By Amanda Leff Ritchie
Concerned about the care of surgical patients with obstructive sleep apnea, alumna Dr. Linda Lakdawala (’10), DNP, RN, CPAN, used her experience in Chatham’s Doctor of Nursing Practice (DNP) program to affect positive change in the care administered to these patients.
As part of her capstone project in the DNP program, Linda, a medical surgical advanced practice nurse at UPMC Presbyterian Shadyside Hospital, sought to determine how nurses can use screening tools to create a safer perioperative environment for patients with episodes of apnea. Surgical apnea patients can breathe easier thanks to the results of her research, published in the February 2011 issue of the Journal of PeriAnesthesia Nursing (JOPAN). The article recently won first place in JOPAN’s best practice category.
The DNP capstone project requires students to tackle evidence-based practice (EBP) change. Critical to improving healthcare outcomes, evidence-based practice relies on the integration of an individual’s clinical expertise with the best available external clinical evidence, resulting from systematic research.
“The program has helped me to gain an in-depth understanding of the EBP process, which is so vital to nursing quality and outcomes,” says Linda. “Nurses truly need to live and breathe their practice through evidence-based practice approach.”
Beginning with a literature review, followed by a detailed plan for practice change, and culminating with the implementation and evaluation of an actual project, students who complete Chatham’s DNP capstone project emerge with results that can immediately improve nursing care provided throughout the world.
Linda’s research advocates for the use of the “STOP-Bang” screening tool assessment, eight yes or no questions on such topics as snoring, fatigue, blood pressure, and BMI, that assess if the patient is at high or low risk of OSA. According to Linda’s findings, the STOP-Bang scoring model demonstrated a positive predictive value with 95 percent reliability.
This assessment tool is now used at UPMC Presbyterian Shadyside Hospital as part of a pilot project that Linda presented to the facility’s Risk Management Board. Linda’s findings indicated that using the STOP-Bang scoring model, the hospital had a 14 percent increase in high-risk sleep apnea patients. When an assessment indicates a high risk of apnea, a follow-through process is initiated to monitor and educate patients on sleep apnea and encourage follow-up care with primary care physicians, says Linda.
After the publication of her quality improvement research, Linda has been contacted by perianesthesia nurses from multiple hospitals throughout the country thanking her for paving the way for the better monitoring of sleep apnea patients. She was also recently appointed as a member of the American Board of Perianesthesia Nursing Certification.
Linda’s evidence-based practice change project is a prime example of how Chatham University students can work to improve patient care far and wide throughout the course of the DNP program.