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Aims: To explore the acceptability and barriers to the introduction of nurse-led routine screening and brief interventions (SBI) for alcohol misuse on general in-patient hospital wards. Methods: Screening was introduced on an in-patient ward at three general hospitals. Screening rates, numbers of referrals to alcohol liaison nurses (ALNs), brief interventions conducted and patients’ access to specialist alcohol services at follow-up were measured. Semi-structured qualitative interviews were conducted to explore staff/patient attitudes. Findings: Screening rates ranged from 17.7% to 36.6% in the three wards. The highest rates of screening and positive screening scores were recorded on a gastrointestinal (GI) ward. Attitudes of staff and patients towards the SBI process were generally positive; however, a number of current barriers to its implementation were identified. Conclusions: In order for the SBI approach to be incorporated into routine procedures in in-patient medical settings it may be necessary to provide ongoing support and training from specialist alcohol workers, and to have mechanisms that ensure the screen remains part of routine nursing documentation. [ABSTRACT FROM AUTHOR]