by Dr. Tom Schwieterman
When learning a sport, art or profession, basic fundamentals can be overlooked by amateurs eager to achieve glory-filled moments. But, often it is fundamentals that provide a solid foundation to produce the most successful outcomes. Professional golfers spend hours fine-tuning their putts and drives. Professional musicians tune onstage in the minutes before a performance.
For professional healthcare teams, basic fundamentals, such as vitals assessment, set the stage for successful patient outcomes. In many respects, the entire patient visit relies on information gathered from those first measurements, especially the blood pressure reading. The most recent figures from the CDC state that 29 percent of American adults have high blood pressure, and nearly 1 of every 3 American adults has prehypertension. An accurate blood pressure reading is essential to determine a patient’s current condition and risk for future disorders, and of course, the optimal pharmaceutical treatment.
Even slight discrepancies in measurement accuracy can have a dramatic impact on care management decisions. Thus, it is very important that clinicians achieve the most accurate readings possible with every patient encounter. According to the American Medical Association, actions as seemingly minor as talking with a patient or not supporting his/her arm during blood pressure measurement can change readings by as much as 10 mmHg, a difference that may propel a patient with borderline hypertension into a higher risk category that results in additional testing or medical management.
So, like the golfer tuning his swing before a tournament or a violinist adjusting her instrument to be in tune before performance, we need to tune our methods for taking a simple blood pressure reading.
First, allow patients to sit comfortably for at least five minutes to ensure you are taking a “resting” blood pressure reading, as the name implies. Then, apply these seven simple tips for an accurate blood pressure reading provided by the American Medical Association:
- Empty bladder first
- Support back and feet
- Keep legs uncrossed
- Support arm at heart level
- Put cuff on bare arm
- Use correct cuff size
- Do not have a conversation
By taking the time to practice all the fundamentals in the simple act of blood pressure measurement, clinicians can proceed with confidence that their care management plans are based on sound data, producing several additional benefits:
- Risk-scoring is more precise, thus enabling clinicians to allocate precious interventional resources to the patients who truly need it.
- Pharmaceuticals can be dosed in a manner that reduces the risk of harmful adverse events, such as fainting and falls. A properly taken resting blood pressure is more likely to result in lower medicating requirements and therefore results in lower risk of side effects.
- Clinicians are more appropriately rewarded for improved population health metrics because following the fundamentals of blood pressure testing almost always results in better readings.
- Your patients will gain confidence in you and your team. In my 20 years of experience, patients pay attention – more than you may think – to your professionality and your attention to details.
Revisiting fundamentals is key to success, no matter the sport or profession. In professional medicine, attention to fundamentals is essential to achieve successful outcomes – and there is nothing more fundamental to a successful population health effort than starting every patient encounter with an accurate blood pressure reading.
For additional resources on improving vitals acquisition with better technology, including white papers and case studies, click here.
Dr. Tom Schwieterman practiced family medicine for 12 years before joining the team at Midmark. As vice president of clinical affairs and chief medical officer, he leads the company’s focus on innovative technology and new approaches that enrich experiences between caregivers and their patients at the point of care. Much of his time is focused on advising the development of clinical solutions, recognizing and understanding market trends, monitoring and providing insight on government regulations, and identifying and quantifying new innovations in the medical, dental and animal health markets. Dr. Schwieterman is board certified and continues to practice medicine. For more information about improving vitals acquisition with better technology, download the “Connecting Vitals Acquisition within the Point of Care Ecosystem” white paper by Midmark.
