Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Jean Dols


Holly DiLeo


Mark Rodriguez


The purpose of this project is to increase the adherence of clinic providers to the American Academy of Sleep Medicine’s Clinical Guidelines for the Evaluation, Management, and Longterm Care of Obstructive Sleep Apnea in Adults. OSA is a chronic condition that effects from 2% to 10% of the U.S. adult population. Implications of undiagnosed OSA include excessive daytime sleepiness, fatigue, irritability, difficulty controlling chronic diseases including diabetes and hypertension, heart arrhythmias, gastroesophageal reflux disease, mood disorders, attention deficit disorder, and an increased potential for dementia if left untreated. A protocol was created to align providers with the clinical guidelines. Provider responsibilities included screening all patients 18 and over for OSA, referring patients with a positive screen for a sleep study, prescribing CPAP when indicated, and providing short-term follow-up. At project completion 293/405 patients (72%) ages 18 and over had been screened, 58 (20%) had positive screens, 53 (91%) with a positive screen were referred for sleep study, 19 (35%) completed the sleep study, 19 (100%) were diagnosed with OSA and prescribed CPAP, and 18 (95%) were scheduled for short-term follow-up. There were no significant differences noted between age distribution and the receipt of a positive diagnosis of OSA, F (3,504) = .066, p = .679. During implementation 19 (7%) patients were identified and treated for OSA. The relationship between using a screening tool to assess risk of OSA and receipt a positive diagnosis of OSA was significant, χ2 (1, 505) = 5.982, p < .05. Only 19 out of 53 patients referred for sleep study completed a sleep study indicating a need for continued work on intervention models that will facilitate patient completion of diagnostic testing with subsequent referral for treatment.