Sleep For Nurses
20320 Redwood Road
Castro Valley, CA 94552
Phone: (510) 728 0828
I would like to introduce Dr. Lisa Kuhen. Dr. Kuhen and I became acquainted several years ago during her DNP program. I have asked her to share her exceptional experience with sleep apnea patients, in both the acute care setting and clinical practice. I hope that you find her story inspiring.
Question 1: What made you become interested in the field of sleep medicine?
I honestly fell into sleep medicine with I joined the pulmonary practice 12 years ago. Since sleep disorders is not part of the core curriculum for APRN’s, I knew very little about sleep apnea and sleep disorders and so I had to do a lot of self study. As time when on I started to see consistenc patient patterns that were suggestive of sleep apnea but not see any one in the health care community screening patients routinely in the hospital setting or private practice. The more I learned, the more I was interested in making a difference.
Question 2: What kind of impact to you think your expertise in sleep medicine has made on your patient population?
We now have built inot our practice routine screening for sleep disorders on every pateint at every visit. I educate patients ot hey can make the bese decision for their health in regards to treatment options available and the long ranging impact of choosing not to treat. I find that patients are more likely to be complianct and embrace treatment when they understand what is happening to their body when they sleep. Since dedicating one morning a week to patients with sleep apnea for follow-up visits, education and receiving their “PAP therapy” before they walk out of the office, compliance has increased significantly.
Question 3: I understand your recently completed your Doctor of Nursing Practice. Your project was on sleep apnea in hospitalized patients. Can you explain why you chose this topic and share some of your results?
I chose this topic because sleep apnea is a critical safety concern for hospitalized patients. As a nation, the research shows that 90% of patients with sleep apnea do NOT receive continuation of their PAP therapy while hospitalized. There is no core measure aimed at addressing the safety issues that untreated sleep apnea brings to the hospital setting. Untreated SA puts the patient at a heightened risk to experience cardiorespiratory failure and unanticipated death, longer hospital stays, falls, health care acquired infections, thromboembolism, and higher 30-day hospital readmission risk.
When patients in my pilot project had sleep apnea identified and treated with PAP, they had the shortest hospital length of stay and a “0” percent 30-day readmission compared with the low risk group having a 14.7% readmission rate and the high SA risk-not yet diagnosed or treated but receiving simple nursing interventions, had a 10% readmission rate. So I believe simple no cost to low cost interventions aimed at maintaining the airway and oxygenation make the difference for readmission and hospital days.