Incentive Spirometer Appearance and Patient Care

vanilla bean · Nov 10, 2015

Ok, so what is your own personal opinion? How would you answer the questions posed to us?

jayjay12345 · Nov 10, 2015

Hi Vanilla. I don't find the appearance useful. As simple as it seems I find it complex. Explaining to a patient to inhale to raise the ball or piston doesn't do much to encourage patient use. I notice that patient don't used as prescribed during their admission. I've also seen nurse struggle to teach or explain how to use the device. I would definitely change the appearance that would be a more simplified version then what it is. I think the incentive spirometer is an essential tool that needs to be updated in some way to improve compliance.

mmc51264, BSN, MSN, RN · Nov 10, 2015

I tell them to suck, not blow and not worry about how high. The important part is to inflate lower parts of their lungs and that coughing is a good thing. we teach them 10x/hr (about once everytime a commercial comes on). Most of our pts are pretty good if remind them

Libby1987 · Nov 10, 2015

I'm a believer in the them and can usually get compliance when my patients get a good explanation of how it will help their recovery and they see my buy in.

I think the mouthpiece is too wide, hard to maintain a good seal for some. I think it could be more effective with a more ergonomic mouthpiece.

vanilla bean · Nov 10, 2015

Explaining to a patient to inhale to raise the ball or piston doesn't do much to encourage patient use. I notice that patient don't used as prescribed during their admission.

Simply explaining *how* to use the device wouldn't do much in regards to encouraging the patient to use it, IMO. The important part of patient education to improve compliance is imparting on them *why* IS is important and how its use/nonuse can effect their recovery and outcomes. Teaching proper use is also important - not much sense in them using it if it's done incorrectly. As a PP mentioned, most patients are compliant if reminded. With this new-ish trend of hourly rounding, it's easy to include a quick, "and make sure you do your 10 deep breaths with your IS this hour" while you're there anyway.

RescueNinjaKy · Nov 10, 2015

I've found that most patients have no idea why they're using it. They just figured it was something people wanted them to do and honestly that didn't help to motivate them to do it. I like to provide education to all my surgical patients about them and why it's used. They're always surprised and grateful for that which usually increases their compliance with the 10 breathes per waking hour.

roser13, ASN, RN · Nov 10, 2015

Lol, I was once asking a patient pre-operatively if she had ever had any complications with anesthesia. For instance, had she ever come out of surgery unexpectedly on a "breathing machine"? She said "yes! I was on the breathing machine for 10 days!"

Cue arduous, circular conversation regarding the need for said breathing machine: "It helped me breathe!" Finally, after a painfully long time, she mentioned the yellow ball in her breathing machine. Sigh. :no:

Back to to the thread.......

CryssyD · Nov 10, 2015

My short answer is, that's your job--teaching how and why to use it. And, for a lot of people, the quickie 2 minute explanation won't do--they need time, practice, and encouragement (lots of encouragement, usually!) to use it properly.

Really understanding what it's for, how it works, and why it's important does improve compliance. Teach them about how it expands the lungs in general, and the small airways in particular; draw a picture of the lungs (bronchi, bronchioles, and alveoli--the whole thing looks a lot like a bunch of grapes) and explain what is being opened up and how this prevents pneumonia. (Or talk about the alveoli like little tiny balloons that need to be blown up--every time they get opened up, the easier it is to keep them open--most people understand that a partially-blown up balloon is much, much easier to fully blow up than a completely empty one; if they don't get that, keep some balloons around and show them!)

In general, I find that people comply with instructions so much better when they understand the how and why. Yes, it takes a while to explain, and might take a few sessions, but it's worth it.

Setting goals is a good compliance enhancer, too. If they can only get to 1500 on the first try, make 2000 the goal; find out how long it takes them to hit that goal. Put happy face stickers or colored marker lines on accomplished levels. Use your imagination!

Finally, with all the gadgets we use today, maybe an electronic version that has a digitalized display for the numbers, a database in which to store all recorded efforts, etc would get more use. We seem to respond better to more complex toys, these days.

Farawyn · Nov 10, 2015

I like them. I think it's worth it to teach. I have seen accurate use of this help patients turn the corner.

Mavrick, BSN, RN · Nov 10, 2015

In the PACU, when people are awake enough to focus their eyes 1 foot in front of them we play the "Breathing Game". The IS we have is a simple plastic device that detects air volume with a rising blue cylinder. I can place the pointer at an arbitrary spot and instruct the patient to "blow all your air out, put the mouthpiece in your mouth and suck" As the cylinder rises the excitement builds as the cylinder approaches the pointer and many times surpasses it. Yeah! I raise the pointer, allow the cylinder to return to the bottom then start giving "cheats" on how to do better. "Sit up, blow all your air out, make a tight seal, don't quit until your lungs are all the way full." The next effort is usually better as they buy into the game. Five breaths gets maximum praise and an ice chip.

Loracs72 · Nov 10, 2015

I am an RN and had surgery one year ago. I had never had to use an IS before, but had coached many patients. It was easy to use and did actually make me feel better. Since I'm an RN I used it as I was instructed, but I have noticed that patients will not usually use it unless you remind them ! Maybe some Helium would help to make it more fun ? Ha Ha !