Measurement of lying and standing blood pressure: A brief guide for clinical staff

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The lying and standing blood pressure measurement guide has been designed to assist clinical teams in standardising their approach to falls prevention in hospitals.

A drop in blood pressure (BP) on standing (orthostatic hypotension – OH ) is a common occurrence in acutely unwell hospitalised patients and is a risk factor for falls. In the NAIF 2015 audit only 16% of the sample of 4846 patients had a lying and standing BP recorded by their third hospital day.

The aim of this work was to review current clinical practice in measuring lying and standing BP among clinicians involved in falls risk assessment.

An online survey was sent out to elderly care clinicians. This survey focused on the specifics and interpretation of lying and standing BP recordings in hospital and gave defined responses for each question.

Of 316 responders, 271 clinicians routinely performed these measurements. There was significant variation in time spent supine prior to BP recording, time standing prior to first and second measurements, the device used, and interpretation of results.

This variation likely affects rates of detection and rates of appropriate clinical responses relevant to falls prevention. These results suggest a need for dissemination of clear guidance in order to increase attention to and consistent assessment for OH.

The lying and standing blood pressure measurement guide has been designed to assist clinical teams in standardising their approach to falls prevention in hospitals. Inpatient falls can cause serious injury and are an unnecessary cost to the NHS.

There is also a lanyard guide to be used as an checklist to assist clinical staff in the process of measuring a patients lying and standing blood pressure and identifying abnormalities. A more comprehensive guide is available to download below.

Contact falls@rcplondon.ac.uk for more information.