An observational study of student nurses' measurement of arterial blood pressure by sphygmomanometry and auscultation.

An observational study was conducted looking at blood pressure measurement, in a mock-clinical situation, by Project 2000 students nearing the end of their Common Foundation Programme. The observation schedule looked for compliance with published guidelines for blood pressure determination. The results indicate little compliance with guidelines. Only 6% of the students allowed the subject to rest for at least 5 minutes before taking the blood pressure and no students checked for extraneous variables such as recent eating or smoking which might affect blood pressure. Cuff placement was generally accurate but the arm was usually held straight and nearly one-third of the students left the arm unsupported. In 44% of the observations, the arm was above or below heart level. Only 5 students obtained an estimate of systolic pressure by palpation before using the stethoscope. A clear terminal digit zero preference was evident in the recorded readings and 16% ended in an odd number. These results suggest that preparing students to be 'knowledgeable doers' in relation to blood pressure measurement may require more detailed preparation and supervised practice in the necessary techniques.