Appendix A: Survey Tool
1.
Are you aware of a formal (written) post-operative discharge or overnight admission policy for known/diagnosed
obstructive sleep apnea at your institution?
a) Yes
b) No
2.
Are you aware of a formal (written) post-operative discharge or overnight admission policy for suspected/undiagnosed/
presumed obstructive sleep apnea at your institution
a) Yes
b) No
3.
If you answered yes to question #1 0r #2, to what type of unit are the patients routinely sent postoperatively if admitted?
“if there is an outpatient discharge policy for patients with known or suspected OSA, please explained under “Other “
a) SICU
b) MICU
c) 23 hour PACU
d) Monitored floor bed (telemetry)
e) Other_______________________
4.
If you answered no to question # 1 or #2, what service makes the decision regarding postoperative disposition (discharge
vs admission)?
a) Surgical
b) Anesthesia service
c) Combination of a and b
5.
Prioritize the following decisions that influence whether a suspected OSA patient is admitted or discharged after same day
of surgery. #1 is the first priority. Followed by #2 , #3 ,etc. If any, do not apply mark as N/A.
a) Bed availability
b) Type of Surgery
c) Degree of OSA
d) Staffing
e) Home assistance
f) Drugs administered during anesthesia
g) Compliance with CPAP use at home
h) Resident coverage/expertise
6.
If an OSA patient is transferred to a monitored ward (not ICU) after surgery, what type of monitoring is provided?
a) Pulse oximetry connected to a central alarm
b) Pulse oximetry not connected to a central alarm
c) No respiratory monitoring
d) Other_________________________________________________
7.
In the last 12 months, can you recall a major perioperative complication that you believed is directly attributable to OSA in
a surgical patient (Yes/No)____________
8.
If you answered yes to #7, what was the complication?
9.
During the preoperative anesthesia interview with a surgical patient, what screening tool is used to establish the presence
and degree (mild, moderate, severe) of OSA?
a) STOP questionnaire
b) Flemons criteria
c) ASA guidelines
d) Berlin questionnaire
e) None
f) Other: _____________________________________________