Evaluation of manometer use in manual ventilation of infants in neonatal intensive care units

Variations exist in the techniques used to perform manual ventilation in neonates and in the proficiency levels of nurses in neonatal intensive care units (NICU) who perform the procedure. This study was undertaken to determine (1) whether significant differences exist in nurses' ability to control prescribed peak inspiratory pressure (PIP) accurately when mamometers are used, as compared with when they are not used, during manual ventilation in NICU infants; and (2) whether the number of years of work experience nurses have in the NICU is related to manometer use and success in controlling prescribed PIP. The sample included 60 professional nurses whose experience ranged from 1 to 26 years. A statistically significant difference was found in nurses' ability to control PIP successfully when manometers were used as compared with when they were not used (t = 12.04, p = 0.001). Nurses with more experience tended to rely less on manometers to guide their manual ventilation techniques, but were also less accurate in controlling the delivery of PIP without the devices. We provide recommendations for clinical practice based on these findings.