Policy Manual sample

MDT Home Health Care Agency, Inc. In general, home blood pressure cuffs would not be provided to: 1. An individual patient more than twice without return of the original device. 2. For patients who do not fill their prescriptions for antihypertensive medications. Blood Pressure Measurement. 1 Blood pressure should be measured only by staff that have received training and met the required level of competence. 2 Preferred method of blood pressure measurement is the auscultation method. 3 Automated devices should be used only: i. In patients when it is difficult to obtain auscultation. ii. When frequent measurements and trends are required iii. When elevated blood pressure measurement is obtained by automated device should be repeated by auscultation. • automated devices measure mean arterial blood pressure • blood pressure percentile charts have been created by the auscultation method, individual automated devices do not have any percentile charts for reference 4 Doppler may be used with aneroid sphygmomanometer in infants to obtain systolic blood pressure. 5 The equipment to be used should be assembled prior to measurement and assessed for any faults. 6 The correct size cuff should be selected and used consistently. 7 The patient should ideally be sat up with right (preferably) arm abducted to heart level and supported. 8 Initial assessment should include blood pressure measurement in both arms to ascertain differences. 9 Blood pressure measurement reading should be documented immediately. 4. Equality and Diversity. The Agency is committed to an environment that promotes equality and embraces diversity both within our workforce and in patient service delivery. This policy (procedure/guidance) should be implemented with due regard to Employment and Religious Belief equality rights. Equipment 1. The Cuff. 1.1 The cuff length should cover 80% of the upper arm or limb being used. A cuff too small will indicate a higher blood pressure, a cuff too large may indicate a lower blood pressure but larger cuff is preferable to smaller cuff. 1.2 If using a cuff with an inner bladder, the bladder should be contained within the outer cuff. a. It is the bladder size that should cover 80% of arm, not the outer cuff. 1.3 The rubber tubing should be intact. Damage in the form of cracks or breaks in the rubber tubing indicate the cuff should be replaced. 1.4 Rubber tubing should not be cut or altered in length. 1.5 The Velcro fasting should grip effectively or the cuff should be replaced. 1.6 The cuff should be clean. 2. The Aneroid Sphygmomanometer. 2.1 The sphygmomanometer should be clean. 2.2 The dial needle should be central within the 0 prior to commencing measurement. 2.3 Ensure the connection valve connecting the cuff is tightly secure. Home Health Agency Nursing Care & Procedures K-173