Assessment, Identification, and Management of Obstructive Sleep Apnea Perioperatively Submitted

Background: The most common form of sleep apnea, obstructive sleep apnea (OSA) places patients at risk for higher rates of surgical complications. Perioperatively, the patient with OSA is at risk for a variety of respiratory, cardiac, and neurological complications. Methods: Current literature was systematically evaluated and used to design a practice innovation project (PIP) that focused on identifying patients with OSA undergoing elective surgery and intervening to promote patient safety. The theoretical basis of the PIP follows the Stetler (2001) model of evidence-based care, rational-empirical change strategy, and Hall’s (1964) Care, Cure, Core Model. Screening was performed preoperatively on 1772 adult surgical patients. Patients were identified as low risk, high risk, or previously diagnosed with OSA. All high risk and previously diagnosed patients were given educational materials to improve their sleep hygiene. Inpatients without a prior diagnosis offered OSA diagnostics using portable polysomnography (PSG) postsurgically.Results: Screening found 13% of patients previously diagnosed with OSA and identified another 10% as high risk. High risk status was positively correlated with increased sleep apnea diagnosis, apnea-hypopnea index (AHI), and overnight oxygen requirements. Preoperative screening identifies patients who are at risk for post operative complications and will be continued