 Out of 11 steps to follow during a blood pressure check, medical students correctly completed about 4 of those steps in a simulated patient encounter....but I'm sure other health care professionals would miss some steps too!  Kenny When I was a pharmacy student, the pharmacy I was working at hosted heart health clinic. We would discuss various factors of heart health like blood pressure, cholesterol, diabetes, etc. I would also check people's blood pressure. Looking at the list of 11 steps to follow, I'm certain their blood pressure value was not as accurate as it could have been. I remember breaking the sacred rule "NO talking while checking the blood pressure". The full 11 step list is as follows: (1) resting the patient for 5 minutes prior to the measurement or expressing intent to do so (2) legs uncrossed (3) feet on floor (4) arm supported (5) correct cuff size (6) cuff placed over bare arm (7) no talking (8) no mobile phone use or reading (9) BP measurement taken in both arms (10) correctly identifying BP from the arm with the higher reading as being clinically more important when asked (11) correctly identifying which arm to use for future readings (the arm with higher BP) What's the risk of an incorrect method? Studies show that crossing the legs, for example, raises systolic pressure by 3 to 8 mm Hg and incorrect arm placement raises both systolic and diastolic pressure by 10 mm Hg or more. Are automated BP devices the solution to human error? Possibly. It can reduce observer error, reduce skills re-training costs, increase the number of readings and may reduce white coat hypertension. Publicly available machines (e.g. the ones in pharmacies) are particularly prone to error, due to a combination of human error (the user does not follow all 11 steps) and potentially incorrect cuff size. Sources:
Med students perform poorly on proper blood pressure measurement http://www.canadianhealthcarenetwork.ca/pharmacists/clinical/health-index-therapeutics/cardiology/med-students-perform-poorly-on-proper-blood-pressure-measurement-40479?utm_source=EmailMarketing&utm_medium=email&utm_campaign=Pharmacy_Newsletter Medical Students Fall Short on Blood Pressure Check Challenge http://jamanetwork.com/journals/jama/fullarticle/2653029?amp;utm_source=JAMAPublishAheadofPrint&utm_campaign=30-08-2017 Recommendations for Blood Pressure Measurement in Humans and Experimental Animals http://hyper.ahajournals.org/content/45/1/142 Medical students and measuring blood pressure: Results from the American Medical Association Blood Pressure Check Challenge http://onlinelibrary.wiley.com/doi/10.1111/jch.13018/full |
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