Development of a blood pressure education programme with supporting assessment and clinical guidance.
This example was originally submitted to demonstrate implementation of NICE guideline CG127. The guideline has now been updated and replaced by NG136. The example has been reviewed and practice it describes remains consistent with the updated guidance.
Aims and objectives
To support the implementation of the NICE hypertension clinical management guidance through education, standarising operating procedures & governance. To provide competancy based blood pressure guidelines and training to support clinical practice and ensure all staff are competent and equipment managed in line with guidance.
Reasons for implementing your project
Through various conversations, meetings & observation it became apparent there was an ad hoc service delivery in blood pressure taking & management within Heywood, Middleton & Rochdale community services. This was resulting in inappropriate referrals to General Practice and incorrect blood pressure taking. An audit was carried out of services taking electronic blood pressure measurement to ascertain training received, training needed and interpretation/understanding of results. The results highlighted a staggering need for basic accurate training on taking blood pressure, for qualified & unqualified staff. Also identified, updates needed for already trained staff. Education sessions around hypertension and interpretation of results. An organisational risk assessment was carried out to identify actions needed. This identified standardised training needed with a designated clinical lead, audit & monitoring.
How did you implement the project
A clinical lead (Jill Ridley Vascular Lead nurse) was identified to lead the work. A clinical guideline for taking & recording blood pressure was developed & ratified via the professional practice council of the organisation. A supporting educational programme was developed to run along side implementation of the guideline. Operational managers were asked to identify link BP trainers to support role out of education & assessment sessions throughout teams. Training sessions were set up to educate link trainers with supporting literature, guidance, quizezs to assess learning needs, assessment forms for competence & also incorporating how to take a pulse training. No direct costs incurred, supported by each service via the trainers. Main cost was time allocated to the clinical lead. There was excellent update from link trainers, with further staff coming on board via word of mouth & services seeing the benefit of training. We have a prison supported by the organisation & they came on board for training for their healthcare staff.
Standarisation of training throughout the organisation. Availability for ongoing training via hypertension sessions, full study days, short update sessions & distance learning. Audit. Feedback from link trainers & healthcare professionals was asked for & results acted upon. (Results attached as supporting material). Observation of staff. Standardisation of electronic systems throughout the organisation as per British Hypertension Society guidance. Annual assesssment of competence for unqualified staff, e.g. health trainers carried out by the clinical lead. This resulted in improved patient care & reduced referrals into General Practice. The clinical lead also acts as a reference & clinical resource for staff.
Key learning points
Maintenance of a link trainer database is vital, to monitor staff leaving & retraining of new trainers. An annual update session for link trainers is run with regular email contacts throughout the year. Training is repeated as new staff are identified. Good links with operational managers & other clinical leads essential to continue to deliver the work. Two other nurses have since been trained to assist in the assessment of non clinical staff & provide coverage & support for the clinical lead.