Effective Ways to Assess Withdrawal: Using and Understanding the CIWA-AR and COWS Screening Tools

Course overview

This presentation, by Cheri MacLean, RN, MS, BSN, CARN, PMH-C will provide critically important information for clinical nurses, legal nurse consultants, mental health nurses, and basically all nurses who deal with patients. Many of our members and guests are familiar with Cheri MacLean, as she previously presented an outstanding webinar on 72-hour mental health holds. She continues the mental health theme, by providing information on effective ways to assess withdrawal. Cheri will discuss the use and understanding of the critically important assessment tools - CIWA-AR and COWS. The American Society of Addiction Medicine (ASAM) created clinical practice guidelines for alcohol withdrawal management, and noted that the CIWA score is an effective assessment tool. The COWS tool is used to measure the severity of opioid withdrawal symptoms, and is based on the CIWA screening tool. There is so much to learn on the topic of withdrawal, and many have already been involved in LNC cases in which addiction and/or withdrawal were critical factors in the events. Be prepared for that next case! You do NOT want to miss this presentation! Attendees of this presentation will: 1. Describe medical definitions associated with abuse and dependence addiction; 2. Examine the physiologic process of withdrawal from addictive substances; 3. Identify the top 5 signs/symptoms that most accurately indicate withdrawal; 4. Examine steps to competently use screening tools, such as CIWA-AR and COWS; and 5. Analyze case review findings that can be used to develop an effective plan of withdrawal treatment. SPEAKER, CHERI MACLEAN, RN, MS, BSN, CARN, PMH-C: Cheri has been a registered nurse for 44 years, with a very full and varied nursing career. Her most recent focus has been in mental health and addictions nursing, with over 12 years in a variety of Mental Health/Substance Abuse (MH/SA) settings - acute behavioral health inpatient, inpatient alcohol detox, SA outpatient treatment center, dual-diagnosis outpatient treatment center, methadone clinic, Veteran's Administration, forensics, and her current position as a Behavioral Health Home Health Nurse. Cheri's work with MH, SA, and dual-diagnosis clients includes child, adolescent, adult, and geriatric populations. She has been a Nurse Manager, Facility Director, and Director of Nursing. Currently she is dual certified in both mental health nursing (PMH-C) and addictions nursing (CARN), and also holds an MS degree in Clinical Counseling with a concentration in Substance Abuse Counseling. Cheri is fairly new to legal nurse consulting, but has been retained as an expert in MH/SA cases. She also has extensive experience as a registered nurse in the health insurance industry, reviewing lengthy medical records, which she plans to translate into LNC medical record reviews.