Protocol for incentive spirometry?

[ViolettaCCU, MSN]

Hello Y'all,

Just wondering if your hospital has any protocols for using incentive spirometers? Does your hospital require a physician's order? Who teaches it - the nurse or respiratory therapist or cardiac rehab?

Traditionally, incentive spirometers have been used for post surgical patients. What about the post extubated patient or the general medical patient? I feel there are many medical patients that could benefit from use of incentive spirometers, too. Your thoughts?

[Corey Narry, MSN, RN, NP]

IS is part of our post-op order sets. Implementing IS have always been a nursing responsibility as part of bedside patient education but requires a provider order. In our post-extubation patients, we've devised a protocol that allows the RT to decide on which lung expansion or airway clearance modality would work for specific patients since IS isn't the only device out there. We write an order for RT to assess and determine whether IS, EZ-Pap, Acapella Valve, Aerobika OPEP is more appropriate. The same order can apply to medical patients who are not post-extubation but can benefit from lung expansion or airway clearance strategies that requires an expertise of an RT to determine.