Practice Guidelines for Continuous Pulse Oximetry Monitoring for Obstructive Sleep Apnea Patients
As the rate of obesity has increased in the United States to include approximately 40% of the adult population, there has been a corresponding rise in the number of patients with obstructive sleep apnea (OSA). The OSA population is at risk for adverse perioperative respiratory depression. Continuous pulse oximetry monitoring is indicated for these patients upon discharge from the recovery room into other treatment settings and when cared for by telemetry or by trained hospital staff in the patient's room. The practice question was whether an evidence-based practice guideline could be developed to help ensure safe postoperative monitoring of patients with OSA on the medical-surgical units. Guided by the Iowa model as the framework, a 13-member team from respiratory, anesthesiology, and technology departments participated in the guideline development. Three members of the 13-member interdisciplinary team evaluated the guideline using the AGREE II tool with the highest level of agreement on 6 of 6 domains; 100% of the team members agreed to move the developed guideline to the relevant hospital quality improvement committees. Availability of an evidence-based practice guideline for hospital nursing staff on general medical units has the potential to ensure safe management of patients with OSA while achieving cost savings when higher level of care settings may be unavailable for the growing number of patients with OSA. If safely implemented, these guidelines could be adapted in other healthcare facilities to ensure optimal health outcomes for patients with OSA.