Medicine and Health Sciences Commons^™

Obstructive Sleep Apnea: Emphasis On Discharge Education After Surgery, Arbert Almoite Nazareno, Cresilda Newsom, Esther Lee, Joseph Burkard

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project is to evaluate the effectiveness of discharge education (DCE) on obstructive sleep apnea (OSA) for increasing continuous positive airway pressure (CPAP) compliance after surgery among adult surgical patients diagnosed with OSA, who use CPAP.

Background & Evidence for Problem: In the United States, the prevalence of OSA in the adult population is approximately 20%. Over half of the surgical patients with OSA are predisposed to increased incidence of perioperative complications. Based on recent evidence, obstructive events are at the highest on the third day after surgery, which predisposes them for postoperative complications. …

Preoperative Assessment Clinic Reduces Total Joint Arthroplasty Case Cancellations, Angelica Adriano

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project was to reduce the rate of elective total joint arthroplasty case cancellations by implementing a nurse practitioner-led Preoperative Assessment Clinic (POAC), in the orthopedic department of a major southern California Veterans Affairs (VA) hospital. Retrospective data collected in a 12-month time period showed a surgical cancellation rate of 22%. Reasons for delays or cancellations included: medical instability, abnormal labs and/or studies, patients requiring referral to specialists, dental clearance, patient-initiated cancellations, and active infections. The POAC reduced the rate of case cancellations at 1 year to 17% and at 2 years to 9%. Lost revenue …