Education of Blood Pressure Measurement: A Quality Improvement Project

Abstract

Purpose: This project’s purpose was to increase medical assistants’ (MAs’) knowledge and understanding of the recommended best practices for blood pressure (BP) measurement. Background: Nearly half the population in the United States (US) has been diagnosed with hypertension, leading to a variety of complications including diabetes complications, cerebrovascular disease, ischemic heart disease, kidney disease, etc. Only 39.64% of patients diagnosed with hypertension have controlled hypertension. To complicate this issue, often inaccurate BP measurements are obtained leading to inappropriate medication prescribing and errors with staging and treating hypertension. Methods: MA participants from TMC One Wyatt in Tucson, Arizona were invited to a presentation on best practices for BP measurement. Prior to the presentation, participants completed a pre-intervention survey with questions about best practices for BP measurement technique. Then the presentation was given covering best practices for BP measurement and the importance of adhering to the recommendations. Participants then took a post-intervention survey to assess learning. Results: Nine MAs participated in the project. In the pre-intervention survey, participant scores ranged from 40% to 80% with a median score of 60% and an average score of 57.78%. In the post-presentation survey, participant scores ranged from 60% to 93.33% with a median score of 93.33% and an average score of 87.41%. The overall increase in average scores was 35.56%. Participants demonstrated strong prior knowledge of certain aspects of BP measurement such as positioning of the legs and feet and the effects of using the wrong cuff size. There were also aspects of BP measurement participants exhibited increased knowledge after the presentation such as factors affecting BP measurement or determining the correct cuff size. In addition, some topics showed little to no improvement of knowledge such as the effects of talking during the five-minute rest period or the wait time in between taking multiple BP measurements. Conclusions: Based on the overall increase of knowledge, this project supports providing periodic refresher trainings on BP measurement to improve and maintain knowledge and understanding of best practices.