Background and Review of Literature: Bag-mask ventilation (BMV) is a critical skill in the perioperative setting and is difficult to master for student registered nurse anesthetists (SRNAs). BMV has been shown to be the superior method of adequately pre-oxygenating patients prior to securing an airway. There is a growing body of evidence that all anesthesia providers including CRNAs, resident physicians, and attending physicians have lower levels of confidence with this skill in comparison to other, more invasive skills. Additionally, most providers prefer having access to annual BMV courses to refresh themselves on the latest BMV guidelines.

Purpose: This study assessed changes in first year SRNA competence, knowledge, satisfaction, and confidence levels with BMV after implementing a BMV refresher simulation session prior to beginning clinical rotations.

Methods: A systematic review of the literature was conducted using “bag mask ventilation” or “bag valve mask”. Inclusion criteria included text available in English, articles less than 5 years old, BMV as an intervention, and ventilation as an assessment. Exclusion criteria were laryngeal mask ventilation, passive oxygen insufflation, pilot studies, and unrelated research purposes. This resulted in 14 articles. The Marian University Internal Review Board (IRB) approval was obtained prior to initiating the DNP Project. First year SRNAs at Marian University Leighton School of Nursing were given a survey to assess their knowledge and confidence surrounding BMV prior to, and after attending a simulation session hosted by upper level SRNAs. The simulation session focused on the latest evidence based BMV techniques as well as indications to perform BMV and troubleshooting for patients who are difficult to ventilate. Paired t-tests were employed to compare pre and posttest scores.

Implementation Plan/Procedure: This prospective cohort study and systematic review assesses whether implementation of a hands on, evidence based BMV refresher course, in the simulation setting, improves first-year SRNA knowledge, satisfaction, confidence, and competence regarding BMV. The International Nursing Association of Clinical Simulation Learning (INASCL) standards of simulation education were upheld. Surveys were given prior to and after the simulation sessions on Qualtrics. Data was exported to Excel where statistical analysis was done.

Implications/Conclusions: Eight first year SRNAs participated in the BMV simulation and completed the pre and posttests. There was a statistically significant improvement in SRNA confidence (p = 0.0084) and knowledge (p = 0.00058). This study underscores the importance of implementing BMV refresher courses to SRNAs. Additionally, this intervention should be considered by other anesthesia providers to increase confidence, knowledge, and competence surrounding BMV.

Creator

• Jammes, Cara

• Rosenheck, Miriam

Language

• English

Keyword

• bag-mask ventilation (BMV)

• student registered nurse anesthetists (SRNAs)

• patient pre-oxygenation

• BMV guidelines

• BMV refresher simulation

• e International Nursing Association of Clinical Simulation Learning (INASCL) standards of simulation

Date created

• 2024

Resource type

• Research Paper

Rights statement

• http://rightsstatements.org/vocab/InC/1.0/