四川省基层医疗机构全科护士血压测量规范性调查

Investigation on the standardization of blood pressure measurement of general nurses in primary medical institutions in Sichuan Province

目的了解四川省基层医疗机构血压计配置及其全科护士血压计和测量方法使用规范性。方法于2018年8月26日—10月21日采用方便抽样,利用自制问卷调查全科护士所在机构血压计配置及其用于高血压患者筛查、诊断、随访的血压计和测量方法。结果有效问卷258份。水银柱血压计、电子血压计和动态血压监测仪配置率分别为97.3%、96.5%和34.5%。高血压患者筛查时,68.2%的全科护士最常使用电子血压计,其中,50.6%最常使用的是腕式电子血压计;使用水银柱血压计和动态血压监测仪的占比分别为31.4%和0.4%。为确诊高血压患者,水银柱血压计、电子血压计和动态血压监测仪使用率分别为67.1%、24.8%、8.1%。高血压患者随访管理时,上述3种血压计使用率分别为62.4%、36.8%和0.8%。高血压患者筛查时,90.3%的全科护士最常选择诊室血压测量,其次是动态血压监测(5.4%)和家庭血压监测(4.3%)。在确诊和随访高血压患者时,上述3种血压测量方法使用率分别为81.0%、16.7%、2.3%和68.6%、2.7%、28.7%。结论四川省基层医疗机构水银柱血压计和电子血压计配置率高,动态血压监测仪配备较少。全科护士血压测量欠规范,上臂式电子血压计及动态血压监测仪的使用亟须推广,诊室外血压测量急需重视。

Objective To understand the configuration of sphygmomanometer in primary medical institutions of Sichuan province and the standardization of sphygmomanometer and measurement methods used by general nurses.Methods Convenient sampling was adopted and self-made questionnaire was used to investigate the configuration of sphygmomanom-eters in general nurses'organizations and the sphygmomanometers and measurement methods for screening,diagnosis and follow-up of patients with hypertension.Results A total of 258 valid responses were received.The allocation rate of mercury column sphygmomanometer,electronic sphygmomanometer and ambulatory blood pressure monitor were 97.3%,96.5%and 34.5%respectively.When screening patients with hypertension,68.2%of the general nurses used elec-tronic sphygmomanometer,of which 50.6%used wrist electronic sphygmomanometers,and the utilization rate of mercury column sphygmomanometer and ambulate blood pressure monitor accounted for 31.4%and 0.4%respectively.When di-agnosis people with hypertension,the utilization rate of mercury column sphygmomanometer,electronic sphygmomanome-ter and ambulate blood pressure monitor were 67.1%,24.8%and 8.1%respectively.In the follow-up management of hypertensive patients,the above three types of sphygmomanometer utilization rate were 36.8%,62.4%and 0.8%re-spectively.When screening patients with hypertension,90.3%of general nurses chose office blood pressure measure,followed by ambulatory blood pressure measurement(5.4%)and home blood pressure measurement(4.3%).When di-agnosis and follow-up people with hypertension,the above three blood pressure measure accounted for 81.0%,16.7%,2.3%and 68.6%,2.7%,28.7%,respectively.Conclusion The ratio of mercury sphygmomanometer and electronic sphygmomanometer in primary medical institutions in Sichuan province is high and the ambulatory blood pressure monitor is less.The blood pressure measurement of general nurses is not standardized,the use of electronic sphygmomanometer and ambulatory blood pressure monitor needs to be popularized,and the method of blood pressure measurements outside consulting room should be paid great attention.