Skill 1

Acapella Device

The Acapella is a handheld airway clearance device that provides positive expiratory pressure (PEP) with oral airway oscillations to aid sputum clearance. PEP stabilizes airways and improves aeration of the distal lung areas. During exhalation, pressure from the airways is transmitted to the Acapella device, which helps mucus dislodge from the airway walls, thereby preventing airway collapse, accelerating expiratory flow, and moving mucus toward the trachea. This device combines resistive features of PEP and vibration to mobilize airway secretions. The Acapella device is easy to use as patients are able to perform airway clearance independently. Patients with chronic conditions such as cystic fibrosis appear to receive the greatest benefit from this type of treatment.

Delegation Considerations

The skill of using an Acapella device can be delegated to nursing assistive personnel (NAP). The nurse is responsible for performing respiratory assessment, determining that the procedure is appropriate and that a patient can tolerate it, and evaluating a patient’s response to the procedure. The nurse directs the NAP to:

▪ Be alert for the patient’s tolerance of procedure, such as comfort level and changes in breathing pattern, and to immediately report changes to the nurse.

▪ Use specific patient precautions, such as positioning restrictions related to disease or treatment.

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