Improving Office Blood Pressure Measurement Performance Through Formative Intervention In Primary Care

Abstract

Introduction: The diagnosis of hypertension presupposes the measurement of blood pressure, one of the most frequently performed and undervalued clinical gestures. As blood pressure is a variable hemodynamic phenomenon, there are several factors that can alter the values obtained, so there should be an effort to standardize its measurement by healthcare professionals. In fact, the use of imprecise pressure values can have consequences for the patient, since the values used for diagnosis may correspond to an incorrect classification of hypertension.
Material and methods: Motivated by a previous qualitative analysis of the blood pressure records (5704 users) at the health unit, which indicated possible systematic errors, we evaluated the performance of professionals and implemented a training strategy. In the first phase, the performance of health professionals was assessed through the completion of a 16 parameter grid (n = 37). In a second phase, after the educational intervention, performance was reassessed using the same grid at two different moments (n= 36 and 88, respectively). Finally, blood pressure records from the three years following the educational intervention were also collected and qualitatively analyzed (n = 5535).
Results: The results presented suggest a statistically significant improvement in the professionals’ performance at the first assessment point after the training. In the second evaluation, the data indicate a slight decline in performance, but with no statistically significant difference. On the other hand, comparing 2 moments of the unit’s historical records over a 3-year period a qualitative improvement in the records is appreciated.
Conclusions: The data obtained confirms the need to value the gesture of blood pressure measurement in order to avoid systematic errors, pointing to the relevance of continuous training and development of this basic competence.