Implementing Sleep Apnea Screening Prior to Conscious Sedation Procedures in a Rural Hospital: A Quality Improvement Project.

Abstract

Screening patients for obstructive sleep apnea (OSA) risk factors is an effective method for helping reduce adverse outcomes in conscious sedation. Patients receiving conscious sedation for endoscopy were not being screened for OSA at a rural hospital. The purpose of this quality improvement project was to implement a nurse education program to improve OSA screening of endoscopy patients, using an evidence-based screening tool, and to increase nurse OSA knowledge and patient education. This study was conducted in the outpatient perioperative section of a small rural hospital in northern Michigan. Data were obtained from pre/post chart review and nurse knowledge assessment. Twenty-eight nurses participated in an educational session that included OSA education and instructions on using the STOP-Bang questionnaire for OSA screening. Nurse OSA knowledge increased from 75% preeducation program to 89% posteducation program. Use of the STOP-Bang Questionnaire for patients presenting for outpatient endoscopy procedures requiring conscious sedation and patient OSA education increased from 43.5% to 81.2% pre- to posteducation program. This study's educational session was successful in promoting use of the STOP-Bang questionnaire among perioperative nurses and increasing education for patients screened positive for OSA. Training nurses to use a brief OSA screening tool effectively improved the OSA screening of patients presenting for outpatient conscious sedation involving endoscopy.