Cardiovascular Journal of Africa • SAHS Biennial Congress 2024 25 AFRICA Submission ID: 1625 Introduction The reported prevalence of hypertension varies across studies. A diagnosis or “labelling” of hypertension may result in psychological distress, increased costs and increased work absenteeism. Similarly, a wrongly diagnosed “high” blood pressure also has several negative effects. It is therefore vital to ensure that procedural recommendations are adhered to during the measurement of blood pressure, especially by health care practitioners. A quality improvement project was therefore developed to assess and improve procedural adherence to the 2014 South African Hypertension Society (SASH) guideline for BP measurement at a District hospital in South Africa. Methods A Quality Improvement Plan design was implemented to achieve the study objectives. The study was conducted between February 2020 and August 2020. It was divided into 3 phases; a pre-intervention assessment, an intervention and a post-intervention assessment. In phase 1 and 3, nurses in two wards and the triage unit of a District hospital in Ekurhuleni Health District were observed, each measuring the blood pressure of three patients. Phase 2 was an intervention. A checklist was developed, using the indicators recommended by the 2014 Southern African Hypertension Society guideline for blood pressure measurement, to observe the nurses. The checklist was valid and reliable (Cohen’s kappa: 0.77). Analysis was done using Microsoft Excel and Stata 14. The proportion of nurses adhering to all steps for blood pressure measurement was calculated in Phase 1 and 3. Procedures adherent to all indicators were considered “Acceptable”, while those adherent to some steps were considered “Unacceptable”. The proportion adherent to each indicator was also calculated for phase 1 and 3. Reasons for inadequate procedural adherence was also elicited in phase 1. Ethical approvals were obtained from the Human Research Ethics Committee of the University of the Witwatersrand and the Ekurhuleni Research Ethics Committee. Results Thirty-seven nurses, equally observed 111 times, were recruited to participate in the study. The mean age of participants was 38 years. Thirty-five were female, and 11 were Registered nurses, 20 were Enrolled nurses and 6 were Auxiliary nurses. Some reasons for inadequate adherence to BP measurement procedure were knowledge deficit, staff shortage and uncooperative patients. No nurse adhered to all recommended steps for BP measurement in Phase 1. After a training intervention, 25% of nurses were adherent to all steps recommended for BP measurement in phase 3. Finally, the last calibration date of all the sphygmomanometers used were unknown. Conclusion The study revealed that the level of adherence to the steps of BP measurement, as recommended by the Southern African Hypertension Society 2014 guideline, may be very low. This has implications for the diagnosis and management of hypertension. The study further suggest that an educational intervention may be effective in improving the procedural adherence to the recommended steps for BP measurement. Name: Presenting Author Information Article Category Abstract Title UNIVERSITY OF LIMPOPO edetaniekan@outlook.com English Abstract Researchers/Clinicians - Early, mid & senior career ASSESSING AND IMPROVING ADHERENCE TO BLOOD PRESSURE MEASUREMENT GUIDELINES BY NURSES AT A DISTRICT HOSPITAL IN GAUTENG PROVINCE, SOUTH AFRICA Author Affiliation: Email: DR ANIEKAN EDET Science Theme Clinical Authors Name & Surname Title Expertise Affiliation Email Country EDET, ANIEKAN DR FAMILY MEDICINE UNIVERSITY OF LIMPOPO edetaniekan@outlook.com SOUTH AFRICA AMODU. AFOLAKE DR FAMILY MEDICINE UNIVERSITY OF THE WITWATERSRAND flakypee@yahoo.com SOUTH AFRICA EDET, NWABISA NANCY MRS NURSING UNIVERSITY OF VENDA nkadimengnwabisa@gmail.com SOUTH AFRICA POSTER PRESENTATION
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