Hospital sphygmomanometer use: an audit

Periodic evaluation over the past 20 years of the ability of clinical staff to accurately measure blood pressure, as well as the functional state of sphygmomanometers, has frequently demonstrated significant deficiencies. The data presented here are the results of a recent audit in the Newcastle area. Medical (48) and nursing (217) staff in five general hospitals (3 public, 2 private), were questioned on sphygmomanometer use, observed taking a blood pressure reading and asked to record blood pressures from a videotape. In addition, all hospital sphygmomanometers were checked to see if they were in working order. Of 463 sphygmomanometers evaluated, 58% were in perfect working order. There was a marked variation in the state of equipment between institutions (40 to 94%). Staff knowledge and technical ability in sphygmomanometer use was similar in doctors and nurses, with 69% of doctors and 71% of nurses knowing that phase V Korotkoff sounds best approximated adult diastolic blood pressure. Knowledge of appropriate cuff size and ability to use a sphygmomanometer was also similar between the two groups. However, doctors performed better in measuring systolic and diastolic blood pressures from a videotape (9.3 +/- 1.7 correct compared with 7.8 +/- 1.9 for nurses; P < 0.01). It was concluded that, with the exception of one hospital, the state of repair of sphygmomanometers was poor. Staff knowledge of sphygmomanometer usage and their ability to record blood pressure was satisfactory. However, not all practising health professionals are competent in using a sphygmomanometer.