Practice Assessment for Adoption of the STOP-Bang Screening Tool

Abstract

Patients undergoing surgery with unrecognized obstructive sleep apnea (OSA) are at greater risk of complications. Ninety percent of those affected in the United States remain undiagnosed. To improve identification, screening tools such as the STOP-Bang questionnaire (Chung et al. 2008), provide anesthesia providers a method of detecting undiagnosed OSA. The purpose of this study is to assess anesthesia providers' practice of preoperative screening for OSA. An email survey was conducted at a Level-III trauma center in Phoenix, Arizona. The survey consisted of a 13 question, 5-point Likert scale questionnaire. It was sent to 29 Certified Registered Nurse Anesthetists (CRNA). A total of 8 CRNA's responded. Respondents were either neutral or disagreed that current methods of OSA screening works well and generally agree that the STOP-Bang tool would provide an advantage over the current methods, accurately detect OSA, and inform their anesthetic plan over current methods. Respondents leaned towards strong agreement that improving the recognition of undiagnosed OSA is needed. However, they were generally neutral on agreement that the STOP-Bang is necessary at their facility. Respondents agreed that the STOP-Bang tool is easy to use and interpret. However, most agreed that integrating the tool would add complexity to the preanesthesia evaluation but they remained neutral on whether it would add significant time to this process. Respondents were neutral on their observations that the STOP-Bang tool would improve early detection of OSA or reduce perianesthesia complications. Just 25% of respondents reported being aware of the existence of the STOP-Bang tool and none reported having used it. In conclusion, this project demonstrates that some providers have not used the STOP-Bang screening tool to detect undiagnosed OSA, but agree this tool is preferred over their current method. Results from the survey brought insight to a potential quality improvement strategy related to improving the perianesthesia care of patients with undiagnosed OSA. Improving knowledge through dissemination of evidence illustrates the value of the STOP-Bang prior to piloting the tool. The rates of perioperative complications justify the implementation of perioperative strategies such as the STOP-Bang as a tool for anesthesia providers.