EVALUATION OF THE TECHNIQUE USED BY HEALTH-CARE WORKERS FOR TAKING BLOOD-PRESSURE

The precise guidelines recommended by the American Heart Association f or blood pressure measurement are commonly overlooked by health-care w orkers, who generally take blood pressure in an arbitrary way. To vali date this observation we designed a descriptive and observational stud y to be carried out in a major hospital. One hundred and seventy-two h ealth-care workers divided into four groups (63 general practitioners, 25 clinical and 25 surgical specialists, and 59 nurses) were evaluate d 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 se cond to avoid influencing the practical), the examinee had to answer c orrectly 7 of 10 questions based on the American Heart Association's g uidelines 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 Associatio n's recommendations. Sixty-three percent of systolic and 53% of diasto lic readings were out of range. Surgical specialists obtained the best practical results (45% systolic and 64% diastolic within range), and nurses obtained the lowest values (29% and 39%, respectively; P=.03 ve rsus surgical specialists). These two groups showed deficiencies in th e theoretical test (nurses, 10% correct answers and surgical specialis ts, 16%). Clinical specialists obtained the best results on the theore tical test (60% correct; P<.05 versus the other groups) but were defic ient in the practical test (32% systolic and 60% diastolic within rang e). In conclusion, on practical and theoretical bases health-care work ers took blood pressure inaccurately and incorrectly.