Date of Graduation

Fall 12-17-2021

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Elena Capella


Background: At the VA Puget Sound Healthcare System, care as usual for patients with a new diagnosis of mild obstructive sleep apnea (MOSA) is a letter directing the patient to call the continuous positive airway pressure (CPAP) clinic to establish ongoing care.

Local Problem: This model has resulted in low therapy compliance and does not afford patients the ability to discuss their diagnosis and treatment options with a licensed healthcare provider. A literature review showed telemedicine interventions increase therapy compliance in patients with MOSA.

Context: The Doctor of Nursing Practice project implemented an evidence-based practice change to improve therapy compliance for patients with a diagnosis of MOSA utilizing telehealth appointments. The aim was to increase compliance by 10%.

Interventions: The interventions in this implementation project consisted of screening patients who met inclusion criteria for telemedicine appointments with a registered nurse (RN). The RN verified eligibility and sent a list of patients to the medical support assistant for scheduling. The RN conducted counseling sessions with the patient at the scheduled times to educate them on their diagnosis and treatment options and to answer their questions. The sleep medicine provider cosigned all encounters and made recommendations to the plan of care, as needed.

Outcome Measures: Outcome measures included assessment of patient satisfaction with telemedicine appointments using a five- to eight-question survey. Therapy compliance was assessed via usage reports for CPAP, body mass index for patients who elect lifestyle changes, and patient self-reports. Reimbursement rates were assessed to determine long-term feasibility.

Results: Sixteen patients from both the intervention group and the care as the usual group participated in the follow-up survey. Patient satisfaction was rated higher for the telehealth intervention group than the care as a usual group; 96% of respondents in the intervention group were satisfied with their care, while only 74% in the care as usual group were satisfied with their care.

Included in

Nursing Commons