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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Family Practice 1/2018

Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement

Zeitschrift:
BMC Family Practice > Ausgabe 1/2018
Autoren:
Lauren Block, Sarah J. Flynn, Lisa A. Cooper, Caroline Lentz, Tammie Hull, Katherine B. Dietz, Romsai T. Boonyasai
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12875-017-0682-5) contains supplementary material, which is available to authorized users.

Abstract

Background

The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program.

Methods

Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement. A 20-question pre- and post-intervention survey addressed learners’ knowledge and attitudes. Direct observation of blood pressure measurement technique before and after the intervention was performed. Differences in responses to pre- and post-module knowledge and attitudes questions and in observation data were analyzed using chi-square tests and simple logistic regression.

Results

All 88 clinical staff members participated in the program and completed the evaluation survey. Participants answered 80.6% of questions correctly before the module and 93.4% afterwards (p < 0.01). Scores improved significantly among staff from all job types. Licensed practical nurses and staff who had been in their current job at least a year were more likely to answer questions correctly than registered nurses and those in their current job less than a year. Attitudes toward correct blood pressure measurement were high at baseline and did not improve significantly. Prior to the intervention, staff adhered to 9 of 18 elements of the recommended technique during at least 90% of observations. Following the program, staff was more likely to explain the protocol, provide a rest period, measure an average blood pressure, and record the average blood pressure, but less likely to measure blood pressure with the arm at heart level and use the right arm.

Conclusions

We designed, implemented, and evaluated a web-based educational program to improve knowledge, skills, and attitudes in blood pressure measurement and use of an automated device among nurses and medical assistants in ambulatory care. The program reinforced knowledge related to recommended blood pressure measurement technique.

Trial registration

Retrospectively registered with ClincalTrials.​gov on March 22, 2012; registration number NCT01566864.
Zusatzmaterial
Additional file 1: Pre- and post-intervention surveys are the questionnaires used to assess knowledge and attitudes of clinical staff before and following completion of the continuing education program. (DOCX 3714 kb)
12875_2017_682_MOESM1_ESM.docx
Additional file 2: Observation Form is the form used by RAs to record demographic information and observations about blood pressure measurement during the intake process. (DOCX 17 kb)
12875_2017_682_MOESM2_ESM.docx
Additional file 3: Knowledge assessment data is the deidentified dataset containing the results of our pre- and post-module knowledge assessment. (XLS 441 kb)
12875_2017_682_MOESM3_ESM.xls
Literatur
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