SARASOTA MEMORIAL HOSPITAL

NURSING PROCEDURE
TITLE:

ISSUED
FOR:

INCENTIVE SPIROMETRY
(equ02)

Nursing

7/88
DATE:
11/05
REVIEWED:
1 of 3
PAGES:
RESPONSIBILITY:
RN, LPN, RT
* PCA, Patient Care Specialist

PURPOSE:

To provide a procedure for the delivery of incentive spirometry.

KNOWLEDGE BASE:

1. Incentive spirometry uses a breathing device to encourage

the patient to achieve maximal ventilation. The device
measures respiratory flow or respiratory volume and
induces the patient to take a deep breath and hold it for
several seconds. This exercise establishes alveolar
hyperinflation for a longer time than is possible with a
normal deep breath, thus preventing and reversing the
alveolar collapse that produces atelectasis and
pneumonitis.
2. Incentive spirometry benefits the patient on prolonged bed
rest, especially the postoperative patient who may regain
his normal respiratory pattern slowly because of such
predisposing factors as: abdominal or thoracic surgery,
advanced age, inactivity, obesity, smoking, and a
decreased ability to cough effectively and expel lung
secretions.
3. Incentive spirometry requires a physicians order. The
order will be processed according to established
procedures.
PATIENT EDUCATION:
1. Explain the procedure to the patient, making sure he/she
understands the importance of performing this exercise
regularly to maintain alveolar inflation and help prevent lung
collapse and pneumonia.
2. When possible and appropriate, include incentive
spirometry in preoperative teaching.
INDICATIONS:
To prevent atelectasis and mobilize secretions through deep
inspiratory maneuvers and end-inspiratory breath-holding.

TITLE:

INCENTIVE SPIROMETRY
(equ02)

PAGE: 2 of 3

EQUIPMENT:

1.
2.
3.
4.

Incentive Spirometer (Central Service Cart)

Tissues
Gloves, as appropriate
Noseclips (optional)

PROCEDURE:

1. Read and follow the manufacturers instructions for

spirometer set up and operation. Connect the breathing
tube to the spirometer. The tube and mouthpiece will be
sterile on the first use and clean on subsequent uses.
2. Assist the patient to a comfortable sitting or semi-Fowlers
position to promote optimal lung expansion. If the patient is
unable to assume or maintain this position, perform the
procedure in any position as long as the device remains
upright. Tilting an incentive spirometer decreases the
required patient effort and reduces the exercises
effectiveness.
3. The patients lungs may be auscultated by the nurse or RT
to provide a baseline for comparison with post-treatment
auscultation.
4. Instruct the patient to insert the mouthpiece and to close
his/her lips tightly around it in order to obtain a tight seal.
Noseclips may be used, if necessary.
5. Instruct and encourage the patient to inhale maximally,
following the directions with the incentive spirometer to
maintain inspiratory flow at desired level.
6. Instruct the patient to hold his/her breath for 2 to 3 seconds
and then exhale slowly through the nose.
7. Two to four maximal inspirations should be done per minute
for a period of 5 to 8 minutes.
a. If the patient exhibits light-headedness during the
procedure, stop and allow the patient to rest before
continuing.
b. Stress the importance of patient involvement and the
self-help concept. Involve family.
c. To be continued even after discharge.
d. Procedure should be performed at least every hour
while awake.
8. Instruct the patient to cough to remove accumulated
secretions. Patients should use a small pillow for splinting
chest incisions.
9.

If soiled, wash the mouthpiece in warm water and shake it

dry. Avoid immersing the spirometer itself because this
enhances bacterial growth and impairs the internal filters
effectiveness in preventing inhalation of extraneous

TITLE:

INCENTIVE SPIROMETRY
(equ02)

PROCEDURE (contd):

PAGE: 3 of 3

material.
10. Label the spirometer with the patients name to avoid
inadvertent use by another patient.
11. Provide the patient with the Instructions for Use that are
in the kit. These are helpful as information available in
French and Spanish also.

DOCUMENTATION:

Nursing Reassessment Flowsheet in SCM/CareVISION or

CareVue: Document incentive spriometer frequency and
incentive spirometer volume range.
Education Record: Document the initial procedure, patient
education and patient response. Document any subsequent
patient education, patient response and any other pertinent
information, as appropriate.

REFERENCE(S):

Buchfa, V. (2000). Incentive Spirometry. Nursing Procedure:

Third Edition. (pp 474-476). Springhouse, PA: Springhouse
Corporation
Archer, E. et al., Nursing Procedures and Protocols. (2003).
Lippincott Williams and Wilkins. Philadelphia: PA.

REVIEWING AUTHOR(S):
Cindy Taylor, RN, BSN, CPS, Cardiac
Mark Pellman, RRT, Team Leader, Resp. Therapy
APPROVAL(S):

Nursing Standards & Practice Council 9/1/05

Respiratory Management, 8/26/05