The diagnosis and control of hypertension depend on accurate measurement of blood pressure (BP). The literature on the accuracy of BP recording by health professionals is, however, limited, and no study directly interviewed patients in the hospital setting. This multicenter cross-sectional study aimed at evaluating the compliance to current recommendations on BP measurement by health professionals directly from patients and to investigate potential predictors of higher quality in BP recording.
A trained nurse interviewed a random sample of adult patients hospitalized for an ordinary admission (except in the emergency room) lasting more than one night, without mental disorder, who had their BP routinely measured by the hospital personnel less than 3 h before. The questionnaire contained 15 items on the main procedures that are common to current guidelines.
Fourteen public hospitals from seven regions of Italy participated, and 1334 questionnaires were collected. Nine of the recommended practices were followed in the majority (>70%) of BP recordings, whereas some others were infrequent or rare: in 98.6, 82.2 and 81.1% of the participants, respectively, the arm circumference was never recorded, BP was measured only once, and BP was never recorded in both arms. Overall, 10 or more recommended procedures were followed during 33.4% recordings. At multivariate analysis, physicians were less likely than nurses to provide a more accurate BP measurement.
The operator's compliance to some recommendations in BP measurement is unacceptably low. This survey provides detailed indications for medical directors on the procedures and settings to prioritize in educational programs, which are definitely needed.
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aDepartment of Medicine and Aging Sciences, University of Chieti, Chieti
bDepartment of Biomedical Sciences and Public Health, University of the Marche Region, Ancona
cDepartment of Experimental Medicine, Sapienza University of Rome, Rome
dDepartment of Muskuloscheletal Oncology, Rizzoli Institute, Bologna
eDepartment of Hygiene, Catholic University of the Sacred Heart, Rome
fEleonora Lorillard Spencer Cenci Foundation, Rome
gDepartment of Studies of Institutions and Territorial Systems, University Parthenope, Naples
hDepartment of Public Health University of Siena
iDepartment of Clinical and Experimental Medicine, Section of Public Health, Faculty of Medicine, University of Eastern Piedmont Amedeo Avogadro, Novara
jDepartment of Internal Medicine, Aging and Nephrologic Diseases, University of Bologna
kDepartment of Public Health, University of Turin, Italy
Correspondence to Carmine Pizzi, FESC, Dipartimento di Medicina Interna, dell’Invecchiamento, Malattie Nefrologiche (Padiglione 11), Università di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy. Tel: +39 051 6364911; fax: +39 051 392486; e-mail: firstname.lastname@example.org
Abbreviation: BP, Blood pressure; OR, odds ratio
Received 13 April, 2012
Revised 22 June, 2012
Accepted 27 June, 2012
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