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Use of an Evidence-Based Protocol to Screen for Sleep-Disordered Breathing in a Heart Failure Disease Management Clinic

Garner, Shelby L. PhD, RN, CNE; Traverse, Ramona D. BSN, RN, CCRN, CHFN

doi: 10.1097/NCQ.0000000000000047

Undiagnosed and untreated sleep-disordered breathing can lead to negative health outcomes and increased utilization of health resources among patients with heart failure. The purpose of this evidence-based practice project was to implement and evaluate a new multifaceted sleep-disordered breathing screening protocol in a heart failure disease management clinic. The combined use of a symptoms questionnaire, the Epworth Sleepiness Scale, and overnight pulse oximetry was significantly more effective in identifying patients with a positive diagnosis of sleep-disordered breathing than using the Epworth Sleepiness Scale alone (P < .05).

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Baylor University, Louise Herrington School of Nursing, Dallas, Texas (Dr Garner); and The Medical Center of Plano: Cardiology, Plano, Texas (Ms Traverse).

Correspondence: Shelby L. Garner, PhD, RN, CNE, Baylor University, Louise Herrington School of Nursing, 3700 Worth St, Dallas, TX 75246 (

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: November 30, 2013

Published ahead of print: December 23, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins