Is Education Enough to Change the Practice of Monitoring of Blood Pressure in Outpatient Clinics? Case Report

Leslie M. Smith, Sindhuja Muralidharan, Diana Stanek, A. Yorke
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Abstract

Supplemental Digital Content is Available in the Text. Purpose: Hypertension (HTN) is a prevalent and preventable risk factor for several medical conditions that can lead to death. The purpose of this study was to investigate the frequency of physical and occupational therapists taking blood pressure (BP) in outpatient clinics before and after education focused on the clinical importance of monitoring BP. Methods: This pre/posttest model consists of 2 phases. In phase 1, physical and occupational therapists were surveyed regarding attitudes, behaviors, and barriers toward monitoring BP; and electronic medical records (EMR) were audited to determine frequency of BP documentation. For phase 2, educational webinars were developed highlighting the importance of BP monitoring and followed by another EMR audit. Results: Nine clinicians participated in our survey. Survey results indicated that one-third agreed that BP should be monitored during evaluations, but 100% responded that they rarely take BP. An audit of 488 EMR charts pre-education showed there was no BP documented. Three months after education, another 237 EMR charts were audited, with a 12.7% improvement in the frequency of BP documented. A chi-square analysis showed that this improvement was statistically significant (P < .001). Conclusions: Therapists did not monitor and document BP. After the webinar series, there was a significant increase, however still below recommendations for monitoring BP.
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教育是否足以改变门诊血压监测的做法?案例报告
文本中提供了补充数字内容。目的:高血压(HTN)是一种常见且可预防的危险因素,可导致多种疾病的死亡。本研究的目的是调查物理和职业治疗师在门诊部测量血压(BP)的频率,教育前后重点关注监测血压的临床重要性。方法:该前/后测试模型由两个阶段组成。在第一阶段,对物理治疗师和职业治疗师进行了关于监测血压的态度、行为和障碍的调查;并对电子医疗记录(EMR)进行审计,以确定BP文档的频率。在第二阶段,开展了教育网络研讨会,强调BP监测的重要性,随后进行了另一次EMR审计。结果:9名临床医生参与了我们的调查。调查结果显示,三分之一的人同意在评估期间应监测BP,但100%的人回答说,他们很少服用BP。对488张教育前电子病历表的审计显示,没有BP记录。教育三个月后,又对237张EMR图表进行了审计,BP记录频率提高了12.7%。卡方分析显示,这种改善具有统计学意义(P<.001)。结论:治疗师没有监测和记录血压。在网络研讨会系列之后,出现了显著的增长,但仍低于监测BP的建议。
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