Date of Award

Fall 2019

Degree Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Marjorie Geisz-Everson

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Michong Rayborn

Committee Member 2 School

Leadership and Advanced Nursing Practice

Committee Member 3

Dr. Nina McLain

Committee Member 3 School

Leadership and Advanced Nursing Practice

Abstract

Patients with obstructive sleep apnea (OSA) are at risk for perioperative respiratory and cardiovascular compromise (Opperer et al., 2016). Unfortunately, almost 90% of patients with moderate-to-severe OSA are not diagnosed and unaware of their disorder; however, they remain at increased perioperative risks (Singh et al., 2015). The STOP-BANG questionnaire was developed to meet the need for a reliable, concise, and efficient screening tool for OSA risk. The facility at which this project was conducted did not utilize a prescreening OSA risk tool. The facility not using a prescreening OSA risk tool is especially important because the State of Mississippi currently ranks as one of the most obese states in the nation, and because obesity positively correlates as one of the greatest risk factors for having OSA (National Heart, Lung, and Blood Institute [NHLBI], 2018).

The purpose of this project was to determine the incidence and prevalence of OSA, best anesthesia practice guidelines, and perioperative cardiac and respiratory complications following implementation of the STOP-BANG questionnaire. A retrospective chart review was completed the month prior to, during, and after the implementation of the STOP-BANG questionnaire. De-identified data was provided by a facility employee.

The calculated prevalence of patients identified as having moderate to high risk of having OSA was 2.8%. During the month of implementation, 2% of patients who met inclusion criteria had completed STOP-BANG questionnaires. Awareness of best practice anesthesia guidelines resulted in a decrease in narcotic usage and an increase in paralytic and reversal agents. Perioperative cardiovascular complications (arrhythmias and/or hypotension) during the month of implementation showed a decrease of 0.8% along with a decrease of 4.7% in ICU admissions. Perioperative respiratory complications such as hypoxemic events (oxygen saturation

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