Accident and Emergency Department, North District Hospital, Sheung Shui, Hong Kong.
Hong Kong Med J. 2012 Jun;18(3):201-6.
To determine the characteristics of asymptomatic elevated blood pressure patients in an accident and emergency setting and assess the effect of a nurse-led intervention system.
Cross-sectional study.
Accident and Emergency Department of a regional hospital in Hong Kong.
Patients with blood pressures of 140/90 mm Hg or above recorded twice (at triage and discharge) with no previous history of hypertension. Exclusion criteria were: (1) admission to hospital; (2) known hypertension; (3) referral for hypertension; (4) blood pressure higher than 180/120 mm Hg on rechecking.
Patients were issued a referral by the discharge nurse to follow-up for blood pressure monitoring in primary care.
Diagnosis of hypertension, follow-up rate, and risk factors of hypertension.
Of 245 patients with asymptomatic elevated blood pressure, we were able to contact 222 for follow-up, of whom 136 (61%) claimed to have been followed up for their blood pressure, and 48 (22%) were diagnosed to have hypertension. The nurse time for finding one case was 28 minutes. The projected impact could be large. If this simple nursing guideline is implemented territory-wide, more than 7000 new cases of asymptomatic hypertension might be picked up annually.
The implementation of a simple nurse-led hypertension referral system is a cost-effective way to screen asymptomatic subjects with elevated blood pressures in the accident and emergency department.
确定急诊科无症状性血压升高患者的特征，并评估护士主导的干预系统的效果。
横断面研究。
香港一家地区医院的急诊科。
血压记录为 140/90mmHg 或以上，且无高血压既往史的患者，这些患者在分诊和出院时各记录了两次血压。排除标准为：（1）住院；（2）已知高血压；（3）转诊高血压；（4）重新检查时血压高于 180/120mmHg。
出院护士为患者开出转介单，以便在初级保健中进行血压监测随访。
高血压的诊断、随访率和高血压的危险因素。
在 245 例无症状性血压升高的患者中，我们能够联系到 222 例进行随访，其中 136 例（61%）声称已经对血压进行了随访，48 例（22%）被诊断为高血压。找到一个病例的护士时间为 28 分钟。如果在全港范围内实施这一简单的护理指南，预计每年可能会发现 7000 多例新的无症状性高血压病例。
实施简单的护士主导的高血压转介系统是一种经济有效的方法，可以在急诊科筛查无症状性血压升高的患者。
