The Utilization of the STOP-BANG Tool and Its Impact on Nursing Airway Management in the Post Anesthesia Care Unit

Purpose:
The purpose of this study is to determine if nurse's knowledge of pre-operative STOP-BANG score will decrease the percentage of adult surgical patients requiring nursing airway maintenance post-operatively.

Relevance/Significance:
In the post anesthesia setting, nurses are often required to intervene to maintain a patient's airway patency to avoid hypoxia. In some cases, this situation could have been avoided if the post anesthesia care unit nurse had knowledge of the patient's likelihood of obstructive sleep apnea (OSA) thereby enlisting appropriate practice change methodology.

Strategy and Implementation:
A literature search was conducted using CINAHL, PROQUEST, and EBSCO research databases for a validated tool to measure obstructive sleep apnea. The Methodist Hospital Research and Evidence-Based Practice Council reviewed the literature and voted to recommend the STOP-BANG scoring tool. No past research studies were found that showed an association between OSA and post-extubation airway patency. Methodist Hospital Practice Council approved the use of the scoring tool to pre-operatively assess for OSA in the post-operative setting. Pre-intervention baseline data was collected between May 1, 2014 and July 31, 2014. The STOP-BANG scoring tool was utilized August 1, 2014 through October 31, 2014 to determine if there was an association between an elevated STOP-BANG score (representing OSA) and the need for post-operative nursing airway management.

Evaluation:
Based upon findings, there was a correlation between an elevated STOP-BANG score and nursing airway management needs. Extubation criteria were modified for patients in the Post Anesthesia Care Unit who were at a high risk of obstructive sleep apnea.

Implications for Practice:
In general, modifying nursing practice methodologies for OSA patients noted to be high risk by the STOP-BANG tool lessens the need for emergent nursing airway management during the post-operative unit period.