适当的血压测量初步诊断高血压:最佳实践实施项目

Shu-Yi Sheen, Pei-Hsin Chen, Shu-fen Chen, Cha-Fang Chang, Pao-Tsun Chiu, Li-Ting Lin, Mei-Jyh Sheu, Hsiao-Hui Chiu
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摘要

背景:世界范围内25岁及以上人群高血压患病率超过40%。血压数据的准确性对诊断和治疗非常重要。在心内科门诊患者的自我抱怨中,血压测量不正确的发生率为11.9%。目的:提高门诊血压测量的准确性。方法:采用JBI临床证据实践应用系统(JBI PACES)进行临床审核。根据最佳实践推荐的7项审核标准,进行了为期22周的改进和审核,以评估改善后的血压测量质量。结果:建立了符合临床推荐指南的标准文件,通过组织教育培训和环境整治,项目改善绩效显著提高,实施前临床实践指南符合率提高35%-90%,实施后达到70%-100%。门诊噪声从62 dB降至52 dB,每日11.9%的血压测量错误主诉发生率降至1.1%。结论:循证实践项目成功提高了门诊患者血压测量的准确性。建议:质量改进在血压测量精度方面的实证应用取得了渐进式的效果。重要的因素是环境改造的完成,标准文件的建立,患者和保健志愿者的教育,以及通过持续审查保持效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Appropriate Blood Pressure Measurement for Initial Diagnosis of Hypertension: A Best Practice Implementation Project
Background: The worldwide prevalence of hypertension people aged 25 and above is more than 40%. Data accuracy for blood pressure is important to diagnosis and treatment. In self-complaints among patients in cardiology outpatient clinic, the incidence of incorrect blood pressure measuring was 11.9%.Aims: Enhanced accuracy for blood pressure measurement in the outpatient setting.Method: Clinical audits were conducted using the JBI Practical Application of Clinical Evidence System (JBI PACES). With the 7 audit criteria recommended by best practice, improvement and audits were performed for 22 weeks for evaluation of improved quality for blood pressure measurement.Result: Standard documentation complying with recommended clinical guidance was established, with the organized educational training program and environmental renovation, the project’s performance in improvement was significantly enhanced, compliance with clinical practice guidelines before implementation of 35%-90% increased achieving 70%-100% after implementation. Noise in the outpatient setting of 62 dB decreased to 52 dB, with daily incidence of 11.9% for complaint in incorrect blood pressure measuring decreased to 1.1%.Conclusion: Evidence-based practice project successfully enhanced the accuracy for blood pressure measurement in outpatients.Recommendation: The empirical application of quality improvement in blood pressure measurement accuracy achieves progressive results. The important factors are the completion of environmental transformation, the establishment of standard documents, the education of patients and health care volunteers, and the maintenance of the effect through continuous review.
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