Ezquerra OA, Saucedo MEM, Flores FQ, Vergara SA

Language: Spanish
References: 24
Page: 360-366
PDF size: 166.82 Kb.

ABSTRACT

The poor technique in measuring blood pressure leads to misdiagnosis and an incorrect treatment by showing higher or lower blood pressure than the actual. The objective is to understand how health professionals adhere to the technique within a hospital, and verify if the blood pressure reported is adequate when compared to an expert. Material and methods: A prospective, observational, cross-sectional study was performed and the technique was evaluated at the Mocel Ángeles Hospital. 101 participants were observed, including nurses, residents, interns and nursing assistants. Results: The most frequent omissions were not asking about empty bladder (99% of the cases) and not asking whether the patient received sympathomimetic medications in 96%. Only 4% presented an acceptable technique with more than eight of the 12 steps. There was no identified difference in the quality of the technique according to the position between doctors or nurses (p = 0.113). We observed a significant difference in diastolic pressure between the acceptable technique group and the inadequate technique group (p = 0.020) and between regular and inadequate (p = 0.041). Conclusion: Health professionals do not follow the right procedure when measuring blood pressure inside the hospital. Given a better technique, the variation in diastolic is smaller.

REFERENCES

1. Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 Informe Final de Resultados. [Internet]. Gob.mx. 2019 [Citado 18 Mayo 2019]. Disponible en: https://www.gob.mx/cms/uploads/attachment/file/209093/ENSANUT.pdf.

2. García M, Samblás D, Estéves P, Hernández G, Márquez Correa. El paradigma de la tensión arterial medida por los profesionales de enfermería. Enferm Cardiol. 2006; 12 (39): 13-15.

3. Manzoli L, Simonetti V, D’Errico M, De Vito C, Flacco M, Forni C et al. (In)accuracy of blood pressure measurement in 14 Italian hospitals. Am J Hypertens. 2012; 30 (10): 1955-1960.

4. Graves JW, Sheps SG. Does evidence based medicine suggest that physicians should not be measuring blood pressure in the hypertensive patients? Am J Hypertens. 2004; 17: 354e360.

5. McAlister F. Evidence based treatment of hypertension: measurement of blood pressure: an evidence based review. Br Med J. 2001; 322 (7291): 908-911.

6. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018; 71: e127-e248.

7. Williams B, Mancia G, Spiering W, Agabiti RE, Azizi M, Burnier M et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39 (33): 3021-3104.

8. Mlawanda G, Pather M, Govender S. An analysis of blood pressure measurement in a primary care hospital in Swaziland. Afr J Prim Health Care Fam Med. 2014; 6 (1): 590.

9. Dokoohaki R, Raeiskarimian F, Rahgosha A, Sharifi M. The frequency of errors of blood pressure measurement among nurses in the hospital affiliated to Shiraz University of Medical Sciences. Int Cardiovasc Res J. 2015; 9 (1): 41-45.

10. Campbell N, McKay D. Accurate blood pressure measurement: why does it matter? CMAJ. 1999; (3): 277-278.

11. Guss D, Abdelnur D, Hemingway T. The impact of arm position on the measurement of orthostatic blood pressure. J Emerg Med. 2008; 34 (4): 377-382.

12. Villegas I, Arias IC, Botero A, Escobar A. Evaluation of the technique used by health-care workers for taking blood pressure. Hypertension. 1995; 26: 1204-1206.

13. Mohan B, Aslam N, Ralhan U, Sharma S, Gupta N, Singh V et al. Office blood pressure measurement practices among community health providers (medical and paramedical) in northern district of India. Indian Heart J. 2014; 66 (4): 401-407.

14. McKay DW, Campbell NRC, Parab LS, Chockalingam A, Fodor JG. Clinical assessment of blood pressure. J Hum Hypertens. 1990; 4: 639­645.

15. Jones D, Appel L, Sheps S, Roccella E, Lenfant C. Measuring blood pressure accurately. JAMA. 2003; 289 (8): 1027-1031.

16. Ojo O, Sogunle P, Malomo S, Adeyemo A. Knowledge of blood pressure measurement among tertiary hospital staff in south west Nigeria and its related sociodemographic determinants. J Family Med Community Health. 2018; 5 (3): 1153-1167.

17. Kantola I, Vesalainen R, Kangassalo K, Kariluoto A. Bell or diaphragm in the measurement of blood pressure? Am J Hypertens. 2005; 23 (3): 499-503.

18. Ogedegbe G, Pickering T. Principles and techniques of blood pressure measurement. Cardiology Clin. 2010; 28 (4): 571-586.

19. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 complete report. Hypertension. 2003; 42: 1206e1252.

20. Clarck C, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet. 2012; 379: 905-914.

21. Mitka M. Many physician practices fall short on accurate blood pressure measurement. JAMA. 2008; 299 (24): 2842-2849.

22. Joffres MR, Hamet P, Rabkin SW, Gelskey D, Hogan K, Fodor G. Prevalence, control and awareness of high blood pressure among Canadian adults. CMAJ•JAMC. 1992; 146 (11): 1997-2005.

23. Ray G, Nawarskas J, Anderson J. Blood pressure monitoring technique impacts hypertension treatment. J Gen Intern Med. 2011; 27 (6): 623-629.

24. González-López J, Ramírez J, García R, Esteban S, del Barrio J, Rodríguez-Artalejo F. Knowledge of correct blood pressure measurement procedures among medical and nursing students. Rev Esp Cardiol. 2009; 62 (5): 568-571.