Current Chinese nursing students give more accurate manual blood pressure readings than their professional peers can. But noise levels don’t influence those numbers.
A group of Asian researchers tried to determine whether practiced professionals or students produced more accurate blood pressure readings. Also, the researchers looked at whether a quiet or a noisy setting would provide another variable by which to measure the practitioners’ results using manual, auscultatory blood pressure (BP) readings.
This gold-standard measurement is defined as one in which a listening device such as a stethoscope is utilized. The researchers did not include any automatic BP-measuring devices in their study.
Medical research has shown that BP incidents affect more than 40% of people worldwide. Thus, healthcare professionals recommend regular readings of both systolic blood pressure (SBP) and diastolic (DBP) as preventive steps for early diagnosis and treatment of hypertension.
The current study, published in Clinical methods and pathophysiology, involved a 20-person population. The researchers divided participants into four groups, each with five people. One group consisted of nurses, ages 35-45 years, with 10 or more years of experience; the second group of nurses had practiced between one and nine years and were between 25-34 years old; group 3 was composed of 20- and 21-year-old students studying for a nursing bachelor’s degree at Sichuan University. Individuals aged 20-60 without prior medical experience, who were trained in BP reading procedures, formed the fourth group.
Each participant’s hearing was tested to ensure normal acuity. In addition, the same computer and same audio listening device were utilized as part of the blood-pressure readings.
The researchers collected 32 videos of SBP and DBP blood-pressure-reading sounds. Each BP reading is associated with a visible rise and fall of the substance in the blood-pressure cuff and has a corresponding sound. Each participant was trained in this process and logged the readings for each blood processes.
All measurements were further analyzed by participants within each of the four groups.
During testing, each participant performed an auscultatory BP reading on his respective patient in a quiet environment, and in a noisier one, such as normally found around a nursing station. Each tester conducted this test in the two locales on two separate days to generate four readings for each patient.
Records showed no “statistically significant” recordings of BP-readings between quiet or noisy environments over the two days of measurements that any of four groups’ participants recorded — a finding never before documented.
Every group participant generated mostly similar DBP data, with the nurses with 1-9 years of experience slightly lagging those in the other three groups. However, when it came to SBP readings, the numbers differed among the groups.
The findings revealed the nursing students provided the most accurate auscultatory BP readings for both SBP and DBP.
Not surprisingly, the non-medically trained group produced the worse SBP readings. When it came to the remaining two groups of nurses, those practicing less than a decade recorded SBP readings that were less accurate than those of their peers.
Researchers concluded their study’s strengths demonstrate the fact noise levels don’t really affect BP readings – a first. A strength of the research findings included the demonstration that nursing students, who adhere to established Chinese BP measuring standards, produce a highly accurate reading.
Researchers recommended that practicing nurses should periodically undergo refresher training to sharpen skills, such as taking BP readings. Further, they suggested that internationally established BP measurement standards and protocols, along with training materials, ought to be adopted in China.
Potential study limitations come from the fact that more experienced nurses may have worked on the managerial side of the profession and hence experienced a dulling in their everyday skills from lack of practice. Also, this study included nurses and nursing students only and did not compare them with doctors or medical students in a similar situation. In addition, the study group admitted the fact the small participant group may have prevented wider measurement discrepancies.
Written By: Susan Mercer Hinrichs, MA, MBA, CPhT