Nearly every patient visiting or admitted to a medical facility will have their blood pressure taken as a very quick means of assessing their state of health. Although extraordinarily useful, blood pressure is a highly variable measurement and there is a good chance these critical readings are not being recorded accurately. Inaccurately read and/or recorded blood pressure measurements can have far reaching, almost always negative, ramifications for the patient.
Why?
Because blood pressure readings that are high may be an early indicator of heart disease or an early indicator of increased risk of stroke1. Misreading and/or mis-recording blood pressure can result in treatment being withheld because a problem has not been identified or a patient being prescribed treatment they do not need.
While there is consensus that accuracy in blood pressure readings is critical to patient care, it is deceptively challenging to consistently collect accurate readings. Here is why:
- Each patient is different,
- Medical facilities have different blood pressure protocols,
- There are different devices available.
- Staff may not all use the same techniques and,
- Patient anxiety, known clinically as White Coat Hypertension, can have a big influence on blood pressure.
In the modern healthcare landscape, there are all manner of devices designed to improve the accuracy of critical measurements such as blood pressure and by extension, patient outcomes. This post will explore:
Why Accuracy in Blood Pressure Readings is Important
Automated Blood Pressure Devices Improve Accuracy
Features of Automated Blood Pressure Devices
Why Accuracy in Blood Pressure Readings is Important
According to the American Heart Association (AHA)
- normal blood pressure is defined as readings consistently less than 120/80,
- elevated blood pressure readings consistently fall between 120-129/80, and
- stage 1 Hypertension showing readings consistently between 130-139/80-89.2
With tolerances so tight, it is clear a small difference in measurement can have a big impact when it comes to diagnosing, or misdiagnosing, hypertension.
For example, in one study, a manual blood pressure reading ended in zero 32.8% of the time, while only 12.4% of automated blood pressure readings ended in zero.3 That is a significant difference.
Changing a measurement from 129/80 to 130/80 may seem harmless because it is only one mmHG, but that one digit could be the difference between normal and elevated blood pressure and change the course of treatment.
Based on AHA blood pressure guidelines every digit in a blood pressure reading matters.
Recording errors associated with manual blood pressure readings have their roots in human nature. Because we are human, we gravitate toward simple numbers, especially when we must remember and write them down later.
Automated Blood Pressure Devices Improve Accuracy
Digital blood pressure devices can help eliminate the propensity to mentally “round” numbers to the nearest ten by digitally displaying the reading clearly on the screen. Additionally, these devices can connect directly to electronic medical records (EMR), reducing transcription errors and because a patient’s history is immediately accessible through the EMR, automatically calculate an average blood pressure reading with the stored data.
While automated blood pressure devices can improve the accuracy of the reading and minimize transcription errors by recording the reading directly into a patient record, nothing can replace the proper implementation of Technique, Time, and Tools to take a blood pressure reading.
Proper implementation of Technique, Time, and Tools, the Three T’s, are the foundation for accurate blood pressure measurement.
Technique: AHA suggests:
- The patient should avoid caffeine, exercise, and smoking for at least 30 min before measurement.
- Use proper cuff size and place over a bare arm.
- The patient should be seated for 3-5 min without talking or moving around before taking the first blood pressure reading.
Time: Averaging several readings – with rest periods in between – and repeating over 2-3 office visits.4
Tools: Using automated blood pressure devices for in-office measurements per AHA recommendations.4 These devices allow for unattended blood pressure measurement to mitigate white coat hypertension and averaging of blood pressure readings – both AHA recommendations.
Fun Fact: Did you know that up to 48% of the time a clinician will not put the blood pressure cuff on a patient’s bare arm?5
Features of Automated Blood Pressure Devices
These days, automated blood pressure measurement devices are the go-to for healthcare facilities, and for good reason. It follows then that carefully considering features is an important step in the evaluation process.
When evaluating digital blood pressure devices look for features that:
- Ensure a comfortable patient experience. For example, a cuff that will not inflate too tightly,
- Facilitate easy device programming to start blood pressure averaging,
- Ensure proven and accurate blood pressure measurements,
- Capture other vital signs (such as temperature and SpO2) in addition to blood pressure to optimize office workflow, and
- Make the device EMR ready to help reduce documentation errors.
Welch Allyn offers a wide range of point of care vital signs measurement and monitoring devices to healthcare professionals in acute and primary care settings around the world. Their blood pressure measurement and monitoring devices have a proven track record of accuracy, are easy to use, and in many cases are EMR ready.
Shop CME for the Welch Allyn 44WT-B 4400 Series Spot Vital Signs Monitor, Welch Allyn Connex Spot Monitor, or the Welch Allyn Connex Vital Signs Monitor.
Click CHAT to start a conversation with a CME expert about the wide range of Welch Allyn blood pressure measurement and monitoring devices. Our medical equipment experts can help select the best blood pressure devices for your patient populations, healthcare staff, and budget.
1. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13.
2. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison C, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension. 2018;71(19):e13–115.
3. Kottke TE, Anderson JP, Zillhardt JD, et al. Association of an Automated Blood Pressure Measurement Quality Improvement Program With Terminal Digit Preference and Recorded Mean Blood Pressure in 11 Clinics. JAMA Netw Open. 2022;5(8):e2229098. doi:10.1001/jamanetworkopen.2022.29098.
4. Muntner P, Shimbo D, Carey RM, et al. Measurement of blood pressure in humans. A scientific statement from the American Heart Association. Hypertension 2019; 73: e35-e66. DOI: 10.1161/HYP.0000000000000087.
5. Mishra B, Sinha ND, Gidwani H, Shukla SK, Kawatra A, Mehta S. Equipment errors: a prevalent cause for fallacy in blood pressure recording - a point prevalence estimate from an Indian health university. Indian J Community Med. 2013 Jan;38(1):15-21. doi: 10.4103/0970-0218.106622. PMID: 23559698; PMCID: PMC3612291.
About Baxter: Baxter and its subsidiary, Welch Allyn, offer broad portfolios of medical devices and products to healthcare providers worldwide. The comprehensive array of devices and products in these portfolios address a wide range of medical care needs such as diagnostic, critical care, hospital and surgical products, patient monitoring, and physical exams. Capitalizing on Welch Allyn’s 100 years of innovation, 268,000 customers and 100 configurable products, Baxter is uniquely positioned to help transform global healthcare for years to come.
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