The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Vincent Mwavu, David Chang; University of South Alabama, Mobile, AL

BACKGROUND: Vibratory PEP therapy has been used to mobilize secretions in different health care setting. Its effectiveness mainly depends on the proper teaching and couching by the therapist and correct use of this device by the patient. The purpose of this study was to evaluate the adherence of recommended procedure for Acapella therapy by respiratory therapists in one metropolitan hospital. METHODS: IRB approvals were obtained from the university and hospital. The recommended 12-step procedure for Acapella therapy published by the UCSF Medical Center was used in this study. The researcher used this 12-step procedure and developed a checklist (Table 1) for use in direct observation of staff therapists providing the therapies. The staff therapists were selected in random and they were blinded to the data collection of this study. For each of these 12 steps, it was scored as “observed” or “not observed.” Under “not observed,” notations might be made for later data interpretation. A descriptive method was used for interpretation of data. RESULTS: A total of 30 therapists were studied under direct observation for adherence of the 12-step procedure. The results were provided in Table 1. Major findings of this study included the following steps: Step (3), 25 of 30 therapists (83.3%) did not provide aerosol drug delivery in conjunction with the Acapella. Step (8), 9 of 30 therapists (30%) did not emphasize the importance of inhaling slowly, breath holding, and suppressing the urge to cough. Step (9) 8 of 30 patients (26.7%) could not exhale for 3 to 4 sec due to pain or under mild sedation. Step (10) 17 of 30 patients (56.7%) could not perform the number of breaths or “huff” coughs due to pain, under mild sedation, or being too sick and weak. CONCLUSIONS: For the institution in this study, the therapists should evaluate the feasibility of combining aerosol drug delivery with Acapella therapy. The therapists should also emphasize to the patients the correct breathing techniques with an Acapella device. For patients who are unable to use the Acapella due to changing medical conditions, the therapists should recommend an alternative to Acapella therapy. Sponsored Research - None Adherence of recommended procedure for Acapella therapy by respiratory therapists