Implementation Science: Incorporating Obstructive Sleep Apnea Screening and Capnography Into Everyday Practice

This article describes the implementation and maintenance of obstructive sleep apnea (OSA) screening and capnography monitoring. A quality improvement project. A multidisciplinary team provided staff education to three perianesthesia care units. Using the STOP-Bang screening tool, five or more posit...

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Bibliographic Details
Published in:Journal of perianesthesia nursing 2020-02, Vol.35 (1), p.7-16
Main Authors: Scully, Kathryn R., Rickerby, Jennifer, Dunn, Jessica
Format: Article
Language:English
Subjects:
capnography
Capnography - instrumentation
Capnography - methods
Female
Humans
Implementation Science
Male
Mass Screening - instrumentation
Mass Screening - methods
Middle Aged
Nursing
obstructive sleep apnea
Postanesthesia Nursing - methods
Postanesthesia Nursing - trends
postoperative complications
Postoperative Complications - prevention & control
Quality Improvement
Sleep Apnea, Obstructive - blood
Sleep Apnea, Obstructive - diagnosis
Surveys and Questionnaires
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Summary:This article describes the implementation and maintenance of obstructive sleep apnea (OSA) screening and capnography monitoring. A quality improvement project. A multidisciplinary team provided staff education to three perianesthesia care units. Using the STOP-Bang screening tool, five or more positive responses indicated high risk for OSA. A postanesthesia care unit audit tool tracked STOP-Bang scores, capnography use, hypoventilation events, nursing interventions, and respiratory complications. Among 314 patients with OSA, 36% were identified as high risk. Nurses used capnography on 76% of OSA patients and were able to readily identify hypoventilation and intervene. Respiratory complications occurred in 10.8% (n = 34) requiring a higher level of care. Postimplementation, all six postanesthesia care units employ this best practice. Perianesthesia nurses found OSA screening and capnography easy to incorporate into nursing practice. This process can reduce respiratory complications in the surgical patient with OSA. An Evidence-Based Practice Fellowship Program facilitated this practice change.
ISSN:1089-9472
1532-8473
DOI:10.1016/j.jopan.2019.06.004