Doctor of Nursing Practice Projects
Date Degree Awarded
8-2025
Document Type
Project
Degree Name
Doctor of Nursing Practice (D.N.P.)
School
Nursing
Committee Chair
Dr. Chu-Yu Huang
Second Committee Member
Dr. Anne Russell
Keywords
obstructive sleep apnea, STOP-BANG, screening, polysomnography, cardiovascular disease, quality improvement, outpatient cardiology
Abstract
Abstract
Background: Obstructive sleep apnea (OSA) is significantly underdiagnosed in patients with cardiovascular comorbidities, despite associations with hypertension, arrhythmia, stroke, and myocardial infarction (Miller & Berger, 2016). Approximately 80% of OSA cases remain undetected (Hwang et al., 2021). Purpose: This quality improvement (QI) project evaluated the impact of implementing the STOP-BANG questionnaire on referral rates for polysomnography (PSG) in an outpatient cardiology clinic. Methods: This QI project was conducted using the Plan-Do-Study-Act (PDSA) and Advancing Research and Clinical Practice through Close Collaboration (ARCC) frameworks. This QI project took place over four weeks at a cardiology clinic in Dayton, Ohio and included 512 adult patients without a prior OSA diagnosis. Providers received a 30-minute in-service on administering the STOP-BANG questionnaire, interpreting results, and referring patients with scores ≥3 for PSG testing. The tool was administered during standard clinic visits. Data was collected via retrospective chart audits and analyzed using chi-square. Results: The PSG referral rate was significantly higher after the STOP-BANG implementation (χ² = 29.85, p < .001). Male patients were significantly more likely to be referred than females (χ² = 11.30, p < .001). Conclusion: Implementation of the STOP-BANG questionnaire significantly improved referral rates for sleep apnea evaluation in a cardiology setting. Future studies should examine diagnostic completion post-referral and assess implementation across diverse settings to support early detection and promote equitable cardiovascular care. Keywords: obstructive sleep apnea, STOP-BANG, screening, polysomnography, cardiovascular disease, quality improvement, outpatient cardiology
Recommended Citation
Darnell, Jessica, "Improving Cardiovascular Outcomes: Increasing Referral Rates Through Stop-Bang Questionnaire Utilization" (2025). Doctor of Nursing Practice Projects. 1.
https://digitalcommons.cedarville.edu/dnp_projects/1
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
