Implementation of the STOP-BANG Screening Tool in the Primary Care Setting: A Quality Improvement Project
Doctor of Nursing Practice
Susan Penque, PhD, APRN, ANP-BC, NE-BC
Luis Rojas, DNP, APRN, FNP-BC
Significance and Background. There are approximately 25 million adults in the United States with obstructive sleep apnea (OSA). OSA is a sleeping disorder that is caused by periodic airflow blockage during sleep. It has been linked to numerous health problems and within the primary care setting OSA is not routinely screened for at visits. This leads to delayed diagnosis of a serious health issue and the potential for poor health outcomes. The STOP-BANG questionnaire (SBQ) is a simple eight-question tool that is used to screen patients for OSA. The STOP section focuses on snoring, tiredness, observed apnea, and high blood pressure. The BANG section focuses on BMI, age, neck circumference, and male gender. The evidence gathered showed that the SBQ is reliable and sensitive in the detection of obstructive sleep apnea in the primary care setting.
Purpose: To screen patients aged 50 and over with essential hypertension and a BMI (Body Mass Index) of 35 kg/m2 or greater, in a mixed primary care practice over ten weeks using the SBQ for OSA.
Methods: Institute for Healthcare Improvement (IHI) Model for Improvement with the Plan-Do-Study-Act as the tool. Plan-educate and implement the SBQ screening tool within the primary care and cardiology offices. Do- provide education on importance of OSA screening and use of SBQ within setting. Study- data from provider education, completed SBQ screenings and referrals. Act- use gathered data to inform PDSA cycles.
Outcome: Over ten weeks 83 total patients were screened using this tool. 45 or 54.2% were female and 38 or 45.8% were male. Primary care completed 60 referrals and cardiology completed 23. A total of 38 patients accepted sleep referral studies.
Discussion: Providers should be keen to screen patients for OSA as it predisposes them to hypertension, cardiovascular disease, fatigue, and many neurological symptoms. The SBQ questionnaire is a quick and reliable tool which makes it utility in the primary care setting ideal. The use of the SBQ within the primary care setting augments the care given which in turn promotes positive health outcomes especially in a community that have many social and health determinants that impact their quality of life.
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Powell, T. (2023). Implementation of the STOP-BANG screening tool in the primary care setting: A quality improvement project [Unpublished DNP project]. Sacred Heart University.
Available for download on Wednesday, May 08, 2024
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A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.