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Analysing the technique of blood pressure measurement in primary care: a single pilot study
Background: Accurate blood pressure (BP) measurement is essential for the diagnosis and management of hypertension. However, BP measurement technique is often suboptimal in primary healthcare facilities, potentially leading to misdiagnosis and inappropriate management. Objective: To assess the quali...
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| Format: | Thesis |
| Language: | Eng |
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Department of Public Health and Family Medicine
2024
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| Summary: | Background: Accurate blood pressure (BP) measurement is essential for the diagnosis and management of hypertension. However, BP measurement technique is often suboptimal in primary healthcare facilities, potentially leading to misdiagnosis and inappropriate management. Objective: To assess the quality of BP measurement technique in a primary healthcare facility in the Western Cape, South Africa, and to identify factors that may affect the accuracy of BP recordings. Methods: A cross-sectional study was conducted using a questionnaire and clinical point of care audit to assess the knowledge, attitude, and skills of healthcare workers involved in BP measurement. Digital BP machines were also audited for calibration and cuff size appropriateness. BP measurements were observed for 102 patients to audit the technique of BP measurement and compared to measurements obtained by the research team using a pre- validated, standardised technique. Results: Knowledge of BP measurement was adequate (>60% on knowledge quiz) amongst 72% of doctors, and inadequate (<60% on knowledge quiz) amongst 81% of nurses. We found widespread use of improper BP cuff sizes and non-calibrated digital BP machines. The use of digital BP machines produced significantly higher systolic BP readings than manual readings (145 vs 141.1; p=0.031), with non-significant differences in diastolic and mean arterial pressures. Conclusion: This study successfully piloted a novel method of assessing BP measurement technique, and identified several factors that could influence measurement outcomes, potentially impacting on clinical care. Recommendations for further research and targeted staff training are suggested. |
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