title: Nurse-driven training courses: impact on implementation of ambulatory blood pressure monitoring.
abstract: BACKGROUND
  Ambulatory blood pressure monitoring (ABPM) predicts cardiovascular risk and identifies white-coat and masked hypertension, efficacy of treatment and the circadian cycle of hypertensive patients.
  
  
  OBJECTIVE
  To analyze the effectiveness of ABPM implementation thoughtout a nurse-driven training program.
  
  
  METHODS
  Twenty eight professionals were involved in the study carried out in the primary care center of the metropolitan area of Barcelona that serves 34,289 inhabitants. The ABPM implementation program was driven by two nurses that held four education sessions. After a 2-year follow-up period, we assessed the outcome of attendance at the educational sessions. First, we evaluated whether the program increased the number of orders of ABPM. Second, we used a survey to evaluate to what extent the input of our educational sessions was understood by attendants. Third, we analyzed the effect ABPM results had on the treatment of patients with a bad control of their hypertension.
  
  
  RESULTS
  After the training sessions we found a 6-fold increase in the number of patients undergoing ABPM. We analyzed 204 hypertensive individuals: 41% dippers, 34% were non-dippers, 20% were risers and 5% were extremely dippers. According to our survey, 100% of attendants had a good practice regarding ABPM management. However only 27% of riser patients were studied with a second ABPM.
  
  
  CONCLUSIONS
  Specific training processes are needed for implementation of ABPM and an even more concentrated effort should be focused on training in the correct interpretation of ABPM results.
authors.affiliation: ABS Canaletes, Institut Català de la Salut. Cerdanyola del Vallès and Barcelona ; ABS Guinardó, Institut Català de la Salut. Cerdanyola del Vallès and Barcelona.
authors.forename: Estel
authors.initials: E
authors.lastname: Félez-Carrobé
authors.forename: Maria
authors.initials: M
authors.lastname: Sagarra-Tió
authors.forename: Araceli
authors.initials: A
authors.lastname: Romero
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rubio
authors.forename: Lourdes
authors.initials: L
authors.lastname: Planas
authors.forename: María José
authors.initials: MJ
authors.lastname: Pérez-Lucena
authors.forename: Montserrat
authors.initials: M
authors.lastname: Baiget
authors.forename: Cristina
authors.initials: C
authors.lastname: Cabistañ
authors.forename: Jordi
authors.initials: J
authors.lastname: Félez
keywords: Ambulatory; blood pressure; cardiovascular morbidity; educational program; essential hypertension; primary care.