Effect of an educational program for the knowledge and quality of blood pressure recording

Daniel, Ana Carolina Queiroz Godoy; Veiga, Eugenia Velludo; Machado, Juliana Pereira; Mafra, Ana Carolina Cintra Nunes; Cloutier, Lyne

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Brasil

Revista Latino-Americana de Enfermagem

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Brasil

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Sumário

Original Article • Rev Lat Am Enfermagem 27 • 2019 • https://doi.org/10.1590/1518-8345.3011.3179 copy

Effect of an educational program for the knowledge and quality of blood pressure recording^* * Paper extracted from doctoral dissertation “Educational program concerning blood pressure documentation in emergency department: an intervention study”, presented to Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

to evaluate the effect of an educational program on blood pressure recording for nursing professionals in relation to theoretical knowledge and the quality of these records.

Method

quasi-experimental study conducted in a hospital service located in the city of São Paulo. The theoretical knowledge of 101 professionals was measured using a validated questionnaire before and after the educational intervention; the quality of blood pressure records was evaluated using a validated form which was applied to 354 records in the pre-intervention period and 288 in the post-intervention period. The educational program was based on active teaching-learning methodologies and consisted of two strategies: expository/dialogue class and a board game. The Wilcoxon, Mann-Whitney, Fisher and Chi-Square tests were used for comparisons, adopting a level of significance of α=0.05.

Results

the median of the professionals’ scores increased from 19 to 22 points in the post-intervention period (p<0.001). There was an improvement in the quality of the blood pressure recordings regarding the variables: cuff size (p<0.001), arm used in the procedure (p<0.001) and patient position (p<0.001).

Conclusion

the educational program showed positive results in the promotion of knowledge among nursing professionals and in the improvement of the quality of blood pressure recording.

Medical Records; Blood Pressure Determination; Education, Professional; Education, Continuing; Education, Nursing; Teaching Materials

Quality of the blood pressure recordings	Pre-intervention period (n=354) n (%)	Post-intervention period (n=288) n (%)	p-value*
Recording of AC measurement^†	2 (0.6)	1 (0.3)	>0.999
Recording of cuff size	0 (0.0)	71 (24.7)	<0.001
Recording of arm in which AC was measured^†	2 (0.6)	84 (29.2)	<0.001
Recording of patient position	0 (0.0)	199 (69.1)	<0.001

Characteristics	No. (%)	Median [IQR]*
Age (years)		34.00 [29.00; 39.00]
Gender – Female	75 (74.3)
Professional category
Assistant	1 (1.0)
Technician	58 (57.4)
Nurse	42 (41.6)
Time of professional training (years)		9.00 [4.92; 15.00]
Time working in the institution (years)		5.00 [2.66; 10.00]
Work shift
Morning	37 (36.6)
Afternoon	36 (35.6)
Night	28 (27.7)

Questions	Pre-intervention (n)	Post-intervention (n)
1. What is the importance of BP* recording for nursing care?	82	93
2. Which BP* values recorded in the patient’s chart may be a sign of hemodynamic severity?	67	82
3. When verifying significant alterations in BP* values, one should:
Ensure that the BP* measurement was performed with correct technique, otherwise it should be measured again.	101	101
Communicate the results obtained to the patient/companion.	82	91
Communicate the values obtained to the nurse/physician responsible for the patient.	101	101
Register in the nursing record that the nurse/physician was communicated, and the conduct was performed.	100	101
Communicate clinical engineering that there are errors in the device.	89	89
4. In relation to the advantages of using automatic devices for recording BP*, choose true or false:
Accuracy of the results obtained.	79	95
Possibility of storing BP* values in the device.	90	99
Calculation of mean arterial pressure and values described in up to three digits.	95	97
Several measures can be performed in a time interval determined by the operator.	91	95
Rounding of values.	89	90
5. We should always record the patient’s position during BP* measurement, because:	96	97
6. We should always record the patient’s heart rate during BP* measurement, because:	46	79
7. To select and register, with practicality, the cuff size that best suits the patient’s arm, one should:	9	73
8. The BP* verification must be recorded:	99	100
9. To fill the nursing prescription item on the frequency of the verification of vital signs, the nurse should take into consideration:	99	99
10. In relation to the frequency of BP* recording, choose true or false:
The BP* of unstable patients or patients receiving vasoactive drugs should be registered every 15 minutes at most.	94	101
The BP* of patients classified as high risk should be recorded every 2 hours at most.	78	100
The BP* of patients classified as very urgent should be recorded every 4 hours at most.	87	100
The BP* of patients classified as urgent should be recorded every 6 hours at most.	96	101
The BP* of patients classified as less urgent or nonurgent should not be recorded.	88	90
11. During and after the procedure of BP* measurement with automatic devices, the steps that should be recorded in the medical chart are:	63	96

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Ana Carolina Queiroz Godoy Daniel E-mail: carol.enf.usp@hotmail.com https://orcid.org/0000-0003-4877-9191