Nursing Assessment for Predicting Obstructive Sleep Apnea: Community Hospital Approach

Angela P. Halpin, MN, CNS, RN; Jennifer M. Bunting, AAS; Paul A. Selecky, MD; Suzette G. Bosveld, RN, BSN, MSN, CCNS, NP-C; Derrick Hong, MD

Disclosures

Topics in Advanced Practice Nursing eJournal. 2008;8(1) 

In This Article

Conclusions

Today, there are more national and clinical drivers advocating for OSA assessment. Foremost is the support of studies indicating correlations between health and apneas.[4] The evaluation of hospital practice is essential to estimate the application of screening tools to patient assessments and care. The community hospital discussed in this article adopted sleep assessment questions to screen patients at the time of admission. Patient outcomes have improved as indicated by a rise in appropriate ordering of sleep oximetry tests and CPAP. This review recognized OSA as a vital risk to healing and recovery. Respiratory events related or caused by sleep apnea must be dealt with by a multidisciplinary health team.

Heart, neurologic, and respiratory complications from OSA have been demonstrated by researchers and organizations.[4] Death and cardiorespiratory complications have been associated postoperatively with OSA.[27] The perioperative period has become an important aspect in evaluation of risk and identifying patients at risk for OSA. Decisions about screening and monitoring approaches in community hospitals are essential going forward. Recent adoption of standards for anesthesiologists has motivated practice changes.

In the near future, a standardized procedure should be developed to ensure timely assessment and interventions after nursing recognition of patients at risk. Together with physician management and oversight, care is augmented with timely intervention. Patients at community hospitals should receive optimized care that is based on evidence-based best practice per national clinical standards for identification of OSA.

There is a paucity of research in regard to use of a nursing assessment format as a screening tool to identify hospitalized patients at risk for sleep disturbances. Therefore, the conclusions of this pilot study strongly suggest that more research is required to demonstrate the beneficial patient outcomes of this change in practice. The synopsis may serve as an innovative model for future nursing research on the advantage of OSA evidence-based practice as part of nursing assessment.

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