HJAR Nov/Dec 2025

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2025 43 The Role of Patient Preparation Patient participation significantly im- pacts the reliability of readings. A full blad- der can increase systolic blood pressure by up to 10 mmHg, and recent smoking or caffeine intake can cause temporary ele- vations. 12 Nurses can help patients prepare appropriately by providing brief verbal reminders and posting educational post- ers or infographics in clinic waiting areas. These reminders improve patient aware- ness and readiness for the BPM procedure. Engaging patients in understanding prop- er positioning and preparation not only improves measurement accuracy but also promotes health literacy, a key factor in hypertension self-management. Common Sources of Error Despite awareness of BPM’s impor- tance, errors remain widespread. Common issues include: • Incorrect cuff size or placement over clothing; • Inadequate patient rest time; • Device calibration errors; • Talking or moving during measure- ment; and • Measuring immediately after activity, recent caffeine intake, recent smok- ing, or stress. 13 Even small deviations can significantly affect readings and subsequent treatment decisions. For example, taking a measure- ment with crossed legs or unsupported arms can alter systolic readings by more than 10 mmHg. 14 Over time, this can lead to inappropriate medication adjustments or delayed interventions. Advancing Accuracy Through Nursing Leadership Nurses in all practice settings, including but not limited to acute care, community health, and academia, can lead initiatives to improve BPM accuracy. This includes developing competency validation check- lists, hosting refresher workshops, and ensuring policy alignment with the ACC/ AHA 2025 guidelines. Nurse educators can incorporate simulation and e-learning re- sources, such as the “Achieving Accuracy in Blood Pressure Measurement” modules offered through the AHA, to reinforce best practices among students and faculty. Blood pressure measurement is more than a routine vital sign; it is a cornerstone of preventive care and a determinant of treatment success. In Arkansas, where nearly half of adults report hypertension, improving BPM accuracy can directly re- duce preventable morbidity and mortali- ty. By fostering a culture of measurement accuracy, nurses contribute not only to patient safety but also to statewide health improvement. Arkansas nurses are uniquely posi- tioned to lead in this effort by applying evidence-based BPM practices, educat- ing patients, and modeling excellence in clinical accuracy. As frontline providers and educators, nurses have the power to transform hypertension management, one accurate measurement at a time. n REFERENCES 1 “National Hypertension Statistics,” Centers for Disease Control and Prevention, 2024, https:// www.cdc.gov/high-blood-pressure/data- research/facts-stats/?CDC_AAref_Val=https:// www.cdc.gov/bloodpressure/facts.htm. 2 “High Blood Pressure in Arkansas,” America’s Health Rankings, 2025, https://www. americashealthrankings.org/explore/measures/ hypertension/AR. 3 “National Hypertension Statistics.” 4 Martha Gulati, Lori-Ann Peterson, and Anastasia Mihailidou, “Assessment of Blood Pressure Skills and Belief in Clinical Readings,” American Journal of Preventive Cardiology 8, no. 100280 (2021), https://doi.org/10.1016/j.ajpc.2021.100280; Daniel Jones, et al., “AHA/ACC/AANP/AAPA/ ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/ PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines,” Circulation 152 no. 11 (2025): e114-e218, https://doi.org/10.1161/ CIR.0000000000001356. 5 James Sharman, et al., “Lancet Commission on Hypertension Group Position Statement on the Global Improvement of Accuracy Standards for Devices that Measure Blood Pressure,” Journal of Hypertension 38, no. 1 (2020): 21–29. https://doi. org/10.1097/HJH.0000000000002246. 6 “High Blood Pressure in Arkansas.” 7 Jones, et al., “Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults.” 8 Rupinder Hayer, et al., “Using Web-Based Training to Improve Accuracy of Blood Pressure Measurement Among Health Care Professionals: A Randomized Trial,” Journal of Clinical Hypertension 24, no. 3 (2022): 255–262, https:// doi.org/10.1111/jch.14419. 9 K. Asayama, et al, “Automated Office Blood Pressure Measurement: Best Practice and Future Directions,” Hypertension Research 47, no. 5 (2024): 65–683. 10 Hayer, et al., “Using Web-Based Training.” 11 Jones, et al., “Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults.” 12 Saad Rehman and Mohammad Hashmi, “Blood Pressure Measurement,” StatPearls, December 28, 2022, https://www.ncbi.nlm.nih.gov/books/ NBK482189/. 13 Jones, et al., “Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults”; Hayer, et al., “Using Web-Based Training.” 14 Avery Orrall, “Incorrect Arm Positions Increase Blood Pressure Readings,” Journal of the American Medical Association 332, no. 20 (2024): 1691, https://doi.org/10.1001/jama.2024.22061. Heba Sadaka, DNP, MSN, RN, CNE, is an associate professor and certified nurse educator with 32 years of nursing experience, including over 19 years in nurs- ing education. Her expertise includes online and in- terprofessional education,QualityMatters–certified courses, and simulation. She currently serves as a nursing program site peer evaluator and president of the Sigma Gamma Xi at-Large Chapter. Heba Sadaka, DNP, MSN, RN, CNE Associate Professor of Nursing University of Arkansas at Little Rock