May is High Blood Pressure Education Month, an opportune time to reevaluate blood pressure measurement processes and talk to patients about managing their high blood pressure. Measuring blood pressure may seem like a normal routine. During a busy day, seemingly minor issues can impact blood pressure measurement, artificially inflating a patient’s blood pressure by anywhere from two to 40 mmHg.
To ensure an accurate measure, make sure that:
1. The patient’s feet are flat on the floor, and legs are uncrossed.
2. The patient’s arm and back are properly supported.
3. The patient doesn’t need to use the restroom and can comfortably remain still.
4. The patient’s arm is bare, and the sphygmomanometer cuff is on skin, not over any clothing.
5. The patient is not speaking and has had at least three minutes of quiet time prior to the measurement.
Incorporating these standardized principles into practice workflows is a key element of the AMA’s Improving Health Outcomes initiative. A pilot program involving multiple clinical sites in two states is implementing principles of safe design into the ambulatory setting to improve outcomes around hypertension. Similar approaches, such as hospitals using checklists to reduce central-line infections, have seen successful results.
To apply safe design principles to blood pressure management, the AMA is collaborating with researchers at Johns Hopkins University and the pilot sites to develop and test a set of evidence-based recommendations, based on a simple framework called the M.A.P. for achieving optimal hypertension control:
- Measuring blood pressure accurately every time it’s measured
- Acting rapidly to address high blood pressure readings
- Partnering with patients to promote self-management of high blood pressure
From the American Medical Association, May 2014