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Incentive spirometry has been used to help prevent pulmonary complications after surgery, although its therapeutic efficacy remains in dispute (Freitas, Soares, Cardoso, & Atallah, 2008; Haeffener, Ferreira, Barreto, Arena, & Dall'Ago, 2008). At the author's urban tertiary care hospital, incentive spirometry is part of the postoperative respiratory care protocol for most surgical patients hospitalized longer than 24 hours. The author of this small clinical trial found no evidence of any benefit from incentive spirometry in reducing pulmonary complications in adults undergoing coronary artery bypass graft (CABG). In this study of patients undergoing CABG, the success of the use of an incentive spirometer for reinforcing a breathing pattern that prevents or reverses breathing complications and im - proves lung function was measured. The author suggested the results should be interpreted cautiously, as there were limitations related to methodology and reporting.
An extensive literature search (2001-2008) found no references for the use of an incentive spirometer for patients admitted with medical diagnoses. No other studies to date have assessed incentive spirometry use among hospitalized general medical patients, with most reports targeting specific surgical populations to evaluate the efficacy of incentive spirometry in preventing pulmonary complications. Over the past few decades, conflicting results have been reported regarding the therapeutic usefulness of incentive spirometry in the perioperative period. Recent studies reported benefits for patients following major abdominal surgery (Westwood et al., 2007) and CABG (Haeffener et al., 2008), whereas others found no conclusive evidence that incentive spirometry prevents pulmonary complications following either thoracic surgery (Agostini, Calvert, Subramanian, & Naidu, 2008) or CABG (Freitas et al., 2008). Incentive spirometry has been reported to benefit patients with pulmonary disease after elective cardiopulmonary or non-cardiopulmonary surgery (Bapoje, Whitaker, Schulz, Chu, & Albert, 2007).
When patients are admitted to the hospital for exacerbation of a medical condition, they may spend a great deal of time in a supine position with a reduction of their routine daily activities. The result of this activity reduction may be respiratory distress, often requiring transfer to the intensive care unit. For medical patients, nurses follow the dictum that good respiratory function and oral hygiene are essential for preventing pneumonia and other respiratory complications. These are basic foundations of nursing care.
Any patient developing respiratory distress prompts immediate mobilization...