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Accurate blood pressure measurement is essential to appropriately diagnose and treat hypertension. Blood pressure is usually measured by taking a single automated office blood pressure (AOBP) reading, but there are newer, fully automated devices that calculate the mean of several blood pressure readings. A quality improvement initiative was conducted in a US ambulatory care setting to determine whether there were differences in the accuracy of blood pressure measurement when measuring mean AOBP versus single AOBP. A population of 126 patients attending a transitional care clinic at an urban hospital were randomly assigned to receive mean AOBP measurement at the beginning of their appointment, at the end of their appointment, or not at all. This randomised prospective evaluation did not find conclusive evidence regarding the use of mean AOBP measurement versus single AOBP measurement. However, using a fully automated device that calculates mean AOBP may be useful in busy clinical settings, allowing nurses to spend more time on other aspects of their role such as patient education and care coordination. [ABSTRACT FROM AUTHOR]

Primary care providers (PCPs) are essential components of a health care system, but there are shortages of PCPs. Nurse practitioners (NPs) are essential in meeting the needs of an increased demand for primary care, but there is a wide variety in the training offered to NP students. The purpose of this analysis is to determine student self-reported comfort in a variety of care delivery, covering primary care topics, including knowledge and skills. We conducted a preclinical and postclinical survey. Surveys were obtained before and at the conclusion of two clinical rotations in Baltimore, MD. Students were a part of a Health Resources and Services Administration–funded program to prepare NP students to practice in urban, underserved settings. Seventeen NP students NP students responded to both our pre- and postsurveys. Overall, student comfort increased in many focus areas, but no change was seen in important domains, including interpreting imaging studies, filling out common forms, and interpreting certain diagnostic tests. Further study of student skills and confidence at the conclusion of their study would be beneficial in determining if these gaps persist at entry into NP practice. Given wide variation in NP student training programs, it would be additionally beneficial to understand how these differences impact student skills and confidence during their clinical rotations and on entry to practice. Well rounded, broad-based education is necessary for the development of highly trained PCPs; greater understanding of student confidence, knowledge, and skills can assist educators in assuring that all NPs enter practice as safe and competent providers. [ABSTRACT FROM AUTHOR]