Identifying Obstructive Sleep Apnea Risk in the Preoperative Setting Utilizing the STOP-Bang Questionnaire: A Quality Improvement Project
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Abstract
Introduction/Purpose: Patients with a medical diagnosis of obstructive sleep apnea (OSA) and those with undiagnosed OSA have a greater chance of having an adverse event during endoscopy procedures related to their medical condition. This Doctor of Nursing Practice quality improvement (QI) project aims to address the lack of obstructive sleep apnea screening during the preoperative assessment at an endoscopy center by implementing and evaluating a preoperative screening protocol.
Methods: A multidisciplinary, evidence-based quality improvement (QI) project was implemented in an ambulatory adult endoscopy center to address an identified gap in best practice. Participants were preoperative endoscopy patients. The STOP-Bang Questionnaire was added to the preoperative assessment protocol. Pre- and post-chart reviews evaluated the screening protocol by examining the rates of patients who were identified as at-risk for OSA before and after the intervention. The data was analyzed using descriptive statistics.
Results: This scholarly quality improvement (QI) found a statistically significant difference (p < 0.001) in the identification of patients who were at risk for obstructive sleep apnea when using the STOP-Bang Questionnaire (SBQ) during the preoperative assessment compared to the identification of patients with a known diagnosis of OSA. A Chi-square test confirmed strong associations between risk categories and total scores, validating the risk categorization system of the STOP-Bang Questionnaire. Descriptive Statistics found the STOP-Bang Questionnaire to be an effective tool for screening preoperative patients for OSA risk.
Discussion: The STOP-Bang Questionnaire (SBQ) is a reproducible, evidence-based screening tool for OSA that has a known impact on identifying patients at risk for airway obstruction and perioperative medical complications. Early detection of OSA patients may diminish or eliminate potential adverse events. Preoperative protocols that support the use of preoperative screening for OSA can improve the overall quality and safety of care provided to patients undergoing endoscopy procedures.