Assessing and Optimizing Blood Pressure Measurement Technique in Clinical Practice The BPRIGHT Project (Blood Pressure Reliability through Implementation of Guidelines and Holistic Training).

Accurate blood pressure (BP) measurement is essential for the early detection and management of hypertension (HTN), yet gaps persist in routine clinical practice. This study aimed to improve the quality of office BP measurement through a structured quality improvement intervention at Shalamar Hospital, Lahore. Conducted over six months, the project comprised three phases: baseline assessment, targeted interventions, and post-intervention reassessment. Interventions included BP measurement workshops, hands-on training sessions, educational posters, and ergonomic improvements across 14 outpatient sites. All sites used manual BP measurement with mercury sphygmomanometers, performing a single reading per patient. Significant improvements were observed following the intervention: ensuring 5-minute patient rest before measurement (9% to 88%, p < 0.0001); correct seating with back support and feet flat (13% to 83%, p < 0.0001); separate identification of systolic and diastolic BP (33% to 92%, p < 0.0001); inflating the cuff 20-30 mmHg above systolic BP (46% to 96%, p < 0.0001); and deflating at an appropriate rate (38% to 90%, p < 0.0001). Checking for smoking or caffeine intake within 30 minutes improved modestly (0% to 26%). The number of readings per patient remained unchanged. Structured educational and ergonomic intervention were associated with marked short-term improvements in adherence to recommended office blood pressure measurement practices. While these findings support the feasibility and effectiveness of targeted implementation strategies in routine clinical settings, the generalizability of the results is limited, and the durability of these improvements beyond the short follow-up period remains uncertain. Larger, multi-centre studies with longer follow-up are needed to evaluate sustained impact and implications for clinical outcomes.