Obstructive Sleep Apnea Syndrome

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Design For Change Proposal Guidelines
Obstructive Sleep Apnea Syndrome is a common comorbidity that can have detrimental results on patient safety in the perioperative phase. Symptoms of OSA include daytime somnolence, loud snoring, and irritability. Obesity and anatomic abnormalities are considered risk factors of this sleep disorder. (Brousseau, Dobson, & Milne, 2014). OSA is characterized by periods of apnea during sleep which are caused by obstruction of the upper airway. The obstruction can be partial or complete and places a patient at a high risk for complications in conjunction with general anesthesia. OSA occurs in 28% of women and 38% of men and the rate increases with a BMI > 40. (AORN, 2014). Currently, with the exception of patients
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Patients using CPAP should be instructed to bring their machine on the operative day. OR booking must be notified and patients with severe sleep apnea should be scheduled as early as possible to accommodate prolonged recovery times. The OR schedule should reflect sleep apnea diagnosis to alert the perioperative team. On the day of surgery the patient’s chart should be flagged and the patients given a yellow arm band. Available CPAP machines would have to be cleared by the biomedical engineering department for hospital use. If CPAP is needed, respiratory therapy must be made aware so CPAP can be implemented as early as needed postoperatively. The anesthesia team can then formulate a plan of care tailored to the patient’s surgical needs with acknowledgement of OSA as a comorbidity. Decreased use of opioids with the use of NSAIDs, intravenous Tylenol, and other methods of pain management would be utilized by the nursing staff…show more content…
Continuing education is important for nurses to remain competent and facilitate quality care. Education based on research is crucial in making practice changes and research based on tried and true evidence will influence these changes. The Johns Hopkins Nursing Evidence-Based Practice Process is evidence-based and consists of eighteen steps that are performed in three phases. The phases are practice question, evidence, and translation. (Dearholt & Dang, 2012) and it came about through collaboration between clinical nurses and nursing faculty. “The strength of the Johns Hopkins model is its reliance on a strong academic-collaboration as a foundation for mutual benefit.” (Houser, 2015, p. 465). A Magnet designated institution has a responsibility to contribute to the education of nurses using research based evidence to make practice guidelines.
Practice Question
Step 1: Recruit Interprofessional Team
A perioperative team comprised of the pre-admission testing nurse manager, the PACU manager, a preoperative nurse, an anesthesiologist, and a respiratory therapist will be formulated and led by the author who represents the PACU nurses. This group of professionals will have a vested interest in promoting a safe surgical course for a patient with OSA.

Step 2: Develop and Refine the EBP
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