Rationale and key points

Accurate measurement of a patient’s blood pressure (BP) is essential to identify hypotension or hypertension and to inform subsequent management and treatment decisions. The auscultatory, or manual, method remains the gold standard for non-invasive BP measurement, so it is vital that nurses are able to undertake this procedure accurately. This article explains how to take and record a manual BP measurement using an aneroid sphygmomanometer and a stethoscope. Nurses and nursing students undertaking this procedure must be equipped with the knowledge and skills to do so proficiently and work within their scope of practice.

• BP measurement comprises two pressure readings, systolic and diastolic, which are measured in millimetres of mercury (mmHg) and expressed in documentation as a ‘fraction’.

• Inaccurate BP measurement, whether overestimation or underestimation, can result in diagnostic errors and incorrect risk assessment and decision-making.

• Various factors can influence the accuracy of BP measurement, including patient positioning, cuff size, arm position and correct use of the stethoscope.

• It is vital to ensure regular maintenance and recalibration of BP measuring equipment, in accordance with the manufacturer’s instructions, to ensure accuracy of readings.

Reflective activity

‘How to’ articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of:

• How this article might improve your practice when taking a manual BP measurement.

• How you could use this information to educate nursing students or your colleagues on the appropriate steps when taking and recording a manual BP measurement.