Study objectives: We describe emergency department (ED) nursing and physician staff tobacco and alcohol screening behaviors before educational program implementation.

Methods: This study was conducted in the ED at 1 site of a 3-site, tertiary care, community teaching hospital. We conducted a structured retrospective medical record review of 326 charts during a 3-month period during spring 2003. Patients aged 14 years and older who were alert, cooperative, not critically ill, and were discharged from the ED were included in the study. Patient tobacco and alcohol use patterns of this ED population were calculated. Screening frequency (by nurses and physicians) of patient tobacco and alcohol use was reviewed. The differences between nurse and physician screening rates were compared using the χ² test of association. Significance was determined by P values less than .05.

Results: The median patient age range was 35 to 44 years. Smoking frequency in this population was 107 (32.8%) of 326. One hundred eighty-three patients (56.1%) out of 326 were identified as nonsmokers and 36 (11.0%) of 326 as either previous smokers or “unknown.” Alcohol use was self-reported in 106 (32.5%) of 326 of the patients. One hundred ninety-seven patients (60.4%) out of 326 identified themselves as nondrinkers and in 23 (7.0%) of 326 of the patients, alcohol usage was unknown. Two hundred eighty-six (87.7%) of 326 charts were screened by nurses for patient tobacco use, which was similar to the 280 (85.9%) of 326 screening rate for alcohol use. Fewer charts, 245 (75.2%) of 326, were screened by physicians for tobacco use. Comparatively, only 208 (63.8%) of 326 patients were screened by physicians for alcohol use. The differences between screening for tobacco (87.7% for nurses and 75.2% for physicians) was statistically significant (χ²=17.06, P<.001). The difference between screening rates for alcohol (85.9% for nurses and 63.8% for physicians) was statistically significant (χ²=42.0, P<.001).

Conclusion: In this study, nursing staff had high rates of screening patients for tobacco and alcohol use. Physician screening rates were lower than that of nurses in both categories, more substantially so in alcohol screening.