Table 5 Pre-Post Differences in Patient Preparation and Blood Pressure Screening (Patient Direct Observation)
Screening Standards | Pts screened by Triage Nurse | Patients Screened by AMO/MO | Patients screened by ACO/CO | |||
|---|---|---|---|---|---|---|
Patient preparation prior to BP screening (automated/manual BP device) | Pre (n=70) | Post (n=67) | Pre (n=48) | Post (n=103) | Pre (n=88) | Post (n=21) |
n(%) | n(%) | n(%) | n(%) | n(%) | n(%) | |
Pt informed BP is being measured | 68(97.1) | 62(92.5) | 19(39.6) | 103(100)** | 55(62.5) | 20(95.2)** |
Pt rested 2-5m before measurement | 62(88.6) | 60(89.6) | 20(41.7) | 92(89.3)*** | 61(69.3) | 20(95.2)* |
Pt back supported | 42(60.0) | 53(79.1)* | 9(18.7) | 69(67.0)*** | 31(35.2) | 20(95.2)*** |
Pt feet supported | 61(87.1) | 66(98.5)* | 19(39.6) | 85(82.8)*** | 56(63.6) | 19(90.5)* |
Pt feet and legs uncrossed | 61(87.1) | 66(98.5)* | 21(43.7) | 85(82.5)*** | 53(60.2) | 20(95.2)** |
Cuff on bare arm | 64(91.4) | 67(100)* | 20(41.7) | 89(86.4)*** | 58(65.9) | 20(95.2)** |
Middle of cuff at brachial artery | 59(84.3) | 65(97.0)* | 20(41.7) | 88(85.4)*** | 54(61.4) | 20(95.2)** |
Cuff at mid heart level | 55(78.6) | 59(88.1) | 20(61.7) | 90(87.4)*** | 56(63.6) | 19(90.5)* |
Pt arm rested on flat surface | 41(58.6) | 57(85.1)** | 19(39.6) | 87(84.5)*** | 53(60.2) | 20(95.2)** |
Pt did not speak, text, use cellphone | 40(57.1) | 59(88.1)*** | 21(43.7) | 84(81.5)*** | 54(61.4) | 18(85.7)* |
Screening Quality Index mean(+/-SD) | 3±3.5 | 8.4± 1.0*** | 3.5± 4.1 | 7.6±2.4*** | 5.4± 3.8 | 8.4± 2.0*** |
BP Measurement (Automatic device) | N=60 | N=67 | N=12 | N=53 | N=37 | N=19 |
30 second rest period between measurements (if >1 reading) | 5(8.3) | 45(67.2)*** | 1(8.3) | 53(100)*** | 21(56.8) | 19(100)** |
Document confirmatory measurement (average of 3 measurements) | 3(5.0) | 36(53.7)*** | 1(8.3) | 41(77.4)*** | 22(59.5) | 14(73.7)*** |
BP Measurement (Manual device) | N=10 | N=0 | N=36 | N=50 | N=51 | N=2 |
Tightly closed BP cuff valve stem | 9(90.0) | N/A | 10(27.8) | 48(96.0)*** | 26(51.0) | 1(50.0) |
Correct placement of steth earpieces | 3(300) | N/A | 10(27.8) | 48(96.0)*** | 25(49.0) | 1(50.0) |
30 second rest period between measurements (if >1 reading) | 5(50.0) | N/A | 1(2.8) | 27(54.0)*** | 0(0.0)_ | 1(50.0) |
Documented confirmatory measurement (average of 3 measurements) | N/A | N/A | 2(5.6) | 42(84.0) | 0(0.0) | 1(50.0) |
Record of BP Readings, Height, Weight | N=70 | N=67 | N=48 | N=103 | N=88 | N=21 |
Medical record designated place for BP reading | 20(28.6) | 34(51.5)** | 22(45.8) | 47(45.6) | 36(40.9) | 10(47.6) |
Pts with 1 SBP/DBP reading | 70(100) | 67(100) | 20(41.7) | 103(100)*** | 60(69.2) | 20(95.2)* |
Pts with 2 SBP/DBP reading | 0(0.0) | 20(29.9)*** | 2(4.2) | 99(96.1)*** | 17(19.3) | 20(95.2)*** |
Pts with 3 SBP/DBP readings | 0(0.0) | 1(1.5) | 0(0.0) | 85(82.5)*** | 2(2.3) | 20(95.2)*** |
Pt weight measured | 50(71.4) | 45(67.2) | 0(0.0) | 53(51.5)*** | 7(7.9) | 9(42.9)*** |
Pt height measured | 10(14.3) | 13(19.4) | 0(0.0) | 32(31.1)*** | 4(4.5) | 9(42.9)*** |