RESUMEN
OBJECTIVE: To assess the effectiveness of an intervention to promote standardized arm circumference measurement as way to choose appropriate cuff size to measure blood pressure. PATIENTS AND METHODS: A before-after intervention study was performed in a basic health care area in Barcelona. Doctors, nurses and pharmacy staff participated by filling out an anonymous self-administered questionnaire pre- and post-intervention (3m). Variables included: demographics, type of professional, years since they finished their studies, availability of different cuff sizes, if arm circumference measurement were obtained or not, knowledge about the cutoff values for each cuff size and type of blood pressure monitor. INTERVENTION: The written results were given to the participants and presented in sessions. RESULTS: Pre- and post-intervention: 74.3 and 67.3% answered the questionnaires (P=ns), respectively. Determination of arm circumference varied from 1.3 to 19.1% (P=.009). A total of 37.3% and 44.1% declared that they had 2 or more available cuff sizes (P=ns). Knowledge about the correct measurement of the cuffs was 2.7 to 33.8% regarding the standard cuff size (P=.0198) and 0 to 23.5% for obese subjects (P<.05). When more than one cuff was available, reasons for the choice went from: «making a rough guess¼ or «when velcro stops sticking¼ before and after the intervention. All blood pressure devices in our primary health care center were electronic and automatic as were those of the 9 pharmacies. CONCLUSION: The intervention increased the determination of arm circumference prior to the reading of the blood pressure and the knowledge about the cutoff interval for standard and obese cuff size after intervention. There was greater availability of different sized cuffs. Despite this, the choice of the appropriate cuff size was not made based on arm circumference.
Asunto(s)
Determinación de la Presión Sanguínea , Brazo , Presión Sanguínea , Humanos , Obesidad , EsfigmomanometrosRESUMEN
Objetivo: Evaluar la eficacia de una intervención para promover la determinación del perímetro braquial para seleccionar el manguito adecuado para la toma de la presión arterial. Pacientes y métodos: Estudio de intervención antes-después. Incluyó médicos, enfermeras y personal de oficinas de farmacia de un área básica de salud en Barcelona. Encuesta autoadministrada pre y posintervención (3 m). Variables recogidas: demográficas, tipo de profesional, años desde la finalización de los estudios, disponibilidad de manguitos de diferentes medidas, determinación o no del perímetro braquial, conocimiento o no de los valores de corte para cada manguito y tipo de aparatos de medida. Intervención: entrega de los resultados escritos y presentación en sesiones. Resultados: Pre y posintervención: 74,3 y 67,3% encuestas cumplimentadas (p = ns), respectivamente. La determinación del perímetro braquial varió del 1,3 al 19,1% (p = 0,009). Declararon disponer de 2 o más manguitos de diferente medida el 37,3 y el 44,1% de los encuestados (p = ns). El conocimiento del intervalo de medida correcto de los manguitos fue del 2,7 al 33,8% para el manguito estándar (p = 0,0198) y del 0 al 23,5% para el de obesos (p < 0,05). Cuando disponían de más de un manguito la elección se realizaba por motivos como «a ojo» o «cuando salta el velcro» antes y después de la intervención. La totalidad de los aparatos del centro de atención primaria eran electrónicos automáticos, así como los de 9 farmacias. Conclusión: La intervención aumentó la determinación del perímetro braquial previa a la lectura de la presión arterial y el conocimiento del intervalo de los manguitos estándar y para obesos. Hubo una mayor disponibilidad de manguitos de distinto tamaño. A pesar de ello, la utilización de uno u otro manguito no se realizaba en función de la medida del perímetro braquial
Objective: To assess the effectiveness of an intervention to promote standardized arm circumference measurement as way to choose appropriate cuff size to measure blood pressure. Patients and methods: A before-after intervention study was performed in a basic health care area in Barcelona. Doctors, nurses and pharmacy staff participated by filling out an anonymous self-administered questionnaire pre- and post-intervention (3 m). Variables included: demographics, type of professional, years since they finished their studies, availability of different cuff sizes, if arm circumference measurement were obtained or not, knowledge about the cutoff values for each cuff size and type of blood pressure monitor. Intervention: The written results were given to the participants and presented in sessions. Results: Pre- and post-intervention: 74.3 and 67.3% answered the questionnaires (P = ns), respectively. Determination of arm circumference varied from 1.3 to 19.1% (P = .009). A total of 37.3% and 44.1% declared that they had 2 or more available cuff sizes (P = ns). Knowledge about the correct measurement of the cuffs was 2.7 to 33.8% regarding the standard cuff size (P = .0198) and 0 to 23.5% for obese subjects (P < .05). When more than one cuff was available, reasons for the choice went from: «making a rough guess» or «when velcro stops sticking» before and after the intervention. All blood pressure devices in our primary health care center were electronic and automatic as were those of the 9 pharmacies. Conclusion: The intervention increased the determination of arm circumference prior to the reading of the blood pressure and the knowledge about the cutoff interval for standard and obese cuff size after intervention. There was greater availability of different sized cuffs. Despite this, the choice of the appropriate cuff size was not made based on arm circumference