Date of Award

4-25-2019

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Scarlet R. Spain

Abstract

Obstructive sleep apnea (OSA) is a widely prevalent chronic disease estimated to affect 22 million Americans, with 80 percent of moderate to severe cases undiagnosed (American Sleep Apnea Association [ASAA], 2017). Unmanaged OSA has been associated with numerous detrimental health outcomes including hypertension, chronic heart failure, atrial fibrillation, stroke, and other cardiovascular conditions (ASAA, 2017). The purpose of this evidence-based practice project was to determine if the implementation of a screening protocol would affect providers’ adherence to screening for OSA. The Theory of Planned Change was used as a guide to optimize providers’ adherence to the protocol at a family medicine clinic in Northwest Indiana. Following an extensive review of the literature, the screening protocol was designed instructing providers’ which patients needed to be screened for OSA and the preferred method. To determine if the screening protocol had an effect on providers’ adherence to screening, a two-group comparison design was utilized. Pre-intervention group data were manually collected from medical records of at-risk patients at the clinic prior to protocol implementation. Post intervention group data were collected from medical records of patients managed after protocol implementation. In the pre-intervention group, 1 (0.7%) patient at-risk for OSA were screened compared to the post-intervention group 44 (34.9%). Using chi-square test, a significant association was found between providers’ adherence to screening at-risk patients between the groups (X2(1)=56.67, p<0.001). A significant association was found between providers’ adherence to using the STOP-Bang Questionnaire between the two groups (X2(1)=60.61, p<0.001). No significant relationship was found between the number of patients referred for OSA diagnostic testing between the two groups (X2(1)=.488, p=.485). Although the intervention significantly improved providers’ adherence to screening for OSA, clinical significance is limited since there was no significant relationship found in the number of patients referred for diagnostic testing or incidence of patients with a new diagnosis of OSA.

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