title: Barriers to referral for elevated blood pressure in the emergency department and differences between provider type.
abstract: A multidisciplinary sample of emergency department providers across the United States (n=450) were surveyed to identify barriers to referral for elevated blood pressure (BP) in the emergency department and differences between provider type. Registered nurses reported less knowledge of stage I hypertension (P=.043) and prehypertension (P<.01); were less aware of definitions for hypertension (P<.001); reported more difficulty in caring for patients who are asymptomatic (P=.007); required financial compensation to refer (P=.048); and perceived that BP referrals are influenced by the medical director (P<.001). Medical doctors reported more skills to refer (P=.008) and time as a barrier (P=.038). Physician assistants were more likely to report patients are not aware of health benefits (P=.035), doubted their concern for their BP (P=.023), and felt emotionally uncomfortable when referring (P=.025). Despite these differences, there was no significant difference between provider type and referral rates.
authors.affiliation: Mount Sinai Medical Center, New York, NY; New York University College of Nursing, New York, NY.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Souffront
authors.forename: Deborah
authors.initials: D
authors.lastname: Chyun
authors.forename: Christine
authors.initials: C
authors.lastname: Kovner
mesh_terms: D003144:Communication Barriers; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D009726:Nurses; D010823:Physician Assistants; D010820:Physicians; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014481:United States