Anesthesia Hand Off Process for Patients at High Risk for Obstructive Sleep Apnea

ABSTRACT Background: Obstructive sleep apnea is a prevalent medical condition contributing to increased risk for cardiovascular disease, stroke, and other medical co-morbidities affecting quality of life. Certified Registered Nurse Anesthetists (CRNAs) are in a valuable position to assess patient OSA risk. The goal of this quality improvement project is to develop a practical electronic “hand off” tool to report this risk to a patient’s primary care provider (PCP). Literature review: Review of literature reveals mixed effectiveness with use of electronic hand off reports between interdisciplinary healthcare providers. Methods: A 5- month retrospective chart review of 485 patients presenting for surgery at one rural hospital revealed 257 patients screened high risk for OSA. A sample population of 184 high OSA risk patients who had undergone elective endoscopy procedures was reviewed. Of this sample, 36 patients were determined by CRNA OSA risk assessment for follow-up with patient PCP, and recommended OSA testing. Results: A department developed electronic “hand off” OSA risk assessment tool will be tested with retrospective chart review of the 36 patients at highest OSA risk. A Likert survey, based on a validated questionnaire developed by Otieno et al (2007), will be completed upon each chart review. Data analysis of the compiled surveys will determine CRNA user satisfaction, efficiency and effectiveness of the electronic “hand off” tool. Implications: An effective, user friendly electronic “hand off” tool of patient OSA risk will improve interdisciplinary communication, promoting patient care follow-up and improved patient outcomes. References Otieno, O. G., Toyama, H., Asonuma, M., Kanai-Pak, M. and Naitoh, K. (2007), Nurses’ views on the use, quality and user satisfaction with electronic medical records: questionnaire development. Journal of Advanced Nursing, 60: 209–219. doi:10.1111/j.1365- 2648.2007.04384.