getting patients to use their incentive spirometer

Nurses General Nursing

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For all you experienced nurses out there, how do you get your patients to actually use their incentive spirometer without having to tell them to every hour?

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I found out when I was hospitalized, that I was no more inclined to use my i.s. than the next patient!

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I describe how much coughing they will do and how much worse they will feel with a fever when they develop post op pneumonia! Seriously, you can only make an adult do so much. Give 'em the facts, encourage compliance and when they refuse or use excuses, document your efforts. Make sure the IS is not moved out of reach (huge pet peeve of mine), enlist the help of their family and visitors as well.

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Specializes in cardiac (CCU/Heart Transplant, cath lab).

Empathize with them, letting them know that you realize it may be painful (surgical patient) or that it may be hard to remember. However, it is better than developing atelectasis and pneumonia which can lead to mechanical ventilation especially if they are not ambulating. Honestly stating the consequences is frequently enough to convince a rational adult to do something.

I explain that when I am in the room doing vitals/assessments (q 1-2hr) that I would like them to use the spirometer.

Also, if they watch tv, you could recommend for them to do it on commercial breaks.

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Specializes in chemical dependency detox/psych.

I've always believed that I should 1.) educate and 2.) Remind them, remind them, remind them. :clown:

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I'm thinking, maybe if there was some sort of cap to the mouthpiece...the one that I am familiar with, the spirometer came in a plastic bag. How appealing is it to put something in your mouth that has been lying in the bed, maybe knocked into the floor a few times....

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Specializes in Med Surg, Specialty.

Get the family involved. They are often itching for some way to help out anyway and this makes them feel useful. Remind the patient about the IS and why its important, explain again to them and the family member how to use it, say it should be done 10x/hr and then ask the family to help remind the patient. This has always worked out very well for me.

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I have them name it! Bought one for my mother last year and she named hers "Wendy"... lol.

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Specializes in OB/GYN, Peds, School Nurse, DD.
I've always believed that I should 1.) educate and 2.) Remind them, remind them, remind them. :clown:

Absolutely! And don't assume that because you or someone else has already explained it to them that they actually remember how to do it.You have to keep telling them over and over. Just because you see it laying there doesn't mean the patient has any idea what it's for.

I had some serious abd surgery several years ago--my outpatient laparoscopy went terribly wrong and I ended up staying for a week. At some point during my stay someone dropped off the IS. I have no memory of it because I was on a morphine pump, sucking it down as hard as I could. My DH remembers it being there but he didn't know what it was, so he put the tube away. According to him, no nurse ever asked about it and I certainly wasn't in my right mind. Not only did I not do the IS, I didn't cough either, becuase, DUH...it hurts!:uhoh3: And the nurses never made me do it. So about the 3rd day, when I was slated to be discharged, I woke up with a fever of 103 and short of breath. Ta-da! Atelectasis! At that point I had PLENTY of nurses telling me to use the IS, scolding me because "you should know better, you're a nurse!" Yeah, A NURSE ON MORPHINE YOU IDIOT! At least my DH understood it all--he started staying with me 24/7 to make sure I a)did what I was supposed to and b) had an advocate so the nurses didn't continue to have rag on me for causing my own collapsed lung & pneumonia. :mad:

Never assume...

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Give them basic information in laymen's terms of why and how and when. I also obligate the family (they are the ones who are the most of top of it) and they follow through.

Most are very easy to teach, and do follow.

For the ones that don't, I usually scare them a little....with some dramatic flair attached. Sometimes I pull out an ET tube and a BVM and place it next to the bed. Then I explain why it's there....

That works well too.

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IC is a curious dichotomy IMHO. If somebody is well enough to properly utilise it several times an hour as intended, do they actually need it?

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Specializes in home health, dialysis, others.

I have always attached it to the 'start of the next TV show'. Also, try to make a game of it - measure what they can do early in your shift, and explain that they need to it a bit more by the end. Ascertain that the pt/family knows what to do, how to do it, and WHY!!

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