A survey conducted by the American Heart Association and AMA found that physician assistants, primary care physicians, nurses and medical assistants do not typically undergo refresher training on BP measurement, although there is a broad interest to participate in training modules.
“Good blood pressure control is foundational for preventing heart disease and strokes,” Robert Harrington, MD, president of the AHA and interventional cardiologist, the Arthur L. Bloomfield Professor of Medicine and chairman of the department of medicine at Stanford University, said in a press release. “An accurate blood pressure measurement is important to help clinicians gauge treatment decisions and for patients to have confidence in their efforts to manage their health. That’s why both the AMA and AHA strongly support refresher training for health care professionals as a critical component to providing the highest quality of care and patient safety.”
Both associations conducted a survey of more than 2,000 health care professionals, which included PCPs, nurses, physician assistants, pharmacists and certified medical assistants. Interviews were conducted by phone and the internet to learn more about BP measurement practices.
Nurses and medical assistants are primarily responsible for measuring BP, although most health care professionals do measure it sometimes. Compared with other health care professionals, the most confidence in BP measurement skills are seen in nurses and medical assistants, although the confidence does not match actual skills. One in 10 medical assistants currently answered all six questions related to best practices in BP measurements. Approximately 13% of nurses answered all six questions correctly. The question that was most difficult to recall was on proper cuff-wrap inflation, followed by proper brachial artery cuff position, according to the survey.
Health care professionals said they believed that 25% to 41% of BP measurements are not 100% accurate. Despite this inaccuracy, most health care professionals said they feel that their practice is better than others with regard to producing fewer inaccurate BP readings, according to the survey.
Even in the presence of BP measurement inaccuracies, refreshing training on BP measurement techniques does not seem to be a priority among health care professionals, as training is often not required or infrequently performed. One-third of nurses, one-quarter of medical assistants and nearly half of physician assistants and primary care providers have never received refresher training after their initial medical training. Medical assistants were most likely to receive refresher training, as about half reported receiving it within the past 3 years.
Although refresher training is not a priority, health care professionals broadly support the requirement of BP refresher training for all primary clinicians. An interest in a BP training module was seen in most health care professionals, although physician assistants and PCPs were least likely to participate in this training.
Patrice A. Harris
“Hypertension is a leading risk factor for heart attacks, strokes and preventable death in the U.S.,” Patrice A. Harris, MD, MA, president of the AMA, said in the release. “Inaccurate blood pressure readings can lead to diagnosis errors, which means getting an accurate reading is vital to treating the condition. To support physicians and care teams, we will continue working with health care organizations on implementing quality improvement efforts that enhance the standard of care and safety for the patients they serve.” – by Darlene Dobkowski
AMA. Blood Pressure Measurement Training Research Report.
Disclosures: Harrington is president of the AHA. Harris is president of the AMA.