Don’t Give in, Just Breathe in

Project Topic:

Use of an incentive spirometer to improve outcomes related to respiratory complications

Hospital Unit:

Cardiothoracic Intensive Care Unit

CSI Participants:

• Taylor Barney, BSN, RN, CCRN
• Amelia Chierchie, BSN, RN, CCRN
• Anna Sklyarova, BSN, RN, CCRN
• Jessica Vigh, BSN, RN

Project Goals/Objectives:

1. Decrease the amount of time a patient requires supplemental oxygen by encouraging the use of the incentive spirometer
2. Decrease the overall length of stay post-operatively
3. Prevent readmission of patients with respiratory complications
4. Foster a multidisciplinary care approach to encourage patient use of the incentive spirometer

Project Outcomes:

1. Decreased readmissions 40%
2. Decreased time on oxygen 477 minutes (12%)
3. These outcomes resulted in a positive estimated annual fiscal impact of $56,820.

Project Overview:

For 11 months prior to implementing our CSI project, the average time patients in our unit spent on oxygen was 3,830 minutes, the average overall length of stay was 136.6 hours and the readmission rate related to respiratory complications was 35%. Our CSI team set a goal to decrease these metrics.

Our team educated unit staff about our overall goals and our focus on encouraging patient use of the incentive spirometer to achieve these goals. We identified methods to recognize and reward staff members for their participation. Our team encouraged staff to have patients perform a return demonstration of incentive spirometer use as positive reinforcement and to remind patients to use their incentive spirometers. We also began the practice of teaching patients how to use an incentive spirometer before surgery.

As a result of our efforts, the new average time patients spent on oxygen decreased to 3,353 minutes (a 12% reduction) and the readmission rate decreased 40%.