A new abstact just sent to the AHA FYI

[Guest guest]

We have documented poor knowledge and practice of blood pressure (BP) measurement and its improvement after update training in undergraduate and graduate medical and nursing professionals, who have previously been taught by others to take BP. The reasons for the poor pre-update knowledge and performance seemed to be a failure to master and/or practice the basic skills needed to gat an accurate BP when originally trained. We have developed and tested the BP-Shared Care Observer Research/Education program (BP-SCORE) for quality improvement in BP observers.

We trained and then tested 276 experienced medical professionals from research clinics being updated in BP skills to standardize BP across sites. We used the new AHA guidelines as our standard for evaluation of training and practice yet only 8% had ever read them and 66% stated they had never heard of them. Only 40% had ever been tested with a double stethoscope. Pre-test written knowledge score was 49% in the first time participants, but 73% in those who had previously been updated (p=<.05). Both improved after the new update with an average post written score of 90%. Thus even prior BP-SCORE trained participants benefited from the update. The following items were “new†to the participants who had not been previously updated: Errors associated with an auscultatory gap (60%), the error when BP is measured on an exam table (39%), Korotkoff sounds (25%), and 25% used K4 as the diastolic BP. On video-testing 53% passed on the 1st try and 35% on the 2nd. The most common error was of 8,10,or 12 mm Hg suggesting a lack of concentration on video-testing.

We conclude that all who take BP for research studies need to have a standardized update to improve the likelihood that BP will be measured to the AHA guidelines. We recommend that the AHA take a greater role in insuring that all training programs use and train to AHA guidelines.

May your pressure be low!

C.E. Grim, B.S., M.S., M.D.

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.