The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

EFFECTIVE STRATEGIES TO MONITOR AND MANAGE POST-OPERATIVE SLEEP APNEA.

Joy K. Hargett, John S. Sabo; Respiratory Care, St. Luke’s Episcopal Hospital, Houston, TX

It has been estimated that 80% of the men and 93% of the women with moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed. St. Luke’s Episcopal Hospital developed an intensive screening program to identify undiagnosed OSA patients. This was a pro-active approach to post operative monitoring of patients at high risk to avoid unnecessary complications. The objectives of the program were to promote quality, improve patient care, and increase outpatient sleep study referrals. Nursing and respiratory staff were trained regarding the risks of diagnosed and undiagnosed OSA related to sedation during hospitalization. A six step OSA patient management process was developed. The six steps are 1) Screening, 2) Assessment, 3) Education, 4) Monitoring 5) Intervention and 6) Follow-Up. Patients are identified through routine screening utilizing a modified STOP/BANG questionnaire. This is performed during pre-operative screening or upon admission by nursing and respiratory care. Once the patient is identified with diagnosed or high risk for undiagnosed OSA, further assessment is performed by a respiratory therapist/registered sleep technologist. At that time education regarding the OSA occurs. A determination is made to provide appropriate monitoring and intervention. After discharge patients that were determined to be at risk are contacted regarding their post hospital options associated with their OSA condition. Results: In 2011, there were 34,325 inpatient admissions and 4,636 patients were screened positive for diagnosed or undiagnosed OSA. A total of 1,368 (30%) of these patients were at risk. This determination was based on being assessed as “high risk” for OSA, non-compliant with CPAP therapy or having a previous OSA positive sleep study. Appropriate monitoring and interventions were instituted to prevent negative patient outcomes. Conclusion: A large percentage of patients with diagnosed and undiagnosed OSA are at risk during hospitalization. This population can experience respiratory arrest related to their OSA and sedation. The OSA Screening Program has contributed to safe management of this population. Sponsored Research - None