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The introduction relates the background to the study and after the literature review the aims and goal of the study are clearly presented. The aims of the study are, firstly to describe the participants' education and maintenance of skills in blood pressure measurement, and secondly to ascertain participants' working knowledge of factors critical to accurate measurement of blood pressure. The aims that are stated are not congruent with the title, but they are with what was actually carried out in the study. The goal of the study states "this observational, descriptive study was undertaken to ascertain the need and focus for improvement in quality of technique and standardization in performance of this important diagnostic skill." (p.11)

A historical literature review spanning sixty years of international literature was carried out researching the background to inaccurate blood pressure techniques. The review was medium sized, eight pieces of literature were included, but it only summarized the literature and did not critique the findings of these studies. Some of the literature was very old (18) but this was to gain a historical perspective on the issue.

The study used a total sample of 78 enrolled and registered nurses, this represented 1% of available population (600). It is unclear how the sample was selected. Sample size was reasonable but limited to nurses who worked in acute areas of care surgical, medical, intensive care, and coronary care units. The information provided about the sample was poor, only the year and place of education are mentioned. There is large bias as only one private teaching hospital in Brisbane and only four areas of acute care in that hospital were included in the sample. No inclusion or exclusion criteria was mentioned and both registered nurses and enrolled nurses who have differing lengths and levels of training were included in the study.

Cheap University Papers on This assessment is a summary and critique of aspects of the research carried out by Robin S. Armstrong on "Nurses' Knowledge of Error in Blood Pressure Measurement Technique."

A pilot study was carried out on three different groups at the hospital but these groups were not included in the actual study. The cultural context of the study is similar to New Zealand as New Zealand nurses have a similar education.

Ethical approval was not gained as it was decided that ethical approval was not necessary due to the nature of the study. The researchers did consider the ethical principles of anonymity and confidentiality and respondents were encouraged to answer honestly. It was mention that respondents would be informed of results if requested but this meant that they had to put their name on the "anonymous" questionnaire. Participation in the questionnaire was voluntary. Any risks in taking part were not mentioned.

Self-report questionnaires were used to collect data. All the questionnaires were collected in one hour after being distributed by the study co-ordinator. The origin of data collection tool is not fully stated except for participants were asked to "indicate on a Likert-type scale their level of confidence in the adequacy of their skills"(p.1). The pilot test enabled the researchers to carry out some changes to the questionnaire before it was used in the actual research. Correct answers were gained from "authoritative guidelines for blood pressure measurement" (p.10) but it is not stated what these guidelines are.

The ordinal data (Schneider et al., 1, p.5) presented reflects on the aims stated. Not all the figures add up, but this is mentioned and the number of participants in each question is stated. Data was calculated on a question for question basis as not all of the participants answered every question. The data was analysed using simple descriptive statistics and presented in tables. Data was collected into three groups, "educational information, knowledge, and attributes and influences" (p.11).

The findings were probably disappointing but could have been expected since this fact had already been mentioned in the literature review and the results can be compared research carried out by Kemp, Foster and McKindlay in 14 on a similar topic. Four out of the 11 knowledge questions were correctly answered by less than half of the participants. The demographic, educational and attitude and influences questions also gave poor results. It would have been more meaningful if it were known how the registered and enrolled nurses each performed. Analysing the results together meant there was no way of knowing which group needed more education or whether both groups were equally poor at measurement of blood pressure technique.

The results are presented in table format with explinations long side. This makes them easier to follow and the results are also grouped into the three areas. It is not stated anywhere in the results whether the results are what was expected but by the literature review this is what has been historically well known. Many of the questions were left unanswered by the participants and therefore the data in inclomplete. Two thirds of the participants had gained their training in the hospital setting. Half of the sample were educated between 11 and 18. Only thiryt-eight percent of the sample had ever updated their skills.

The conclusion that nurses' knowledge was inadequate is justified in the data. The researchers also mentioned that the methods of teaching need to be reviewed and standardized.

Limitations to the study were described but these were only factors that could affect blood pressure and were not implications for the actual study. Some limitations include the small sized sample; only one private teaching hospital was involved.

It is difficult to identify nursing implications as no distinction is made between the enrolled and registered nurses. If the registered nurses did better than the enrolled nurses or older nurses performed worse than new graduates, if this kind of detail was included in the discussion then something useful could be said. Authoritative, comprehensive, and easily accessible documents are required to help inform nurses of common errors in blood pressure measurement. Education and training need to be improved and standardization of training across all disciplines is required.

Overall this study is fairly well done but improvements can be made in all areas.

References

Armstrong, R.S. (00). Nurses' knowledge of error in blood pressure measurement technique. International journal of nursing practice, 8, 118-16

Kemp, F., Foster, C. & McKindlay, S. (14). How effective is training for blood pressure measurement technique? Professional Nurse, (8) 51-54.

Schneider, Z., Elliot, D., LoBiondo-Wood, G. & Haber, J. (1). Nursing research Methods, critical appraisal and utilisation (nd ed.). Sydney, Australia Mosby.

Talbot, L.A. (15). Principles and practice of nursing research. St Louis, MO Mosby.

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