Abstract
Introduction:
Orthostatic hypotension (OH) is common in geriatric inpatients and associated with an increased risk of falls, fractures, reduced quality of life and death. Therefore, recognizing OH early is important in prevention of this associated morbidity and mortality. A lying and standing blood pressure (LSBP) measurement is required for the diagnosis of OH and guidelines advice LSBP measurement in patients 65 years and older.
Aim:
This Quality Improvement Project aimed to improve rates of LSBP measurement on all geriatric inpatients during their current admission. To carry this out we extracted data from the electronic observation system (e-Obs), calculated the proportion of patients with LSBP recorded and date of first recording during their current admission.
Results:
Our results show that 24% of geriatric patients had a LSBP taken during their current admission and the average day of first LSBP recording was day 7 of admission.
Intervention:
To prompt staff to record L&SBP we created admission stickers with prompts for LSBP measurement which were disseminated to staff and placed on wards for easy access. Re-evaluation of this intervention after 4 months indicated an increase in recording of LSBP to 48% and a decrease in mean day of first L/SBP recording from day 7 to day 2. The rates of L/SBP may be underestimated due to the use of paper-based records alongside e-Obs.
Conclusion
In conclusion an increase in the recording of LSBP was noted following implementation of the admission stickers. Future interventions should focus on increasing the use of the electronic observation system to further increase the number of patients with L/SBP recorded.