Knowledge and Skills in Blood Pressure Measurement Skills

ABSTRACT

BACKGROUND: Errors during measurement of blood pressure can cause over diagnosis or under diagnosis of hypertension, which can result in inappropriate management of hypertension and follow up consultation. The aim of this study was to investigate the factors affecting the accuracy of blood pressure measurement, which may serve as means to improve the accuracy of blood pressure measurements. METHODS: Among the 123 interns who work at Asan Medical Center, we selected 90 persons who agreed to join the study. Three interns were excluded because of their incomplete response to the questionnaire. Questionnaire for the survey concerning blood pressure measurement was created by selecting 5 case problems from a total of 34 cases provided within the blood pressure measurement CD ROM, which apply the Korotkoff sound technique. The factors that might affect the measurement were analyzed by multiple logistic regression. RESULTS: Fifteen (17.2%) interns failed to accurately measure blood pressure provided by the CD program. They showed a difference of greater than 10 mmHg between the actual and the measured systolic blood pressure. A discrepancy of greater than 5 mmHg was noted in the measurement of diastolic blood pressure. From the total sample of 87 interns, 15 (16.1%) interns showed digit preference (0 or 5), when measuring blood pressure. The discrepancy between the measured and the actual blood pressure was greater among those who had a digit preference (95% CI 1.055~17.770). CONCLUSION: Digit preference was the most important factor that affected the accuracy of blood pressure measurement taken by conventional sphygmomanometry. Effort to correct digit preference would improve the quality of blood pressure measurements.