Implementing the Stop-Bang Assessment Tool to Impact Perceived Stress Among Clinical Staff

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Marino Robinson

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2025

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Nursing

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Anesthesia-related airway emergencies, particularly those involving failed intubation or ventilation, are a significant concern and contribute to poor patient outcomes. Obstructive sleep apnea (OSA) increases the risk of difficult airway events, further compromising patient safety. Despite its predictive value, the STOP-BANG questionnaire is not currently used to screen for OSA risk in the endoscopy lab of an urban outpatient gastrointestinal clinic in Chicago, Illinois. This gap in practice can lead to procedural delays and safety concerns due to unanticipated equipment needs, insufficient staff readiness, and lack of postoperative awareness. This quality improvement project aimed to determine the impact of implementing the STOP-BANG questionnaire compared to the current practice on stress perception among outpatient gastrointestinal (GI) clinic staff over 8 weeks. The Knowledge to Action (KTA) framework was used as a guide to facilitate this project. A pre- and post-implementation Perceived Stress Survey-10 (PSS-10) was administered to clinical staff (n =10). Also, the STOP-BANG questionnaire was used to evaluate patients for possible undiagnosed OSA prior to anesthesia (n =103). Results showed that the mean pre-intervention score for PSS-10 was lower (M = 13.9, SD = 5.72) than the post-PSS-10 survey mean score (M = 16.8, SD = 4.32). However, implementing the STOP-BANG questionnaire categorically changed perceived stress levels from low to moderate among clinical staff at a low rate (n = 2; 20%). Nevertheless, perceived stress levels did not improve. STOP-BANG scores for colonoscopy patients were at an average of 3.66, whereas the average STOP-BANG scores for patients undergoing an esophagogastroduodenoscopy (EGD) were 3.06. Airway maneuvers were needed for 40.98% of patients who had a colonoscopy and 37.93% of patients who had an EGD.

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