Ambulatory Surgery and Obstructive Sleep Apnea—A Challenge and Opportunity for Patient Health Teaching

doi:10.1016/j.jopan.2016.04.001

Journal of PeriAnesthesia Nursing

Volume 31, Issue 5, October 2016, Pages 434-439

https://doi.org/10.1016/j.jopan.2016.04.001 Get rights and content

Section snippets

What Is OSA?

OSA is a common syndrome where recurrent partial or complete upper airway obstruction occurs during sleep. These obstructions last 10 seconds or longer and are associated with significant morbidity and mortality.⁴ Of particular concern is that most patients with OSA are undiagnosed, reinforcing the importance of clinicians to be on the alert for signs of OSA and screen appropriately. Considering the volumes of patients that are seen today in ambulatory surgery, this presents a great opportunity

Patient Health Teaching

Health teaching to the patient and family need not be a huge burden to the perianesthesia nurse. By keeping instructions and health teaching simple and reinforcing with pamphlets and other resources for review at home, the patient is empowered with knowledge in how to manage their health and quality of life. See Appendix 1 for an example of a patient information sheet.

Screening Tools

There are user-friendly screening tools to facilitate the patient assessment and identify patients with suspected OSA. The STOP-BANG tool is a resource commonly used in the perianesthesia specialty.⁵ Refer to Appendix 2 for further information. Factors such as elevated body mass index, large neck circumference, and a history of loud snoring are considered red flags.² A score of ≥3 is considered high risk for the presence of OSA.⁶ Once the patient is identified as potentially having OSA, the

Conclusion

With the high prevalence of OSA, ideally all patients should be screened for its presence before surgery. However, there are times when a preoperative screening visit does not occur. This may be due to a number of factors such as access to a preoperative clinic, organizational resources, and other factors. The perianesthesia nurse can be the gatekeeper in these situations and identify patients who may have undiagnosed OSA. Patients who are undergoing surgery may be a captive audience to receive

Heather Ead, RN, BScN, MHS, is the Clinical Educator, Trillium Health Partners, Mississauga, Ontario, Canada

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References (9)

B. Gammon et al.
An evidence-based checklist for the postoperative management of obstructive sleep apnea
J PeriAnesthesia Nurs
(2012)
D. Spence et al.
Obstructive sleep apnea and the adult perioperative patient
J PeriAnesthesia Nurs
(2015)
Practice guidelines for the perioperative management of obstructive sleep apnea. An updated report by the American Society of Anesthesiologists Task Force on perioperative management of patients with obstructive sleep apnea
Anesthesiology
(2014)
H. Ead
Meeting the challenge of obstructive sleep apnea—Developing a protocol that guides perianesthesia patient care
J PeriAnesthesia Nurs
(2009)

There are more references available in the full text version of this article.

Cited by (1)

A rapid-cycle evaluation and adjustment of paediatric tonsillectomy primary caregiver education: Qualitative research in implementation science
2024, International Journal of Africa Nursing Sciences
Tonsillectomies are generally performed on paediatric patients in ambulatory settings. The children are discharged after a short post-operative period of three to four hours which results in their parents becoming the primary caregivers at home. It is imperative that they receive extensive preparation and guidance on how to prevent, identify and manage complications related to the surgery at home. In this study, rapid-cycle evaluation and adjustment in combination with qualitative research in implementation science were used to show how health education can be revised during implementation.
The study aimed to evaluate and adjust the paediatric tonsillectomy primary caregiver health education at a designated ambulatory hospital.
A rapid cycle evaluation and adjustment of paediatric tonsillectomy health education was done through qualitative research in implementation science. It was guided by the contextual and interventional facilitators and barriers of the Consolidated Framework for Implementation Research. Two rounds of semi-structured interviews were conducted with parents as the primary caregivers of children and nurses who was directly involved with the health education.
The process of evaluation and adjustment provided the researcher with valuable information that were applied to create a more compressive piece of primary carer health education. A guideline was created with current information to manage pain, eating practices and to limit post-operative haemorrhaging.
Rapid-cycle evaluation and adjustment in combination with qualitative research in implementation science is effective to revise health education processes and material.

Heather Ead, RN, BScN, MHS, is the Clinical Educator, Trillium Health Partners, Mississauga, Ontario, Canada

: Conflict of interest: None to report.

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Ambulatory SurgeryAmbulatory Surgery and Obstructive Sleep Apnea—A Challenge and Opportunity for Patient Health Teaching

Section snippets

What Is OSA?

Patient Health Teaching

Screening Tools

Conclusion

First page preview

J PeriAnesthesia Nurs

J PeriAnesthesia Nurs

Practice guidelines for the perioperative management of obstructive sleep apnea. An updated report by the American Society of Anesthesiologists Task Force on perioperative management of patients with obstructive sleep apnea

Anesthesiology

Meeting the challenge of obstructive sleep apnea—Developing a protocol that guides perianesthesia patient care

J PeriAnesthesia Nurs

Ambulatory Surgery
Ambulatory Surgery and Obstructive Sleep Apnea—A Challenge and Opportunity for Patient Health Teaching