“Prevention is better than cure”

Obstructive sleep apnea (OSA) is highly prevalent, associated with several chronic medical conditions. Undiagnosed OSA increases health care costs, making early identification crucial (Aurora & Quan, 2016). OSA is rarely reported and addressed by primary health providers (Miller & Berger, 2016). As a sleep provider, I have realized the importance of timely diagnosis and treatment of OSA. On the other hand, I found OSA screening and assessment fragmented and ineffective in the primary care office where I work. Primary care providers encounter OSA patients but lack routinely screening evaluation or referral to a sleep specialist.

This gap in OSA diagnosis is a crucial quality and safety issue. The timely diagnosis of OSA improves the quality of sleep and life of patients, preventing cardiovascular morbidity and mortality. The use of EMR for OSA screening can improve compliance with screening and identifying patients at high risk for OSA at primary care offices (Stubberud et al., 2019).


DNP Essentials Linked: I, II, III, IV, V, VI, VII, VIII



Aurora, R. N., & Quan, S. F. (2016). Quality Measure for Screening for Adult Obstructive Sleep Apnea by Primary Care Physicians. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine12(8), 1185–1187. https://doi.org/10.5664/jcsm.6064

Miller, J. N., & Berger, A. M. (2016). Screening and assessment for obstructive sleep apnea in primary care. Sleep medicine reviews29, 41–51. https://doi.org/10.1016/j.smrv.2015.09.005

Stubberud, A. B., Moon, R. E., Morgan, B. T., & Goode, V. M. (2019). Using the Electronic Medical Record to Improve Preoperative Identification of Patients at Risk for Obstructive Sleep Apnea. Journal of perianesthesia nursing: official journal of the American Society of PeriAnesthesia Nurses34(1), 51–59. https://doi.org/10.1016/j.jopan.2018.04.002




2 comments on “Exemplar on Quality and Safety

  • Sonica,

    Your Exemplar on Quality and Safety is well done and utilizes all the DNP essentials.
    Your thought process is clear and concise. The OSA issues you have addressed are critical to enhancement of quality care for OSA patients. The diagnosis screening tools should be in the EMR as you have mentioned.
    When I worked with EPIC, we had OSA screening tools built in which were utilized by all providers especially if the patient was coming in for a preoperative screening.
    Well done.
    Joanne Coleman

  • Sonica,
    Thanks for sharing your exemplar on quality and safety. Prior to reading your blog, I would not have considered the clinical aspect of OSA as a quality and safety concern. However, you articulated the background, problem and significance of screening for OSA as critical to the safety of patients and quality of care. Especially as our nation grapples with increasing rates of obesity, the number of American’s with OSA will also increase. It is certainly imperative that screening practices include early identification of this clinical problem. and certainly automating this screening tool into EMR to promote adherence to screening. Great job.

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