Upcoming Transition to Severity of Ethanol Withdrawal Score (SEWS)
A Message from Colin Grissom, MD, Senior Medical Director, Acute and Ambulatory Medical Specialties Clinical Program
Beginning Sept. 22, Intermountain Health will transition to the Severity of Ethanol Withdrawal Score (SEWS) to assess patients for alcohol withdrawal.
SEWS will replace the current Clinical Institute Withdrawal Assessment (CIWA) in the emergency department, acute care floors, intermediate care units, intensive care units, and in women’s services. Pediatrics and behavioral health are excluded.
In addition to incorporating SEWS into the new alcohol withdrawal order sets, the revised order sets will expand the use of full initial phenobarbital bolus doses for eligible patients on acute care units. More information on patient benefits and dosing is available in the resources section below,
The SEWS order sets, which include phenobarbital orders, are currently available for use in the Epic playground, and caregivers can start using them now. Nursing caregivers must complete the training before using the order sets.
Resources
Visit the SharePoint page for provider, nursing, and pharmacy resources.
Alcohol Withdrawal Order Set document.
The Acute Alcohol Withdrawal Treatment training module is available in Workday.
Troubleshooting order set/flowsheet issues
If you experience issues with order sets, documentation, or workflow functionality after go-live, submit a ServiceHub ticket in Epic using F1.
Clearly specify that the issue is related to the SEWS Alcohol Withdrawal Protocol Go-Live.
Be as specific as possible regarding whether the issue involves an order set, nursing documentation, workflow, or training need.
For urgent patient care impacting issues, follow your normal process for contacting Computer Support/Help Desk to ensure appropriate prioritization.
Important CIWA cutover information
To support a safe transition, patients already on a CIWA alcohol withdrawal treatment plan prior to the Sept. 22 go-live will remain on their existing CIWA protocol and order set.
Patients whose treatment began under the CIWA protocol before go-live should generally remain on that treatment pathway.
Existing CIWA orders will not automatically convert to SEWS.
New alcohol withdrawal orders placed after go-live will use the updated SEWS protocol and order sets.
Caregivers should not switch a patient from CIWA to SEWS in the middle of treatment unless ordered through the appropriate clinical process.
This work is focused on ensuring a consistent, evidence-based approach to alcohol withdrawal management across applicable settings. Transitioning from CIWA to SEWS is an evidence-based implementation. SEWS has been shown to decrease the time of treatment for alcohol withdrawal and is easier for nurses to administer. In addition, SEWS was implemented in two Peaks Hospitals, Saint Joseph and Lutheran, and resulted in a decreased hospital length of stay.
We appreciate your partnership and support as we transition to SEWS as the new alcohol withdrawal assessment tool.