Assessment of Adherence to Standard Operating Procedure in Blood Pressure Measurement of Children Above Three Years of Age Among Nurses Working in Paediatric Unit at Pondicherry Institute of Medical Sciences
Authors: Rai Bishnu , Rajesh Rose , G Saritha 
Published: March 2024

Blood Pressure (BP) is the pressure of the blood flow which exerted against the wall of arteries when the ventricles contract. BP measurement based on guidelines is quality care and safe nursing practice. Adherence to guidelines reduces inaccuracies that may expose the patient to misdiagnosis and inappropriate care An infant may have a pretty common blood pressure of 80/45 mm of Hg, while that evaluation in an adult is considered low. A teenager may have a satisfactory blood pressure of 110/70 mm of Hg, but that value would be of apprehension in a toddler. Measurement of BP in children is more difficult than in adults because readings are likely to be falsely high in crying children, and an appropriately sized cuff may not be available. According to Paediatric resuscitation guidelines 2012, it is important to measure Blood Pressure while assessing a sick child to determine the circulatory and neurological status. Therefore, BP measurement based on guidelines becomes truly a valuable tool in screening for high-risk patients, early detection and control of hypertension, and prevention of complications.
STATEMENT OF THE PROBLEM: “A Descriptive Study to assess adherence to the standard operating procedure in blood pressure measurement of children above three years of age among nurses working in the paediatric unit at Pondicherry institute of medical sciences”
OBJECTIVES:
1. To determine the level of adherence among the staff nurses in following the standard operating procedure in blood pressure measurement in pediatric patients admitted to the Pondicherry Institute of Medical Sciences.
2. To identify the barriers in adhering to the standard operating procedure in blood pressure measurement.
3. To associate the demographic variables of staff Nurses with their level of adherence in following standard operating procedures for BPM.
METHODOLOGY A descriptive non-experimental method was used to assess the level of adherence of standard operating procedures in blood pressure measurement of children above three years of age. The study was conducted in the pediatric ward, Pondicherry Institute of Medical Sciences, Pondicherry, in September 2019. Purposive sample method was used and the sample included 33 nurses. Each sample was observed three times using the observational checklist, which consists of twelve steps. Descriptive statistics were used to analyze the data. Frequency and percentage were used to assess the adherence level in following the standard operating procedure in blood pressure measurement.
RESULT The result of the analysis of data shows that the majority of 32 (97 %) were female nurses, 31(94%) had B.Sc. Nursing degree and the majority of 27 (81.8 %) had work experience less than 4 years. Out of 33 participants, 6 (18.2 %) had adhered to the standard operating procedure in blood pressure measurement, 27 (81.8 %) were not able had adhered at all times while checking blood pressure with Aneroid BP Apparatus. Barriers related to adherence to SOP were related to lack of time, less manpower, workflow constraints, and some assumed that it is not necessary to follow each step every time, the cooperation of the child.
CONCLUSION The result of the study showed that very few nurses adhered to each step in the SOP of blood pressure measurement. The study concludes that there is a need to conduct in-service education between regular intervals on the importance of SOP and skills and the importance of blood pressure measurement among nurses of PIMS

Keywords: Standard Operating Procedure, Blood Pressure, Adherence, Nurses, Pediatric Unit