Adherence to blood pressure measurement guidelines in long‐term care facilities: A cross sectional study

Abstract

ObjectiveTo assess the extent to which long‐term care facilities in Japan adhere to blood pressure (BP) measurement guidelines.DesignCross‐sectional, observational survey.SettingJapan (nationwide).ParticipantsGeriatric health service facilities that responded to a questionnaire among 701 facilities that provide short‐time daycare rehabilitation services in Japan.MethodsA written questionnaire that asked about types of measurement devices, number of measurements used to obtain an average BP, resting time prior to measurement, and measurement methods when patients’ arms were covered with thin (eg, a light shirt) or thick sleeves (eg, a sweater) was administered.Main outcome measureProportion of geriatric health service facilities adherent to BP measurement guidelines.ResultsThe response rate was 63.2% (443/701). Appropriate upper‐arm BP measurement devices were used at 302 facilities (68.2%). The number of measurements was appropriate at 7 facilities (1.6%). Pre‐measurement resting time was appropriate (≥5 minutes) at 205 facilities (46.3%). Of the 302 facilities that used appropriate BP measurement devices, 4 (1.3%) measured BP on a bare arm if it was covered with a thin sleeve, while 266 (88.1%) measured BP over a thin sleeve. When arms were covered with thick sleeves, BP was measured on a bare arm at 127 facilities (42.1%) and over a sleeve at 78 facilities (25.8%).Conclusions BP measurement guidelines were not necessarily followed by long‐term care service facilities in Japan. Modification of guidelines regarding removing thick sweaters and assessing BP on a visit‐to‐visit basis might be needed.

Comparison of routine office blood pressure measurement versus standardized attended manually activated oscillometric office blood pressure measurement in patients with chronic kidney disease

“…In a study by Sachiko Ozone et al . [ 22 ] in long-term care facilities in Japan, appropriate upper arm BP measurement devices were used at 68.2% of the facilities while the number of measurements was appropriate in only 1.6% of the facilities. Edgardo Sandoya Olivera did a cross-sectional study to determine the quality of blood pressure measurements performed during routine care in community health centers.…”

Effects of Different Rest Period Durations Prior to Blood Pressure Measurement: The Best Rest Trial

“…For decades, national and international hypertension guidelines have recommended that patients rest for 3 to 5 minutes before initiation of BP measurements, citing this step as one of the “key steps for proper blood pressure measurement.” 3 This rest period is challenging to implement, particularly in resource-constrained settings, and is often not adhered to in clinical practice, even in economically developed countries. 4–6…”

“…3 This rest period is challenging to implement, particularly in resource-constrained settings, and is often not adhered to in clinical practice, even in economically developed countries. [4][5][6] The effect of resting for less than the recommended 3 to 5 minutes on BP among patients with both normal and elevated BP has not been reported yet would be informative in assessing the risk of misclassifying a diagnosis of hypertension. Our principal objective was to determine the effect of no rest (0 minutes) or a shortened rest (2 minutes) period on BP when compared to BP values measured after 5 minutes of rest.…”