An audit of 67 adult outpatients revealed overall non-compliance with NICE blood pressure measurement guidance, with 0% having their pulse checked or BP measured in both arms.
Cross-Sectional (n=67)
No
There is significant non-compliance with NICE in-office blood pressure measurement guidance, highlighting the need for better staff education and training to prevent mismanagement.
Objective: Hypertension is a leading cause of morbidity and mortality across the world with over one billion people affected by this condition. Accurate measurement and documentation of blood pressure (BP) in the outpatient department is paramount for diagnosis and follow up of patients with hypertension. Faulty technique can result in inaccurate BP reading leading to unnecessary referrals for work up, adding to patient anxiety as well as burden on health systems. The National Institute for Health and Care Excellence (NICE) has set out guidance for accurate measurement of BP in outpatient clinics. The aim of our study was to assess adherence to NICE guidance for BP measurement in Outpatient clinics at our hospital. Design and method: It was a single center prospective study, where we collected data on a prespecified proforma designed in accordance with NICE guidance for measurement of blood pressure in Outpatient clinics. Results: We collected data for 67 adult patients over a period of two weeks. BP was mainly checked by clinic nurses (60%) and health care assistants (39%). All patients had their BP checked by an automated machine. The environment was suitable in 91% and an appropriately sized blood pressure cuff was used in 75% of the patients. None of the patients had their pulse checked to see if it was irregular with subsequent manual BP checks. Furthermore, none of the patients had BP measured in both arms and only 10% of those who had an initial blood pressure of >140/90 had a repeat measurement done. The documentation of BP reading was accurate in all patients who were studied. Conclusions: These results show that although a suitable environment and equipment was available for blood pressure measurement, overall, there is non-compliance with NICE in-office blood pressure measurement guidance. These inaccuracies may lead to mismanagement of patients, mainly resulting in over-investigation and prescription. These findings emphasize the need for better education and training of the staff on blood pressure measurement, especially those working in outpatient clinics.
Khan et al. (Fri,) conducted a cross-sectional in Hypertension (n=67). Blood pressure measurement practices was evaluated on Adherence to NICE guidance for BP measurement. An audit of 67 adult outpatients revealed overall non-compliance with NICE blood pressure measurement guidance, with 0% having their pulse checked or BP measured in both arms.