Incentive Spirometry

Post operative respiratory complications such a chest infections and pneumona may occur after surgery. The main causes of complications include:

• Anaesthesia
• Reduced mobility
• Pain
• Inability to cough and clear secretions

Complications are mostly treatable but often lead to:

• A longer stay in hospital
• The need for additional medical interventions and treatments
• A slower overall recovery

In 2015, funded by the surgical directorate, we introduced flow controlled incentive spirometry for patients undergoing major elective surgery. Respiratory physiotherapists were involved in the training of pre-assessment nurses who were then responsible for providing the incentive spirometer to patients and explaining how to operate the device. A patient information leaflet was also created including a pre-operative practice record chart.

When comparing 132 patients (undergoing major elective colorectal surgery) prior to the introduction of incentive spirometry to 182 patients after the introduction we found there had been an absolute risk reduction in the incidence of pneumonia by 4.5% and HDU admissions due to pneumonia is also reduced from 4.5% to 0.5%. We are now looking at rolling the intervention out in other specialities.

We have created a small training video on the use of incentive spirometry for patients. This will be avaliable shortly here.