It’s axiomatic that care teams can’t properly screen, diagnose or monitor high blood pressure patients if they can’t first get an accurate BP measurement. So, it’s no wonder that hypertension rates are so high in the U.S. A recent study found that, on average, health professionals couldn’t perform even half of the 14 skills considered necessary to accurately measure BP.
The problem goes back generations: Members of care teams get too little training in BP measurement—typically only in their professional education and never again—and whatever skills they acquired way back when inevitably decay.
That’s why the AMA and the American Heart Association developed a 30-minute e-learning module, “Achieving Accuracy: BP Measurement”—to refresh and improve measurement knowledge and clinical skills among all care team members responsible for measuring and tracking patients’ blood pressure.
The study, a randomized controlled trial published in The Journal of Clinical Hypertension, evaluated the impact of the module. It showed those 30 minutes alone are enough to significantly improve BP measurement skills.
Through the end of May, physicians and others can get 25% off the e-learning module with the code BP25*.
In the researchers’ initial assessment of 170 health professionals—including physicians, registered nurses, and medical assistants—participants in both the intervention and control groups had mean scores of just 5.5 and 5.9 out of 14, respectively. Following their use of the module, however, the intervention group performed an average of 3.4 more skills correctly, compared with 1.4 in the control group.
“Our findings reinforce existing evidence that errors in provider blood pressure measurements are highly prevalent and provide novel evidence that refresher training improves measurement accuracy,” wrote the authors, including Rupinder Hayer, MPH, senior program manager of improving health outcomes at the AMA.
“Now imagine if the e-learning module was paired with some additional solutions or guidance,” Hayer said in an interview, noting that scores might be even higher if care team members reviewed the module two or three times. “Then we could really move the needle in terms of measurement accuracy.”
The “Achieving Accuracy: BP Measurement” e-learning module is broken into these three sections.
Know the science. This covers the epidemiology of hypertension, the importance of blood pressure control and the categories of high BP. It also explores the clinical guidelines that support comprehensive plans to achieve blood pressure control.
Accurate measurement every time. The biggest part of the module, this section drills down on best practices for taking accurate blood pressure measurements on multiple devices, as well as the dos and don’ts of taking blood pressure. It also reviews proper techniques, from cuff selection to patient preparation.
Partners in care. Determining how to consistently obtain—and communicate—accurate blood pressure measurements is vital. Participants learn how partnering with their teammates can produce better patient outcomes.
The authors noted several limitations of this study, including the short follow-up time for assessing knowledge and skills. Current guidelines recommend re-training every six to 12 months.
“Further research can help clarify the frequency at which re-training is best implemented,” they wrote. “Retraining alone, without addressing systems-level barriers to accurate BP measurement, is likely inadequate to address this performance gap. However, BP measurement retraining should be a cornerstone of any health care organization's quality improvement program.”
The AMA launched the AMA MAP BP™ program in 2019 to provide a clear path to significant, sustained improvements in blood pressure control. It features powerful data and metrics—including through a dashboard that provides monthly reports and tracking data on process and outcome metrics. In addition, AMA experts provide planning and support during program setup and implementation, such as help with assessing practice sites’ readiness, training clinical teams and creating kickoff event presentations.
The resources offered by the AMA as part of AMA MAP BP are provided at no cost. Contact the AMA to learn how your organization can get started.
