Barriers to Accurate Blood Pressure Measurement in the Medical Office
Background: Despite the high prevalence of blood pressure (BP) measurement errors in the outpatient setting, little is known about why primary care clinics struggle to achieve consistently accurate BP measurements in routine practice. We investigated barriers affecting measurement of BP for adult pa...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2018-12-01
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| Series: | Journal of Primary Care & Community Health |
| Online Access: | https://doi.org/10.1177/2150132718816929 |
| _version_ | 1819152924411953152 |
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| author | Kevin O. Hwang Aitebureme Aigbe Hsiao-Hui Ju Victoria C. Jackson Emily W. Sedlock |
| author_facet | Kevin O. Hwang Aitebureme Aigbe Hsiao-Hui Ju Victoria C. Jackson Emily W. Sedlock |
| author_sort | Kevin O. Hwang |
| collection | DOAJ |
| description | Background: Despite the high prevalence of blood pressure (BP) measurement errors in the outpatient setting, little is known about why primary care clinics struggle to achieve consistently accurate BP measurements in routine practice. We investigated barriers affecting measurement of BP for adult patients in primary care. Methods: We conducted a qualitative evaluation in 6 adult primary care clinics. BP measurement was observed during 54 routine patient encounters. Six managers completed semistructured interviews and 18 clinical staff members participated in focus group discussions. We used an inductive, data-driven approach to identify and organize findings into cohesive, overarching themes describing factors affecting BP measurement. Results: Observed errors in BP measurement spanned the entire spectrum of steps required to obtain BP properly. Barriers to proper BP measurement were related to staff knowledge and behavior (inadequate knowledge, training, and feedback); workflow constraints (need to multitask, inadequate time); and equipment issues (BP monitors, seating). Patient characteristics and behavior also affected BP measurement. Conclusions: Correct measurement of BP is affected by a wide range of factors and is challenging to accomplish consistently in primary care. These findings may inform the design of performance improvement programs to maximize the quality of BP measurement in the outpatient setting. |
| first_indexed | 2024-12-22T14:57:01Z |
| format | Article |
| id | doaj.art-265fcacfd6924e658ada99f36513ab27 |
| institution | Directory Open Access Journal |
| issn | 2150-1327 |
| language | English |
| last_indexed | 2024-12-22T14:57:01Z |
| publishDate | 2018-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Primary Care & Community Health |
| spelling | doaj.art-265fcacfd6924e658ada99f36513ab272022-12-21T18:22:12ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272018-12-01910.1177/2150132718816929Barriers to Accurate Blood Pressure Measurement in the Medical OfficeKevin O. Hwang0Aitebureme Aigbe1Hsiao-Hui Ju2Victoria C. Jackson3Emily W. Sedlock4University of Texas at Houston–Memorial Hermann Center for Healthcare Quality and Safety, Houston, TX, USAUniversity of Texas at Houston–Memorial Hermann Center for Healthcare Quality and Safety, Houston, TX, USAUTHealth Cizik School of Nursing, Houston, TX, USAUTHealth McGovern Medical School, Houston, TX, USAUniversity of Texas at Houston–Memorial Hermann Center for Healthcare Quality and Safety, Houston, TX, USABackground: Despite the high prevalence of blood pressure (BP) measurement errors in the outpatient setting, little is known about why primary care clinics struggle to achieve consistently accurate BP measurements in routine practice. We investigated barriers affecting measurement of BP for adult patients in primary care. Methods: We conducted a qualitative evaluation in 6 adult primary care clinics. BP measurement was observed during 54 routine patient encounters. Six managers completed semistructured interviews and 18 clinical staff members participated in focus group discussions. We used an inductive, data-driven approach to identify and organize findings into cohesive, overarching themes describing factors affecting BP measurement. Results: Observed errors in BP measurement spanned the entire spectrum of steps required to obtain BP properly. Barriers to proper BP measurement were related to staff knowledge and behavior (inadequate knowledge, training, and feedback); workflow constraints (need to multitask, inadequate time); and equipment issues (BP monitors, seating). Patient characteristics and behavior also affected BP measurement. Conclusions: Correct measurement of BP is affected by a wide range of factors and is challenging to accomplish consistently in primary care. These findings may inform the design of performance improvement programs to maximize the quality of BP measurement in the outpatient setting.https://doi.org/10.1177/2150132718816929 |
| spellingShingle | Kevin O. Hwang Aitebureme Aigbe Hsiao-Hui Ju Victoria C. Jackson Emily W. Sedlock Barriers to Accurate Blood Pressure Measurement in the Medical Office Journal of Primary Care & Community Health |
| title | Barriers to Accurate Blood Pressure Measurement in the Medical Office |
| title_full | Barriers to Accurate Blood Pressure Measurement in the Medical Office |
| title_fullStr | Barriers to Accurate Blood Pressure Measurement in the Medical Office |
| title_full_unstemmed | Barriers to Accurate Blood Pressure Measurement in the Medical Office |
| title_short | Barriers to Accurate Blood Pressure Measurement in the Medical Office |
| title_sort | barriers to accurate blood pressure measurement in the medical office |
| url | https://doi.org/10.1177/2150132718816929 |
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