Incentive spirometry: Impacting sickle cell disease care by changing the spectrum through provider education
Nature and scope of the project
Sickle cell disease is an autosomal recessive hematologic condition that affects 100,000 Americans and over three billion people worldwide (CDC, 2023). Because hemoglobin has a sickle shape, the body's organs suffer from inadequate oxygenation. Bronchial hygiene during hospitalization can help prevent ACS (Niss et al., 2017). However, at the University of Chicago, our adult SCD patients do not receive incentive spirometers (tools for bronchial hygiene) or education on the importance of using them during their hospital stay.
Synthesis and analysis of supporting literature
At 25%, ACS is the leading cause of death and the second most common cause of prolonged hospitalization (Bhasin et al.,2023). ACS accounts for an average of 10.5 days of prolonged hospitalization (Novelli et al.,2016), increasing the risk of admission to the intensive care unit (Cheminet et al.,2022).
In one study, pulmonary complications were significantly decreased in the incentive spirometry group (1 in 19 hospitalizations) compared to the placebo group (8 out of 19 hospitalizations), p=0.019.
Project implementation
Nursing and auxiliary staff (CNAs) will be educated on incentive spirometry, emphasizing its significance for the adult SCD population. With the help of the Epic team, a new flowsheet has been created to facilitate documentation and user management. A dedicated Sickle Cell order set has been established to incorporate bronchial hygiene.
Evaluation criteria
The researcher will utilize the Likert scale to survey nursing staff before and after education on incentive spirometry.
Outcomes
The desired outcome is to note increased IS use among the SCD patient population. Also, there is a rise in IS orders among our providers.
Recommendations
The Society of Hospital Medicine (2023) synthesized the literature, demonstrating a strong correlation between ACS and VOC hospitalization. Their guidelines concluded a high recommendation for IS use throughout an SCD patient admission to prevent ACS.
Incentive spirometry: Impacting sickle cell disease care by changing the spectrum through provider education
