title: Quality of blood pressure measurement in community health centres.
abstract: OBJECTIVE
  To determine the quality of the blood pressure measurements performed during routine care in community health centres.
  
  
  METHODS
  An observational, cross-sectional study was conducted in 5 private and public health centres in Maldonado, Uruguay, in July-August 2015. The observations were made during the measurements performed by health personnel, using the requirements established by the American Heart Association. An analysis was made on 36 variables that were grouped in categories related to environment, equipment, interrogation, patient, and observer. Statistical analysis was performed using Chi2test or Fisher test. Statistical significance was considered to be less than 5% (p<.05).
  
  
  RESULTS
  The measurements were made by a registered nurse or nurse in 71% of cases, physician in 20%, and student nurse in 9%. An aneroid sphygmomanometer was used in 89%, and mercury 11%. Satisfactory results were found in variables related to environment (93%), equipment (99%), and patient attitude (82%), and intermediate in the attitudes of the operator (64%), and poor in relation to the interrogation (18%), with the mean of correct variables per measurement being 69%.
  
  
  CONCLUSIONS
  The main flaws in the procedure were the operator. The measurement of blood pressure is a manoeuvre that healthcare professionals perform thousands of times a year. If the measurement is used for the diagnosis and/or chronic management of arterial hypertension, not systematically applying the established recommendations leads to an inappropriate care of a very significant number of patients.
authors.affiliation: Facultad de Medicina, Instituto Universitario CLAEH , Maldonado, Uruguay; Facultad de Enfermería y Tecnologías de la Salud, Universidad Católica del Uruguay , Montevideo, Uruguay.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Sandoya-Olivera
authors.affiliation: Instituto de Bienestar y Salud, Universidad Católica del Uruguay , Montevideo, Uruguay; Facultad de Enfermería y Tecnologías de la Salud, Universidad Católica del Uruguay , Montevideo, Uruguay. Electronic address: auferrei@ucu.edu.uy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Ferreira-Umpiérrez
authors.affiliation: Facultad de Medicina, Instituto Universitario CLAEH , Maldonado, Uruguay; Asistencial Médica Departamental de Maldonado , Maldonado, Uruguay.
authors.forename: Federico
authors.initials: F
authors.lastname: Machado-González
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001795:Blood Pressure Determination / Q000592:standards*; D003151:Community Health Centers; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D014583:Uruguay; D055815:Young Adult
keywords: Ambulatory blood pressure monitoring; Atención Primaria de salud; Calidad de la atención de salud; Hipertensión; Hypertension; Medida de la presión arterial; Primary health care; Quality of health care