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Jones TN, Wilson P, Hoy E, Pherwani S, Meng J, Jethwa N. 1151 IMPROVING THE MEASUREMENT OF POSTURAL BLOOD PRESSURE WITH AD-HOC MOBILE TEACHING SESSIONS FOR NURSES AND HEALTHCARE ASSISTANTS. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract
Introduction
Falls are a major cause of morbidity and mortality in patients over 65. Unrecognised postural hypotension is a significant and treatable contributor. Training nurses and health-care assistants (HCAs) in correct measurement technique can be challenging, as these groups are rarely able to fully attend single sessions due to urgent clinical commitments, night duties and staff-shortages. We aimed to improve the frequency and quality of lying-standing blood pressure (LSBP) measurement in a Geriatric inpatient cohort.
Methods
Three PDSA cycles were performed over a 10-month period on a single Care of the Elderly ward, including an initial audit in March 2021. The outcome measures were:
1. the percentage of non-bedbound patients having LSBP correctly measured (5-min recumbent, 1 and 3-min standing readings), assessed by chart review and
2. the understanding and confidence of measurers in correct technique, as assessed by a questionnaire.
The intervention was developed into three separate days of ad-hoc mobile teaching sessions to allow reinforcement of knowledge. Trainers moved from bay-to-bay delivering a 5-minute pre-prepared presentation/demonstration on the indications and correct technique of LSBP measurement. This was repeated throughout each day until all measurers had participated.
Results
On initial assessment, only 21% (6/28) of non-bedbound patients had LSBP correctly measured. This improved to 44% (8/18) by July and 62% (8/13) by December 2021. When sampled, measurers had sustained improvements from July (n=8) to December (n=7), in terms of self-rated confidence (mean 4.4/5 vs 4.9/5), correct technique (25% vs 100%), interpretation of results (25% vs 43%) and knowledge of contraindications to measurement (88% vs 100%).
Conclusions
We describe a strategy using ad-hoc mobile teaching sessions to train nurses and HCAs to measure LSBP in a Geriatric inpatient cohort, which resulted in sustained improvements. We believe this technique is readily applicable to other units and areas of practice.
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Affiliation(s)
- T N Jones
- London North West University Healthcare NHS Trust Department of Medicine for Older People, Northwick Park Hospital, , Watford Rd, Harrow HA1 3UJ, London
| | - P Wilson
- London North West University Healthcare NHS Trust Department of Medicine for Older People, Northwick Park Hospital, , Watford Rd, Harrow HA1 3UJ, London
| | - E Hoy
- London North West University Healthcare NHS Trust Department of Medicine for Older People, Northwick Park Hospital, , Watford Rd, Harrow HA1 3UJ, London
| | - S Pherwani
- London North West University Healthcare NHS Trust Department of Medicine for Older People, Northwick Park Hospital, , Watford Rd, Harrow HA1 3UJ, London
| | - J Meng
- London North West University Healthcare NHS Trust Department of Medicine for Older People, Northwick Park Hospital, , Watford Rd, Harrow HA1 3UJ, London
| | - N Jethwa
- London North West University Healthcare NHS Trust Department of Medicine for Older People, Northwick Park Hospital, , Watford Rd, Harrow HA1 3UJ, London
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