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Blood pressure measurement by family physicians
Canadian Family Physician Medecin De Famille Canadien
|January 22, 2011
Summary
Family physicians can accurately measure blood pressure, but skill-based audits reveal common issues with technique and equipment calibration. Adjustments to both can improve diagnostic accuracy for this vital skill.
Area of Science:
- Family Medicine
- Clinical Skills Assessment
- Diagnostic Accuracy
Background:
- Hospital-based audits have limited utility for community-based family physicians.
- Blood pressure measurement is a critical skill frequently performed with suboptimal technique or equipment.
Purpose of the Study:
- To evaluate the feasibility of a skill-based audit procedure for family physicians.
- To assess the accuracy of blood pressure measurement by family physicians in a practical setting.
Main Methods:
- Physicians attending family medicine rounds participated in a blood pressure measurement skills evaluation.
- Participants' sphygmomanometers were calibrated, and they measured blood pressure on 10 volunteers using their usual technique.
Main Results:
- Most physicians obtained reasonable blood pressure readings, with a slight tendency towards lower diastolic values (1.6 mmHg below gold standard).
- Eight of 19 physicians exhibited significant end-digit bias.
- Two of 16 sphygmomanometers were found to be significantly out of calibration.
Conclusions:
- Family physicians are capable of accurate blood pressure measurement.
- Both technique and equipment calibration present opportunities for improvement in family physicians' blood pressure measurement skills.
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Direct Method
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