MSc (Nursing), Faculty of Health Sciences, University of the Witwatersrand / The purpose of the study was to describe and compare the limits of agreement between
invasive blood pressure (IBP) and non-invasive blood pressure (NIBP) readings obtained
on patients in the adult critical care units (CCU) of a tertiary health care institution, to
describe the factors that affect accuracy of both techniques, to describe the difference in
terms of accuracy and sensitivity and the reasons given by the clinical practitioners for
their choice of blood pressure measurement technique.
A non-experimental descriptive comparative, prospective design was utilized in this two
part study. The sample comprised of CCU patients (n = 80) in five adult critical care units
over a 3-month period. Non-probability purposive sampling was utilized to obtain the
desired sample in part one of the study. Data collection was via IBP and NIBP
measurements obtained by the researcher and a record review of the patient’s critical care
charts. Part two of the study comprised of clinical practitioners (n=50) and convenience
sampling method was utilized. Descriptive and inferential statistics were used to analyse
data.
At the 95% confidence interval, the limits of agreements were found to be in range of ± 35
mmhg of IBP and NIBP systolic, ± 19.5 mmHg of IBP and NIBP diastolic and ±19.3
mmhg IBP and NIBP of mean arterial pressure. In practical terms this means that IBP and
NIBP can not be used interchangeably in CCUs as the two methods did not consistently
provide similar measurements because there was a high level of disagreement that included
clinically important discrepancy of more than 10 mmhg which is the cut off acceptable
reference in terms of discrepancy between the two BP techniques and add to the growing
literature suggesting that IBP remains the gold standard technique for measuring the blood
pressure in critical care setting. Factors such as Inotropic/ vasopressor support, sedation /
analgesia, mechanical ventilation and severity of illness (APACHE II score) did not show
significant influence on the discrepancy of the two BP techniques.
In the second part of the study, more than 80 % of the sample of clinical practitioners
acknowledged that the IBP technique remains the gold standard.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/8804 |
| Date | 27 September 2010 |
| Creators | Ninziza, Jadot |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf |
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