Correctly Capturing and Documenting a Second Blood Pressure in the Outpatient Setting

Abstract

Purpose. This quality improvement project aimed to increase adherence to repeat blood pressure(BP) in an outpatient clinic when the initial reading was equal to or greater than 140/90 mmHg. Background. Hypertension is among the most substantial risk factors for increased morbidityand mortality from heart disease or cerebrovascular disease in the United States (US) (CDC, 2023). Proper management of hypertension is vital to improving patient outcomes. Every 10 mmHg reduction in BP collectively reduces mortality risk by 13% for major cardiovascular diseases, such as coronary heart disease, stroke, and heart failure (Jensen et al., 2019). It is essential to accurately diagnose hypertension to prevent over or under-treatment, as both can cause patient harm (Butt et al., 2015). Methods. This QI project focused on educating the medical assistants in an outpatient cardiologyclinic to increase the documentation for second BP measurement when the initial reading was equal to or greater than 140/90 mmHg. Verbal education and handouts were provided to medical assistants (MAs) who room and vital patients. These staff members received pre and post- education surveys to gauge knowledge of the topic and retention of information provided. Data was collected two weeks after the intervention and compared to repeat BP documentation two weeks prior to the intervention. Results. Seventeen MAs completed the pre-survey. Twenty-two MAs attended the education andreceived handout materials. Twelve MAs completed the post-education survey. Missed repeat BP tasks were decreased by 39 incidences after the educational intervention, which equates to a 15.66% improvement. Common themes for barriers to missed repeat were identified as time, patient cooperation, staffing, and equipment availability. Conclusions. A short verbal education on the importance of repeat BP and handouts to promoteproper measurement and documentation improved medical assistant adherence to protocol.