from a single obstetrical office trained to perform the SBIRT process for first trimester pregnant women. Screening results were tabulated with a retrospective chart reviews to collect demographic data and determine the number of patients at-risk. Office staff and clinicians were surveyed for feedback on the SBIRT process. Results: Implementation of SBIRT resulted in an increased number of women identified as at-risk for an alcohol-exposed pregnancy. Among 35 women who were screened for alcohol use, nine (26%) screened at-risk. All nine women (100%) received an immediate brief intervention from the health care provider. None required a referral to outside treatment. All six staff members and clinicians (100%) believed SBIRT was an effective way of identifying at-risk pregnant women for alcohol use, and four (66%) believed the office should continue to utilize SBIRT for alcohol use in pregnancy. Implications for Practice: The SBIRT process is easy to implement in the prenatal care setting. The screening process provides an opportunity to educate pregnant women about risks of alcohol use during pregnancy including risks of fetal alcohol spectrum disorder. At-risk women receive a brief intervention with the goal of motivating healthier behavior and referral for treatment. The SBIRT process improves maternal and fetal safety as well as pregnancy outcomes.