NURSING PATIENT CARE POLICY & PROCEDURE
April 29, 2016
Nursing Manual (Red)
Policy #: 7.10 AP
Title: Incentive Spirometry
(Adult & Peds)
The incentive spirometer is used to encourage a sustained maximal inspiratory
breathing effort. The indications for use for the incentive spirometer include patients
who are alert and cooperative in the immediate post-operative period and/or
immobilized patients at risk for pulmonary complications until discharge.
Incentive Spirometer (Central Services Item Number 1219150)
A. It is recommended that incentive spirometry be used with deep breathing
techniques, directed coughing, early mobilization, and optimal analgesia to
prevent pulmonary complications.
B. Remove the incentive spirometer from bag. Set on flat surface if unit is not to be
held by patient. The spirometer should remain in an upright position during the
C. Attach the end of corrugated tubing to spirometer outlet.
D. Position the patient in an upright position to maximize inspiratory effort and
facilitate diaphragm movement and thoracic expansion. Splinting of an incisional
area may make the procedure more comfortable for the patient.
E. Instruct patient to seal mouth around mouthpiece. Be sure the patient is inhaling
from the mouthpiece, not through the nose. Follow brand-specific instructions.
1. Instruct the patient to breathe in slowly and deeply, after a normal
2. Instruct patient to hold the deep breath for a few seconds before exhaling.
3. Recommend 10 breaths per therapy performed every one-two hours while
awake as tolerated by patient or as specified by provider order.
F. Document patient usage and response in patient’s clinical record.
G. Encourage the patient to perform an effective cough maneuver after every
treatment with an incentive spirometer.
H. If the patient is not able to achieve an adequate inspiratory capacity, notify the
provider so that another form of therapy more appropriate for the patient may be
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IV. UWHC CROSS REFERENCES
A. Health Facts For You 4403, Incentive Spirometry
B. Health Facts For You 5445, Incentive Spirometry (Pediatrics)
C. Health Facts for You 7289, Your Stay on the Trauma Unit,
page 11 Coughing and Deep Breathing
D. Respiratory Care Services Policy 3.01, Cough and Deep Breathing
A. Restrepo, R., & et al. (2011). AARC Clinical Practice Guideline: Incentive
Spirometry. Respiratory Care, 56(10), 1600-4.
B. Thompson, J. M., McFarland, G. K., Hirsch, J. E., & Tucker, S. M. (2002).
Mosby’s Clinical Nursing (5th Ed.). Elsevier Health Sciences.
VI. REVIEWED BY
Clinical Nurse Specialist, Transplant and General Surgery/Bariatric Center of
Clinical Nurse Specialist, Pediatric Intensive Care Unit
Clinical Nurse Specialist, Pediatric General Medicine and Surgery
Clinical Nurse Specialist, Surgical Specialties and Inpatient Psychiatry
Director, Respiratory Therapy
Nursing Patient Care Policy and Procedure Committee, April 2016
Beth Houlahan, DNP, RN, CENP
Senior Vice President Patient Care Services, Chief Nursing Officer