Related Experiment Video
Updated: Aug 17, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Quality of blood pressure measurement in community health centres
Edgardo Sandoya-Olivera1, Augusto Ferreira-Umpiérrez2, Federico Machado-González3
1Facultad de Medicina, Instituto Universitario CLAEH , Maldonado, Uruguay; Facultad de Enfermería y Tecnologías de la Salud, Universidad Católica del Uruguay , Montevideo, Uruguay.
Insights
Healthcare professionals often make errors in blood pressure measurement, impacting patient care. Adhering to American Heart Association guidelines is crucial for accurate diagnosis and hypertension management.
Area of Science:
- Cardiology
- Public Health
- Nursing Practice
Background:
- Accurate blood pressure measurement is vital for diagnosing and managing arterial hypertension.
- Routine blood pressure checks in community health centers are frequent but may lack standardization.
- Established guidelines exist to ensure measurement quality, yet adherence varies.
Purpose of the Study:
- To assess the quality of blood pressure (BP) measurements in routine care settings.
- To identify specific areas of non-compliance with American Heart Association (AHA) BP measurement standards.
- To evaluate the impact of procedural flaws on patient care in community health centers.
Main Methods:
- An observational, cross-sectional study was conducted in 5 health centers in Maldonado, Uruguay.
- 36 variables across environment, equipment, interrogation, patient, and observer categories were analyzed.
- Statistical analysis included Chi-squared or Fisher tests, with significance set at p<.05.
Main Results:
- Blood pressure measurements were primarily performed by nurses (71%).
- Aneroid sphygmomanometers were used in 89% of cases.
- While environment (93%) and equipment (99%) scored well, operator attitude (64%) and interrogation (18%) showed significant deficiencies, averaging 69% correct variables per measurement.
Conclusions:
- Operator-related factors were the main source of procedural flaws in blood pressure measurement.
- Inconsistent application of established BP measurement recommendations can lead to suboptimal patient care.
- Improving adherence to guidelines is essential for the accurate diagnosis and chronic management of hypertension.
Objective:
To determine the quality of the blood pressure measurements performed during routine care in community health centres.
Method:
An observational, cross-sectional study was conducted in 5 private and public health centres in Maldonado, Uruguay, in July-August 2015. The observations were made during the measurements performed by health personnel, using the requirements established by the American Heart Association. An analysis was made on 36 variables that were grouped in categories related to environment, equipment, interrogation, patient, and observer. Statistical analysis was performed using Chi2 test or Fisher test. Statistical significance was considered to be less than 5% (p<.05).
Results:
The measurements were made by a registered nurse or nurse in 71% of cases, physician in 20%, and student nurse in 9%. An aneroid sphygmomanometer was used in 89%, and mercury 11%. Satisfactory results were found in variables related to environment (93%), equipment (99%), and patient attitude (82%), and intermediate in the attitudes of the operator (64%), and poor in relation to the interrogation (18%), with the mean of correct variables per measurement being 69%.
Conclusions:
The main flaws in the procedure were the operator. The measurement of blood pressure is a manoeuvre that healthcare professionals perform thousands of times a year. If the measurement is used for the diagnosis and/or chronic management of arterial hypertension, not systematically applying the established recommendations leads to an inappropriate care of a very significant number of patients.
Related Concept Videos
01:21Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:25Errors occurring during blood pressure monitoring
Several factors...
01:23Assessment of blood pressure in brachial artery(two-step method)
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:17Measurement of Blood Pressure