How to take and record a manual blood pressure measurement

RATIONALE AND KEY POINTS: Accurate measurement of a patient's blood pressure (BP) is essential to identify hypotension or hypertension and to inform subsequent management and treatment decisions. The auscultatory, or manual, method remains the gold standard for non-invasive BP measurement, so it is vital that nurses are able to undertake this procedure accurately. This article explains how to take and record a manual BP measurement using an aneroid sphygmomanometer and a stethoscope. Nurses and nursing students undertaking this procedure must be equipped with the knowledge and skills to do so proficiently and work within their scope of practice. • BP measurement comprises two pressure readings, systolic and diastolic, which are measured in millimetres of mercury (mmHg) and expressed in documentation as a 'fraction'. • Inaccurate BP measurement, whether overestimation or underestimation, can result in diagnostic errors and incorrect risk assessment and decision-making. • Various factors can influence the accuracy of BP measurement, including patient positioning, cuff size, arm position and correct use of the stethoscope. • It is vital to ensure regular maintenance and recalibration of BP measuring equipment, in accordance with the manufacturer's instructions, to ensure accuracy of readings. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when taking a manual BP measurement. • How you could use this information to educate nursing students or your colleagues on the appropriate steps when taking and recording a manual BP measurement.