Improving ambulatory blood pressure monitoring knowledge in nurses and doctors: impact of a training intervention

Pibernat, Artur Dalfó; Baqué, Antoni Dalfó; Rodríguez, Francisco Javier Pelegrina; Garín, Olatz; Duran, Xavier; Cladellas, Mercè; Colet, Josep Comín

doi:10.1177/1474515118782100

Cited by 9 publications

(4 citation statements)

References 31 publications

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“…6 Similar to HBPM, physician/PA/ APRNs in our study lacked knowledge of guideline-recommended ABPM diagnostic BP thresholds (ABPM daytime average ≥135 mmHg systolic or ≥85 mmHg diastolic). Daflo-Pibernat et al, in a study conducted in Spain, 25 diagnosing hypertension and initiating treatment were ≥140 mmHg systolic or ≥90 mmHg diastolic for all adult patients. 26 From 2013 to 2017, the guidelines changed, incorporating a threshold of ≥150 mmHg systolic for adults aged 60 and over.…”

Section: Discussionmentioning

confidence: 97%

Blood Pressure Checks for Diagnosing Hypertension: Health Professionals' Knowledge, Beliefs, and Practices

Green¹,

Anderson²,

Ehrlich³

et al. 2022

J Am Board Fam Med

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Introduction:The US Preventive Services Task Force recommends out-of-office blood pressure (BP) measurement before making a new hypertension diagnosis and initiating treatment, using 24-hour ambulatory (ABPM) or home BP monitoring. However, this approach is not common.Methods: e-mail-linked surveys were sent to primary care team members (n = 421) from 10 clinics. The sample included medical assistants, licensed practical nurses, registered nurses, and advanced practice registered nurses (LPN/RN/APRNs), physician assistants (PAs), and physicians. Those licensed to diagnosis hypertension (physician/PA/APRNs) received additional questions. Data were collected from November 2017 to July 2019.Results: 2-thirds of invitees responded (163 MA/LPN/RNs, 86 physicians, and 33 PA/APRNs). When making a new hypertension diagnosis, most respondents believed that BP measured manually with a stethoscope (78.6%) or ABPM (84.2%) were very or highly accurate. In contrast, most did not believe that automated clinic BPs, home BP, or kiosk BP measurements were very or highly accurate. Almost all reported always or almost always relying on clinic BP measurements in making a diagnosis (95.7%), but most physician/PA/APRNs (60.5%) would prefer ABPM if it was readily available. Very few physician/PA/APRNs used the guideline-concordant diagnostic threshold (135/85 mmHg) with home monitoring (14.0%) or ABPM (8.4%), with 140/ 90 mmHg the most commonly reported threshold for home (59.4%) and ABPM (49.6%).Discussion: Our study found health care professional knowledge, beliefs, and practices gaps in diagnosing hypertension. These gaps could lead to clinical care that is not aligned with guidelines.Conclusion: System changes and interventions to increase use of evidence-based practices could improve hypertension diagnosis and outcomes.

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Section: Discussionmentioning

confidence: 97%

Blood Pressure Checks for Diagnosing Hypertension: Health Professionals' Knowledge, Beliefs, and Practices

Green¹,

Anderson²,

Ehrlich³

et al. 2022

J Am Board Fam Med

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show abstract

“…Thus, when selecting nurses specifically dedicated to the follow-up of these patients and based on the results obtained, it would make sense to consider the case managers and nurses who had the doctorate and in all cases, and this is especially important in PC, the realisation of a specific training in HF, with those practical tools that have proven their effectiveness (28).…”

Section: Discussionmentioning

confidence: 99%

Nursing knowledge of the principles of self‐care of heart failure in primary care: a multicentre study

Pibernat

Duran

Garín

et al. 2019

Scandinavian Caring Sciences

Self Cite

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Introduction Nurses play an important part in the education of patients with HF. To prepare patients with HF for self‐care maintenance behaviours, nurses must have knowledge of basic self‐care maintenance principles. Aim study The aim of this study was to determine the degree of knowledge of primary care (PC) nurses on the principles of self‐management of HF and variables associated with this. Methodology This is an observational, cross‐sectional descriptive study, carried out in 2014, in the city of Barcelona (Catalonia). Nurses’ Knowledge of Heart Failure Education Principles questionnaire (NKHFEP) was used to assess the principles of HF self‐care education. Instrument items assess knowledge of nurses on 5 themes: diet, liquids/weight, worsening signs or symptoms, medication and exercise. Factors related to adequate knowledge were evaluated. Results Of 216 PC nurses, who completed the questionnaire, the average score was 15.6 (SD: 2.2). Only 36 (16.7%) obtained an adequate level of knowledge and defined as a score ≥ 18 points. In multivariate logistic regression, nurse factors associated with an adequate knowledge of principles of self‐care of HF were having achieved a PhD degree (OR: 36.4, 95% CI: 2.8–468.2, p = 0.006) and previous specific training in HF (OR: 19.8, 95% CI: 1.4–279.3, p = 0.026). Conclusions The degree of knowledge of PC nurses in the principles of self‐care in HF was higher among nurses who had completed the doctorate and in nurses who had received specific training in HF.

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“…In this case, we must not forget aspects such as an adequate measurement of BP and in this case, we must not forget the use of cuffs of adequate size, so as not to over or underestimate the BP values, until we have ambulatory BP values, whether they are with home monitoring of blood pressure (HBPM) or ambulatory blood pressure monitoring (ABPM) validated (Oliveras Puig et al, 2015). In this second case, the ABPM, the necessary professional competence will increase from different training activities that have demonstrated their effectiveness (Dalfó-Pibernat et al, 2018). Finally, there is also comment on the recent study in which it was shown that there is no inferiority in the titration of HF drugs when HF nurses were compared with cardiologists.…”

Section: Nursing Reflections On the Management Of Hypertension And Hementioning

confidence: 99%

Nursing reflections on the management of hypertension and heart failure

Pibernat¹,

Claveria²,

Castiñeiras

et al. 2021

Int J of Nursing Knowl

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Improving ambulatory blood pressure monitoring knowledge in nurses and doctors: impact of a training intervention

Abstract: Knowledge of ABPM is deficient but can be easily improved by training that is most effective in primary care and among nurses.

Cited by 9 publications

References 31 publications

Blood Pressure Checks for Diagnosing Hypertension: Health Professionals' Knowledge, Beliefs, and Practices

Blood Pressure Checks for Diagnosing Hypertension: Health Professionals' Knowledge, Beliefs, and Practices

Nursing knowledge of the principles of self‐care of heart failure in primary care: a multicentre study

Nursing reflections on the management of hypertension and heart failure

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