Need blood pressure checked? You may want to sit down for this news

Dermatology Nursing, August, 2008 by Daniel B. Burfeind

Perching on an exam table with arms and legs dangling is not the most accurate (nor medically recommended) position for a blood pressure check, according to a study released in the April 2008 issue of MEDSURG Nursing. In an eye-opening report on the most common diagnostic test patients receive in the doctor's office, researcher Melly Turner and her colleagues found that patients who were in the proper position--sitting in a chair, back supported, feet on the floor, with arm at heart level--had blood pressure readings consistently and significantly lower than the usual exam table option. The chair position is recommended by the American Heart Association (AHA) Guidelines for Blood Pressure Assessment and the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7).

[ILLUSTRATION OMITTED]

Turner tested 100 patients (male and female) visiting an ambulatory cardiology clinic, comparing the exam table readings with those taken from a chair the proper way. Systolic pressure readings taken in timed intervals in the chair ranged an average of 12.5% to 14.2% lower than the table. Diastolic readings were 4.4% to 7.6% lower. During the study, researchers discovered the majority of staff were unaware of the JNC-7 and AHA recommendations, many saying that they were never trained on the chair position technique. Recognizing the importance of the findings, the authors quickly disseminated the results in newsletters and reports and at meetings. Requests from other facilities on how to implement the findings are flowing in as providers hear the news, and Turner adds that nurses have a key role as front-line providers in ensuring proper techniques.

For more information, see Turner, T., et al. (2008). Measuring blood pressure accurately in an ambulatory cardiology clinic setting: Do patient position and timing really matter? MEDSURG Nursing, 17(2), 93-98.

Daniel B. Burfeind, RN, DNC, is a Staff Nurse, Mohs Department, Panzer Dermatology, Neward, DE; and a Dermatology Nursing Editorial Board Member.