Objective: Accurate and reliable blood pressure (BP) measurement is important for the prevention and treatment of hypertension. The oscillometric-based automatic office blood pressure measurement (AOBPM) is widely used in hospitals and clinics, but measurement errors are common in BP measurements. There is a lack of systematic review of the sources of measurement errors. Approach: A systematic review of all existing research on sources of AOBPM errors. A search strategy was designed in six online databases, and all the literature published before October 2021 was selected. Those studies that used the AOBPM device to measure BP from the upper arm of subjects were included. Main results: A total of 1365 studies were screened, and 224 studies were included in this final review. They investigated 22 common error sources with clinical AOBPM. Regarding the causes of BP errors, this review divided them into the following categories: the activities before measurement, patient’s factors, measurement environment, measurement procedure, and device settings. 13 sources caused increased systolic and diastolic BP (SBP and DBP), 2 sources caused the decrease in SBP and DBP, only 1 source had no significant effect on BPs, and the other errors had a non-uniform effect (either increase or decrease in BPs). The error ranges for SBP and DBP were −14 to 33 mmHg and −6 to 19 mmHg, respectively. Significance: The measurement accuracy of AOBPM is susceptible to the influence of measurement factors. Interpreting BP readings need to be treated with caution in clinical measurements. This review made comprehensive evidence for the need for standardized BP measurements and provided guidance for clinical practitioners when measuring BP with AOBPM devices.

Sources of automatic office blood pressure measurement error: a systematic review

The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the Ch...

Orthostatic Hypotension and Falls in Hospitalized Older Adults.

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Purpose: To determine the nursing staff's knowledge of the proper procedure for measuring orthostatic vital signs. Methods: The Knowledge of Orthostatic Vital Signs Survey was sent via email to direct staff on 31 patient-care units in a large hospital system. Results: Eighty percent of the participants were RNs and 12% were unlicensed assistants. Survey results showed that many respondents did not know how to properly size the cuff and were uncertain about the timing of measurements with position changes. Fifty-seven percent of respondents did not correctly identify abnormal findings with regard to the systolic BP, but 80% were aware of the diastolic BP drop in orthostatic hypotension. Conclusion: This survey identified gaps in the staff's knowledge about the proper procedure for measuring orthostatic vital signs. 

Staff knowledge of orthostatic vital signs measurement

Abstract Purpose: To determine the nursing staff's knowledge of the proper procedure for measuring orthostatic vital signs. Methods: The Knowledge of Orthostatic Vital Signs Survey was sent via email to direct staff on 31 patient-care units in a large hospital system. Results: Eighty percent of the participants were RNs and 12% were unlicensed assistants. Survey results showed that many respondents did not know how to properly size the cuff and were uncertain about the timing of measurements with position changes. Fifty-seven percent of respondents did not correctly identify abnormal findings with regard to the systolic BP, but 80% were aware of the diastolic BP drop in orthostatic hypotension. Conclusion: This survey identified gaps in the staff's knowledge about the proper procedure for measuring orthostatic vital signs.

Measuring lying and standing blood pressure (BP) is an important clinical observation in older hospital inpatients. This is because a drop in BP on standing, known as orthostatic hypotension (OH) is common in older people and in acute illness and, therefore, in hospital patients. OH increases the risk of a fall in hospital. Simple measures such as changes in medication or rehydration can reduce this drop in BP and reduce the risk of falls. In a recent snapshot audit in England and Wales of 179 acute hospitals and 4,846 patients aged 65 years and over admitted with an acute illness, only 16% had a lying and standing BP recorded within 48 hours. A review of the literature showed that existing advice on how to measure and interpret lying and standing BP was often not appropriate for use on the ward with frail and unwell inpatients. An online survey of 275 clinicians' usual practice highlighted variation and the need for clarity and pragmatism. In the light of the survey findings, a clinical guide has been developed on when to measure lying and standing BP, how to measure it and what is considered a significant result.

Measurement of lying and standing blood pressure in hospital.

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Measurement of lying and standing blood pressure in hospital.