Physician training in accurate blood pressure measurement is often limited to a brief demonstration during medical school without retraining in residency, fellowship or clinical practice to maintain skills. The same is true for other health care team members, including nurses and medical assistants, creating a major gap that must be addressed to achieve accurate BP measurement. While quality improvement in hypertension care is multifaceted, it depends upon accurate BP measurement.
To help address the gap in BP measurement, the AMA and American Heart Association (AHA) launched a new online module that provides an engaging and interactive opportunity to refresh skills. Powered by Target: BP, the online module, “Achieving Accuracy: BP Measurement,” creates a comprehensive and standardized training approach to help ensure every health professional within the U.S. is competently trained to measure BP consistently and accurately every time.
Recent market research conducted by the AMA and AHA examined the prevalence of BP measurement training among health professionals. The survey of more than 2,000 U.S. health professionals found that half of primary care doctors and physician assistants have never received BP refresher training.
Meanwhile, only about half of medical assistants had a refresher within the last three years. That is despite recommendations from the AHA that health professionals should receive periodic retraining on BP measurement. The survey also found health professionals believe that 25% to 41% of BP measurements taken across all medical practices are not perfectly accurate.
“Hypertension is a leading risk factor for heart attacks, strokes and preventable death in the U.S. Inaccurate blood pressure readings can lead to diagnosis errors, which means getting an accurate reading is vital to treating the condition,” said AMA President, Patrice A. Harris, MD, MA. “To support physicians and care teams, we will continue working with health care organizations on implementing quality improvement efforts that enhance the standard of care and safety for the patients they serve.”
BP refresher training is not only important for those who take blood pressure measurements every day, such as medical assistants, but for the entire care team, including doctors and physician assistants. Standardized training provides an opportunity to improve competence and confidence across the care team, which can reduce inaccuracies, save time spent retaking BP, and improve the team’s ability to provide patients with the highest quality care. In fact, about 60% of physicians surveyed believe that every medical professional should take BP refresher training.
Physicians and other health professionals can complete three parts of the module to help improve BP measurement techniques across their care team.
In the U.S., 116 million adults have high blood pressure. The 2017 hypertension guideline from the American College of Cardiology and AHA recommends a treatment goal of 130/80 mm Hg, but only 25% of people with high blood pressure have achieved this goal. This first section will help physicians and other health professionals understand the:
- Current epidemiology of hypertension in the U.S.
- Importance of achieving BP-control among people with hypertension.
- Different stages of hypertension.
- Latest clinical guidelines on BP measurement.
When study participants were asked why inaccurate BP measurements occur in their clinics, they often attributed errors to human factors, with the top reason being method or procedural errors by the person taking a patient’s BP. About one-quarter of health professionals also noted general issues with staff, including poor technique or lack of training, as other factors affecting accuracy.
This section of the module focuses on:
- The key steps for taking an accurate BP measurement
- Factors related to devices that impact accurate measurement
- Proper patient preparation/positioning and common positioning errors
- Correct measurement techniques.
Each member of the health care team plays a vital role in the patient’s health. Determining how to consistently obtain and communicate accurate BP measurements for your patients is important in achieving accuracy. In the last micromodule, physicians and other health professionals will learn how to:
- Identify their role on the team.
- Determine how the care team can work together to consistently take accurate BP measurements.
- Produce better patient outcomes.
Physicians and other health professionals can take the module to earn a maximum of 0.50 AMA PRA Category 1 Credit™.
The AMA has developed online tools and resources created using the latest evidence-based information to support physicians to help manage their patients’ high BP. These resources are available to all physicians and health systems as part of Target: BP™, a national initiative co-led by the AMA and AHA.