2.50
Hdl Handle:
http://hdl.handle.net/10755/157514
Type:
Presentation
Title:
EVALUATION: OBSTRUCTIVE SLEEP APNEA - A NURSING APPROACH
Abstract:
EVALUATION: OBSTRUCTIVE SLEEP APNEA - A NURSING APPROACH
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Halpin, Angela, MN, RN, CNS
P.I. Institution Name:Hoag Memorial Hospital Presbyterian
Title:Council of Nursing Research and Excellence (CNER) chairperson, CNS
Contact Address:One Hoag Drive, Newport Beach, CA, 92658, USA
Co-Authors:Jennifer Bunting; Jill Berg; Sarah E. Choi; P. Selecky
EVALUATION: OBSTRUCTIVE SLEEP APNEA - A NURSING APPROACH

PURPOSES/AIMS: To evaluate the effectiveness of an educational program to increase nurses' compliance in completing a protocol for Obstructive Sleep Apnea (OSA) risk for preoperative patients. Effectiveness is determined by a comparison of patient records before and after program implementation.

RATIONAL/BACKGROUND:
Obstructive sleep apnea, if untreated, can cause devastating health consequences such as stroke, heart attack, and sudden death (Caples et al., 2005). The prevalence of OSA in hospital patients has been reported as 27.5%, and approximately 2-26% of hospital patients are at risk for OSA (Chung et al., 2008). OSA poses significant threats to patient safety during hospital stay if not identified and treated properly. According to Chung et al. (2008) & Kaw et al. (2006), adverse surgical outcomes appear to be more frequent in OSA patients. Recognizing the significance of the problem, the ASA practice guidelines now mandate screening of all pre-op patients (Gross et al., 2006).
Theoretical framework
The study uses LewinÆs change theory as a foundation. This theory identifies three (3) stages of change: Unfreezing, Moving and Refreezing. In this study, the investigators use the "unfreezing" and "moving" stages of the theory. In the "unfreezing" stage, the model identifies a clinical issue that requires a change in practice. Since the educational program aims to increase the completion of an OSA protocol, and this involves a change of practice, the theory provides a conceptual framework for the study.

METHODS:
This is a quasi-experimental study to evaluate an educational program to increase nurses' compliance in following protocols in screening pre-operative inpatients for OSA. The setting is an acute care hospital. Medical records of orthopedic surgical patients are reviewed retrospectively pre and post educational program. A total of 400 medical records are selected randomly and then reviewed. Inclusion criteria are 1) Elective orthopedic surgical patients screened in the short stay area with a pre-procedure patient self assessment (PAS), 2) Admitted through a short stay unit and 3) Inpatients requiring orthopedic surgery. Exclusions: Medically unstable patients will be excluded from the study. Institutional Review Board (IRB) approved, there is no active patient participation, and all charts are retrospectively reviewed.
RESULTS:
Preliminary assessment of 1173/1275 (92%) nurses that completed the training show very little difference in scores pre and post education on knowledge of OSA risk. However, of the 135/200 charts reviewed from the pre-education period, RESULTS: indicate nurses' charted approximately only 10% of the time on OSA risk sleeps variables. Post education an additional 200 charts are to be reviewed.
IMPLICATIONS:
Knowledge of OSA risk is not a guarantee of nurses' compliance in OSA assessment. Nursing program implementation may consider the time elements for change in practice to occur. Repeating and reinforcing policy and protocol changes are essential to application of latest evidence based practice initiatives.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEVALUATION: OBSTRUCTIVE SLEEP APNEA - A NURSING APPROACHen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157514-
dc.description.abstract<table><tr><td colspan="2" class="item-title">EVALUATION: OBSTRUCTIVE SLEEP APNEA - A NURSING APPROACH</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Halpin, Angela, MN, RN, CNS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Hoag Memorial Hospital Presbyterian</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Council of Nursing Research and Excellence (CNER) chairperson, CNS</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">One Hoag Drive, Newport Beach, CA, 92658, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">angela.halpin@hoaghospital.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jennifer Bunting; Jill Berg; Sarah E. Choi; P. Selecky</td></tr><tr><td colspan="2" class="item-abstract">EVALUATION: OBSTRUCTIVE SLEEP APNEA - A NURSING APPROACH<br/><br/>PURPOSES/AIMS: To evaluate the effectiveness of an educational program to increase nurses' compliance in completing a protocol for Obstructive Sleep Apnea (OSA) risk for preoperative patients. Effectiveness is determined by a comparison of patient records before and after program implementation. <br/><br/>RATIONAL/BACKGROUND:<br/>Obstructive sleep apnea, if untreated, can cause devastating health consequences such as stroke, heart attack, and sudden death (Caples et al., 2005). The prevalence of OSA in hospital patients has been reported as 27.5%, and approximately 2-26% of hospital patients are at risk for OSA (Chung et al., 2008). OSA poses significant threats to patient safety during hospital stay if not identified and treated properly. According to Chung et al. (2008) &amp; Kaw et al. (2006), adverse surgical outcomes appear to be more frequent in OSA patients. Recognizing the significance of the problem, the ASA practice guidelines now mandate screening of all pre-op patients (Gross et al., 2006). <br/>Theoretical framework<br/>The study uses Lewin&AElig;s change theory as a foundation. This theory identifies three (3) stages of change: Unfreezing, Moving and Refreezing. In this study, the investigators use the &quot;unfreezing&quot; and &quot;moving&quot; stages of the theory. In the &quot;unfreezing&quot; stage, the model identifies a clinical issue that requires a change in practice. Since the educational program aims to increase the completion of an OSA protocol, and this involves a change of practice, the theory provides a conceptual framework for the study.<br/><br/>METHODS: <br/>This is a quasi-experimental study to evaluate an educational program to increase nurses' compliance in following protocols in screening pre-operative inpatients for OSA. The setting is an acute care hospital. Medical records of orthopedic surgical patients are reviewed retrospectively pre and post educational program. A total of 400 medical records are selected randomly and then reviewed. Inclusion criteria are 1) Elective orthopedic surgical patients screened in the short stay area with a pre-procedure patient self assessment (PAS), 2) Admitted through a short stay unit and 3) Inpatients requiring orthopedic surgery. Exclusions: Medically unstable patients will be excluded from the study. Institutional Review Board (IRB) approved, there is no active patient participation, and all charts are retrospectively reviewed.<br/>RESULTS: <br/>Preliminary assessment of 1173/1275 (92%) nurses that completed the training show very little difference in scores pre and post education on knowledge of OSA risk. However, of the 135/200 charts reviewed from the pre-education period, RESULTS: indicate nurses' charted approximately only 10% of the time on OSA risk sleeps variables. Post education an additional 200 charts are to be reviewed.<br/>IMPLICATIONS: <br/>Knowledge of OSA risk is not a guarantee of nurses' compliance in OSA assessment. Nursing program implementation may consider the time elements for change in practice to occur. Repeating and reinforcing policy and protocol changes are essential to application of latest evidence based practice initiatives.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:56:32Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:56:32Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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