Implementation of the STOP-Bang Questionnaire

Casey, Joe V.

Purpose: Obstructive sleep apnea (OSA) is a sleep disorder that has emerged as a significant threat to patient safety within the perioperative setting, with an incidence rate of undiagnosed OSA predicted to be as high as 82% in males and 93% in females. The use of a valid OSA screening tool such as the STOP-Bang Questionnaire would improve the ability of anesthesia providers to reliably identify surgical candidates with risk factors for unrecognized OSA, thereby allowing for better patient risk stratification and perioperative management.

Methods: Prior to the implementation of the STOP-Bang Questionnaire criteria, training and education related to the appropriate administration of the OSA screening questionnaire will be provided to all designated end-users, which includes all anesthesia providers and support staff. After the training, the STOP-Bang Questionnaire criteria will be utilized for all surgical candidates at the project site for a period of 1 month. After IRB approval, a retrospective data collection will consist of a 2-month period for which pre and post questionnaire measurements for PACU LOS and incidence rate for OSA risk factors will be abstracted and compared.

Results: A minimum size of 51 charts per group or total sample size of 102 charts will be reviewed, abstracted, and analyzed to determine a statistical significance between the PACU LOS from the baseline retrospective chart review and the post-questionnaire retrospective chart review. Validation of a successful clinical study will show a higher incidence rate of surgical patients with risk factors for OSA and decreased PACU LOS for surgical patients with a BMI > 30 kg/m² when compared to the baselines for incidence rate of surgical patients with risk factors for OSA and PACU LOS for surgical patients with a BMI > 30 kg/m^2.

Conclusion: The presence of a statistically significant reduction in PACU LOS would suggest that use of the STOP-Bang Questionnaire criteria contributed to the provision of individualized perioperative clinical care that resulted in decreased PACU LOS.