1. Rapid Response Calls and Code Blue Activations relative to Sleep Apnea Status Dr. Tosha Allen, DNP, RN, CEN Jon H. Lemke, PhD Jordan Brautigam, MS Neil Flynn Team Sleep Apnea Genesis Health System Research Summit: June 18, 2015

2.  My Inspiration!  Sleep Apnea affects more than 18 million Americans.  Gap in Literature on cardiopulmonary arrest and sleep apnea exist. Mostly what health risks are associated with sleep apnea disorders.  Sleeping disordered breathing is associated with health conditions across ALL organ systems.  Obstructive Sleep Apnea has been linked to cardiac arrhythmias (Roche et al. 2003). Background

3. The purpose of this quantitative research is to  (a) examine the relationship between rates of rapid response, code blues and sleep apnea status and  (b) analyze the accuracy of nursing and physician documentation in regards to sleep apnea on patients who had an RRT or cardiopulmonary arrest (code blue) activation in the hospital Purpose

4.  Sleep Apnea and RRTs?  Sleep Apnea and Code Blue? (Cardiopulmonary arrests)  Rate of Mortality?  RRT and Documentation?  Code Blue and Documentation? Research Questions

5.  Genesis Medical Center (GMC) Davenport Medical/Pulmonary Unit, Surgical Specialty Unit, Cardiovascular Interventional Unit, Cardiac Stepdown Unit, Neurology Unit, Oncology Unit, Orthopedic Unit, and Peds/Adult Surgical Unit, West ICU, and East CCU/ICU  Transitions in Personnel Restrict Rapid Response Data to: November 4, 2012-February 27, 2013; March 20, 2013-April 20, 2014; and July 1, 2014-November 3, 2014. Setting

6.  Patients have already been screened via Genesis Sleep Apnea Registry.  Logistic regression with demographics and rates  Compare RRT and Code Blue rates across sleep apnea status.  Estimate the probability of dying given sleep apnea status and alerts.  MINITAB, TIBCO Spotfire (S-Plus) or the Cytel studio for exact tests for sparse data. Data Analysis

16.  Nonadherent and Probable Sleep Apnea Patients are more likely to have Rapid Response and Code Blue Alerts.  Nonadherent and Probable Sleep Apnea Patients with Code Blue Alerts are more likely to Survive their Hospital Stay. And, Rapid Responses immediately followed by Code Blue are most predictive of death.  Further Modeling and Disease-Specific Analyses will be Required before Publishing.  With Recognition of Sleep Apnea Status one can come to expect the unexpected. Conclusions