Obtaining Accurate Blood Pressure Measurements

Oct 18, 2016

Added to Collection

American Association of Critical-Care Nurses aims to standardize care with updated AACN Practice Alert

 — Oct. 18, 2016 — Virtually all patients have their blood pressure measured while receiving care, and the results help guide decisions and prevent adverse outcomes.

When done incorrectly, what may seem like a routine assessment can provide inaccurate data for managing patient care and contribute to complications, such as pain, bruising and skin irritation.

Getting accurate results begins with following the latest evidence-based practice, which is outlined in an updated practice alert from the American Association of Critical-Care Nurses (AACN).

The AACN Practice Alert, Obtaining Accurate Noninvasive Blood Pressure Measurements in Adults, details why blood pressure measurement is important and discusses cuff size and placement considerations, patient positioning and patient safety concerns. It includes supporting evidence and photos with correct cuff and arm positioning in patients who are sitting, supine or in bed with their head elevated.

Maureen Seckel, MSN, APN, ACNS-BC, CCNS, CCRN, FCCM, a clinical nurse specialist in the medical pulmonary critical care unit at Christiana Care Health System, Newark, Delaware, developed the initial practice alert for AACN.

“Measuring blood pressure measurement is not a one-size-fits-all practice, and nurses need to know the best way to get accurate results from each patient,” Seckel said. “There are a lot of variables to consider each time blood pressure is measured to get the best results.”

The Practice Alert also includes expected actions for nursing practice:

  • Determine the best site and method of blood pressure for each patient
  • Use the appropriate size cuff for the patient’s size and extremity
  • Follow the facility’s procedures for blood pressure measurement, including documentation of site and interarm differences
  • Promptly report any equipment or cuffs that are not working properly and take them out of service until they can be inspected
  • Ensure appropriate positioning of patients during blood pressure measurement
  • Compare acquired values with the actual assessment of the patient and his or her clinical condition
  • Evaluate skin at the site and circulation in the extremity being used for blood pressure measurement
  • Make sure all personnel are competent in use of the types of equipment available on your unit

This alert is the latest in a series issued by AACN to standardize practice and update nurses and other healthcare providers on new clinical advances and trends. All practice alerts are available on the AACN website, www.aacn.org/practicealerts.

Supported by authoritative evidence, each AACN Practice Alert seeks to ensure excellence in practice along with promotion of a safe and humane work environment. Topics address both nursing and interprofessional activities of importance for patients in acute and critical care environments. Some alerts include additional resources for staff education and performance-improvement activities.

Previously released alerts address verification of feeding-tube placement, dysrhythmia monitoring, pulmonary artery pressure monitoring, ST segment monitoring, family presence during CPR and invasive procedures, and prevention of catheter-associated urinary tract infections and aspiration.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 225 chapters worldwide. The organization's vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.