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(Hypertension. 1995;26:1204-1206.)
© 1995 American Heart Association, Inc.

Articles

Evaluation of the Technique Used by Health-Care Workers for Taking Blood Pressure

Iván Villegas; Isabel C. Arias; Adriana Botero; Alejandro Escobar

From the Renal Unit, Clínica León XIII, Instituto de Seguros Sociales (I.V.), and Instituto de Ciencias de La Salud, CES, Medellín, Colombia.

Correspondence to Iván Villegas, MD, Unidad Renal, Clínica León XIII, ISS. Medellín, Colombia.

Abstract The precise guidelines recommended by the American Heart Association for blood pressure measurement are commonly overlooked by health-care workers, who generally take blood pressure in an arbitrary way. To validate this observation we designed a descriptive and observational study to be carried out in a major hospital. One hundred and seventy-two health-care workers divided into four groups (63 general practitioners, 25 clinical and 25 surgical specialists, and 59 nurses) were evaluated in a two-part test. In the first part (practical), the examinee had to follow all the steps recommended by the American Heart Association to get a passing score. In the second part (theoretical, which came second to avoid influencing the practical), the examinee had to answer correctly 7 of 10 questions based on the American Heart Association's guidelines to obtain a passing score. The highest accepted variation in systolic and diastolic pressures between examinee and observer was ±4 mm Hg. None of the examinees followed the American Heart Association's recommendations. Sixty-three percent of systolic and 53% of diastolic readings were out of range. Surgical specialists obtained the best practical results (48% systolic and 64% diastolic within range), and nurses obtained the lowest values (29% and 39%, respectively; P=.03 versus surgical specialists). These two groups showed deficiencies in the theoretical test (nurses, 10% correct answers and surgical specialists, 16%). Clinical specialists obtained the best results on the theoretical test (60% correct; P<.05 versus the other groups) but were deficient in the practical test (32% systolic and 60% diastolic within range). In conclusion, on practical and theoretical bases health-care workers took blood pressure inaccurately and incorrectly.

Key Words: blood pressure • data collection • blood pressure determination

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