Blood Pressure Measurement in Pediatric Transplant Recipients

Dallas—Compared with the general pediatric population, life expectancy is decreased among pediatric renal transplant recipients, cardiovascular disease is a key factor in poor outcomes. When blood pressure is improperly measured and thus untreated or undertreated, both cardiovascular health and overall health can be directly affected.

Cindy Richards, BSN,, RN, CNN, and colleagues at Children’s of Alabama, Birmingham, reported on efforts to improve measurement and reporting of blood pressures. The program was described in a presentation at the 2019 ANNA National Symposium in a report titled Standardizing Blood Pressure Measurement to Enhance Renal Transplant Outcomes.

The transplant center created an interprofessional group that included medical doctors, clinic registered nurses, transplant coordinators, and certified nursing assistants. Using the most current recommendations from the International Pediatric Hypertension Association, the group received instruction on appropriate blood pressure measurements for children. The recommendations included measuring arm circumference, how to choose the appropriate cuff size, and a pathway for repeating, documenting, and notifying the physician of elevated blood pressure when a patient is found to be hypertensive.

Before initiation of the pathway, only 54% of the pediatric renal transplant recipients had their blood pressure properly remeasured manually to verify a diagnosis of hypertension. The goal of the revised protocol was to increase the number to 80%, a goal that the center was able to surpass.

In summary, the authors said, “By using an interprofessional group and having input from the entire team to develop this standardized process, we have improved our measurement and treatment of hypertension in our pediatric renal transplant recipients, and thus hopefully decreasing their risk of cardiovascular disease.”

Source: Richards C, Perry P, Seifert M, et al. Standardizing blood pressure measurements to enhance renal transplant outcomes. Abstract of a presentation at the 2019 American Nephrology Nurses Association National Symposium, April 14-17, 2019, Dallas Texas.