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Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement

BACKGROUND: The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood p...

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Autores principales: Block, Lauren, Flynn, Sarah J., Cooper, Lisa A., Lentz, Caroline, Hull, Tammie, Dietz, Katherine B., Boonyasai, Romsai T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761193/
https://www.ncbi.nlm.nih.gov/pubmed/29320994
http://dx.doi.org/10.1186/s12875-017-0682-5
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author Block, Lauren
Flynn, Sarah J.
Cooper, Lisa A.
Lentz, Caroline
Hull, Tammie
Dietz, Katherine B.
Boonyasai, Romsai T.
author_facet Block, Lauren
Flynn, Sarah J.
Cooper, Lisa A.
Lentz, Caroline
Hull, Tammie
Dietz, Katherine B.
Boonyasai, Romsai T.
author_sort Block, Lauren
collection PubMed
description BACKGROUND: The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program. METHODS: Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement. A 20-question pre- and post-intervention survey addressed learners’ knowledge and attitudes. Direct observation of blood pressure measurement technique before and after the intervention was performed. Differences in responses to pre- and post-module knowledge and attitudes questions and in observation data were analyzed using chi-square tests and simple logistic regression. RESULTS: All 88 clinical staff members participated in the program and completed the evaluation survey. Participants answered 80.6% of questions correctly before the module and 93.4% afterwards (p < 0.01). Scores improved significantly among staff from all job types. Licensed practical nurses and staff who had been in their current job at least a year were more likely to answer questions correctly than registered nurses and those in their current job less than a year. Attitudes toward correct blood pressure measurement were high at baseline and did not improve significantly. Prior to the intervention, staff adhered to 9 of 18 elements of the recommended technique during at least 90% of observations. Following the program, staff was more likely to explain the protocol, provide a rest period, measure an average blood pressure, and record the average blood pressure, but less likely to measure blood pressure with the arm at heart level and use the right arm. CONCLUSIONS: We designed, implemented, and evaluated a web-based educational program to improve knowledge, skills, and attitudes in blood pressure measurement and use of an automated device among nurses and medical assistants in ambulatory care. The program reinforced knowledge related to recommended blood pressure measurement technique. TRIAL REGISTRATION: Retrospectively registered with ClincalTrials.gov on March 22, 2012; registration number NCT01566864. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12875-017-0682-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-57611932018-01-17 Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement Block, Lauren Flynn, Sarah J. Cooper, Lisa A. Lentz, Caroline Hull, Tammie Dietz, Katherine B. Boonyasai, Romsai T. BMC Fam Pract Research Article BACKGROUND: The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program. METHODS: Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement. A 20-question pre- and post-intervention survey addressed learners’ knowledge and attitudes. Direct observation of blood pressure measurement technique before and after the intervention was performed. Differences in responses to pre- and post-module knowledge and attitudes questions and in observation data were analyzed using chi-square tests and simple logistic regression. RESULTS: All 88 clinical staff members participated in the program and completed the evaluation survey. Participants answered 80.6% of questions correctly before the module and 93.4% afterwards (p < 0.01). Scores improved significantly among staff from all job types. Licensed practical nurses and staff who had been in their current job at least a year were more likely to answer questions correctly than registered nurses and those in their current job less than a year. Attitudes toward correct blood pressure measurement were high at baseline and did not improve significantly. Prior to the intervention, staff adhered to 9 of 18 elements of the recommended technique during at least 90% of observations. Following the program, staff was more likely to explain the protocol, provide a rest period, measure an average blood pressure, and record the average blood pressure, but less likely to measure blood pressure with the arm at heart level and use the right arm. CONCLUSIONS: We designed, implemented, and evaluated a web-based educational program to improve knowledge, skills, and attitudes in blood pressure measurement and use of an automated device among nurses and medical assistants in ambulatory care. The program reinforced knowledge related to recommended blood pressure measurement technique. TRIAL REGISTRATION: Retrospectively registered with ClincalTrials.gov on March 22, 2012; registration number NCT01566864. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12875-017-0682-5) contains supplementary material, which is available to authorized users. BioMed Central 2018-01-10 /pmc/articles/PMC5761193/ /pubmed/29320994 http://dx.doi.org/10.1186/s12875-017-0682-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Block, Lauren
Flynn, Sarah J.
Cooper, Lisa A.
Lentz, Caroline
Hull, Tammie
Dietz, Katherine B.
Boonyasai, Romsai T.
Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement
title Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement
title_full Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement
title_fullStr Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement
title_full_unstemmed Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement
title_short Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement
title_sort promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761193/
https://www.ncbi.nlm.nih.gov/pubmed/29320994
http://dx.doi.org/10.1186/s12875-017-0682-5
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