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Standardizing Blood Pressure Measurements in Pediatric Hemodialysis: a Collaborative Journey

Audrey B Anaya1, Marsha M Lee1, Alicia M Neu2

  • 1UCSF Benioff Children's Hospital, San Francisco, CA, USA.

Current Hypertension Reports
|July 28, 2023
PubMed

Insights

A quality improvement initiative standardized blood pressure (BP) measurement in pediatric hemodialysis (HD) units. This initiative established a best practice, improving cardiovascular health monitoring for children with kidney disease.

Area of Science:

  • Pediatric Nephrology
  • Quality Improvement Science
  • Cardiovascular Health in Chronic Kidney Disease

Background:

  • Current pediatric hypertension guidelines lack specific recommendations for blood pressure measurement in hemodialysis settings.
  • Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) Collaborative identified variability in pediatric hemodialysis (HD) blood pressure (BP) measurement.
  • Accurate BP measurement is crucial for managing hypertension and cardiovascular risk in pediatric HD patients.

Purpose of the Study:

  • To develop and implement a standardized protocol for BP measurement in pediatric HD patients.
  • To improve the consistency and accuracy of BP measurement practices across a national collaborative.
  • To establish a foundation for enhanced cardiovascular health research and interventions in this population.

Main Methods:

  • A dedicated working group was formed within the SCOPE Collaborative.
  • Quality Improvement (QI) methodology was employed to develop a standardized "BP Bundle".
  • The "BP Bundle" was implemented across participating pediatric HD centers.

Main Results:

  • A standardized best practice for BP measurement in pediatric HD patients was successfully established.
  • Over 85% compliance with the standardized "BP Bundle" was achieved across the SCOPE Collaborative.
  • Consistent BP measurement practices were implemented in pediatric HD centers.

Conclusions:

  • The QI initiative successfully standardized BP measurement practices in pediatric HD units.
  • The established best practice facilitates more accurate study of pediatric HD patient cardiovascular health.
  • This standardization is expected to enhance cardiovascular health outcomes for children undergoing hemodialysis.
Abstract

Keywords:
Blood pressureHemodialysisHypertensionPediatricQualityStandardizing care to improve outcomes in pediatric end stage kidney disease (SCOPE)

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