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Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting

INTRODUCTION: Hypertension (HTN) is increasing in the pediatric population, and hypertensive children become hypertensive adults. Blood pressure (BP) is often overlooked due to factors including distrust in readings, lack of time in visits, and discomfort prescribing antihypertensive medications. Th...

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Autores principales: Woods, Jennifer L., Jacobs, Megan D., Sheeder, Jeanelle L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225357/
https://www.ncbi.nlm.nih.gov/pubmed/34179673
http://dx.doi.org/10.1097/pq9.0000000000000416
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author Woods, Jennifer L.
Jacobs, Megan D.
Sheeder, Jeanelle L.
author_facet Woods, Jennifer L.
Jacobs, Megan D.
Sheeder, Jeanelle L.
author_sort Woods, Jennifer L.
collection PubMed
description INTRODUCTION: Hypertension (HTN) is increasing in the pediatric population, and hypertensive children become hypertensive adults. Blood pressure (BP) is often overlooked due to factors including distrust in readings, lack of time in visits, and discomfort prescribing antihypertensive medications. The objective of our multistage, clinically based quality improvement project was to improve BP measurement and HTN diagnosis and intervention in adolescents. METHODS: Study investigators performed interventions in an adolescent medicine clinic at Children’s Hospital Colorado (ages 12–24 years), which included equipment inventory, mapping clinic processes, manual/automated BP training for staff, education of faculty/staff on guidelines, and creation/implementation of updated best practice alerts (BPAs) based on age-appropriate guidelines for stage 1, 2 HTN in patients younger/older 18years. RESULTS: With equipment updates, medical assistant manual BP certifications, educational sessions for faculty/staff, and creation of a BPA with instruction before the go-live date, confidence in using automated and manual BP measurements increased for faculty/staff. The number of unique patient visits presenting with elevated BPs decreased significantly in the postintervention period reflecting the education/training. Staff used the new order set minimally, but there was an increase in correct diagnoses of elevated BP and laboratory workup. CONCLUSIONS: Having appropriate equipment while introducing BP guideline education in the ambulatory setting with electronic health record reminders and utility of BPAs can decrease erroneous BP values saving providers and staff encounter time. Real-time alerts can aid in accurate diagnosis rates and improved intervention for youth with elevated BP readings. Providers still inconsistently interact with order sets despite such parameters
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spelling pubmed-82253572021-06-25 Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting Woods, Jennifer L. Jacobs, Megan D. Sheeder, Jeanelle L. Pediatr Qual Saf Individual QI projects from single institutions INTRODUCTION: Hypertension (HTN) is increasing in the pediatric population, and hypertensive children become hypertensive adults. Blood pressure (BP) is often overlooked due to factors including distrust in readings, lack of time in visits, and discomfort prescribing antihypertensive medications. The objective of our multistage, clinically based quality improvement project was to improve BP measurement and HTN diagnosis and intervention in adolescents. METHODS: Study investigators performed interventions in an adolescent medicine clinic at Children’s Hospital Colorado (ages 12–24 years), which included equipment inventory, mapping clinic processes, manual/automated BP training for staff, education of faculty/staff on guidelines, and creation/implementation of updated best practice alerts (BPAs) based on age-appropriate guidelines for stage 1, 2 HTN in patients younger/older 18years. RESULTS: With equipment updates, medical assistant manual BP certifications, educational sessions for faculty/staff, and creation of a BPA with instruction before the go-live date, confidence in using automated and manual BP measurements increased for faculty/staff. The number of unique patient visits presenting with elevated BPs decreased significantly in the postintervention period reflecting the education/training. Staff used the new order set minimally, but there was an increase in correct diagnoses of elevated BP and laboratory workup. CONCLUSIONS: Having appropriate equipment while introducing BP guideline education in the ambulatory setting with electronic health record reminders and utility of BPAs can decrease erroneous BP values saving providers and staff encounter time. Real-time alerts can aid in accurate diagnosis rates and improved intervention for youth with elevated BP readings. Providers still inconsistently interact with order sets despite such parameters Lippincott Williams & Wilkins 2021-06-23 /pmc/articles/PMC8225357/ /pubmed/34179673 http://dx.doi.org/10.1097/pq9.0000000000000416 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Individual QI projects from single institutions
Woods, Jennifer L.
Jacobs, Megan D.
Sheeder, Jeanelle L.
Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting
title Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting
title_full Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting
title_fullStr Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting
title_full_unstemmed Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting
title_short Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting
title_sort improving blood pressure accuracy in the outpatient adolescent setting
topic Individual QI projects from single institutions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225357/
https://www.ncbi.nlm.nih.gov/pubmed/34179673
http://dx.doi.org/10.1097/pq9.0000000000000416
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