Evidence-Based Practice: Use of STOP-BANG Questionnaire to Identify Obstructive Sleep Apnea

Certified Registered Nurse Anesthetists (CRNAs) provide care for patients with undiagnosed obstructive sleep apnea (OSA). This evidence-based practice project demonstrated that the STOP-BANG Questionnaire (SB) identified patients with OSA preoperatively and reduced hypoxemia in the postanesthesia care unit (PACU). Evidence from the literature is described; based on this evidence, a change in clinical anesthesia practice was made. Four literature databases were searched using keywords from the following PICOT (patient, intervention, comparison, outcome, time) question: Do patients (P) who have high SB scores (I) compared with patients who do not have high SB scores (C) have a higher incidence of pulmonary complications (O) postoperatively (T)? Five observational cohort studies were critically appraised. The results consistently found that patients with an SB score of 3 or greater had significantly greater postoperative pulmonary complications, including lower oxyhemoglobin saturation (SpO2) in the PACU. At the Brooke Army Medical Center in San Antonio, Texas, the SB was implemented during the preanesthesia assessment. A query of the electronic medical record identified patients with undiagnosed OSA and patients with hypoxemia (SpO2 < 94%) in the PACU. Implementation of the SB increased identification of undiagnosed OSA by 78% preoperatively and reduced the incidence of hypoxemia in the PACU.