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Jake R Gibbon, The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK Search for other works by this author on: Steve W Parry,The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK Population Health Science Institute , Newcastle University, Newcastle upon Tyne NE2 4AX, UK Search for other works by this author on: Miles D Witham,The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK AGE Research Group , NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK Search for other works by this author on: Alison Yarnall,The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK Brain and Movement Research Group , Translational and Clinical Research Institute, Clinical Ageing Research Unit, Newcastle University, Newcastle upon Tyne, UK Search for other works by this author on: James FrithThe Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK Population Health Science Institute , Newcastle University, Newcastle upon Tyne NE2 4AX, UK Search for other works by this author on: Received: 12 January 2022 Revision requested: 11 May 2022
Close Navbar Search Filter Microsite Search Term Search AbstractBackground A postural blood pressure assessment is required to diagnose Orthostatic Hypotension. With increasing remote consultations, alternative methods of performing postural blood pressure assessment are required. Objective Determine whether postural blood pressure measurement at home, without a clinician, is reliable, feasible and safe. Design Service improvement project within a falls and syncope service in Northeast England. Subjects Eligibility criteria: aged ≥60 years; postural blood pressure measurement is indicated and is physically and cognitively able to perform. Exclusion criteria: nursing home residents, attending clinic in person. Methods Postural blood pressure measurements were performed in patients’ homes under clinical observation. Patient-led assessments were performed independent of the clinician, following written guidance. This was followed by a clinical-led assessment after 10-minute supine rest. Outcomes Agreement between patient and clinician derived postural blood pressure values and diagnosis of Orthostatic Hypotension; intervention safety, feasibility and acceptability. Results Twenty-eight patients were eligible and 25 participated (mean age 75, median Clinical Frailty Score five). There was 95% agreement (Cohen’s kappa 0.90 (0.70, 1.00)) between patient and clinician derived readings to diagnose orthostatic hypotension. Postural systolic blood pressure drop correlated strongly (r = 0.80), with patient derived readings overestimating by 1 (−6, 3) mmHg. Limits of agreement, determined via Bland Altman analysis, were +17 and −20 mmHg, greater than pre-determined maximum clinically important difference (±5 mmHg). Twenty participants performed valid postural blood pressure assessments without clinical assistance. Conclusions Patient-led postural blood pressure assessment at home is a reliable, safe and acceptable method for diagnosing Orthostatic Hypotension. © Crown copyright 2022. This Open Access article contains public sector information licensed under the Open Government Licence v3.0 (http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/). You do not currently have access to this article. I agree to the terms and conditions. You must accept the terms and conditions. Submit a comment Name Affiliations Comment title Comment You have entered an invalid code Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email. Personal account
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Signed in but can't access contentOxford Academic is home to a wide variety of products. The institutional subscription may not cover the content that you are trying to access. If you believe you should have access to that content, please contact your librarian. Institutional account managementFor librarians and administrators, your personal account also provides access to institutional account management. Here you will find options to view and activate subscriptions, manage institutional settings and access options, access usage statistics, and more. PurchaseShort-term AccessTo purchase short-term access, please sign in to your personal account above. Don't already have a personal account? Register Feasibility, reliability and safety of self-assessed orthostatic blood pressure at home - 24 Hours access EUR €41.00 GBP £32.00 USD $52.00 RentalThis article is also available for rental through DeepDyve. What is the nurse's priority intervention for a patient with orthostatic hypotension?Instruct the patient to change from a supine/ sitting to a standing position slowly. Orthostatic hypotension occurs when blood pressure drops when standing, decreasing blood supply to the brain. This can increase the risk of falling or fainting and can be avoided by changing positions slowly.
What is the initial step in assessing a patient for orthostatic hypotension?The initial assessment should include BP and heart rate measurement when the patient has been supine for at least 5 minutes and ideally at both 1 and 3 minutes of standing.
Which symptom should prompt an assessment for postural hypotension?A drop of 20 millimeters of mercury (mm Hg) in the top number (systolic blood pressure) within 2 to 5 minutes of standing is a sign of orthostatic hypotension. A drop of 10 mm Hg in the bottom number (diastolic blood pressure) within 2 to 5 minutes of standing also indicates orthostatic hypotension.
How should the nurse assess for orthostatic hypotension quizlet?The nurse recognizes the need to assess for orthostatic hypotension. How should the nurse perform this assessment? Measure the client's heart rate and blood pressure while supine then within 3 minutes of standing.
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In which order will the nurse perform an assessment of an older patient for postural hypotension
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