Standardizing Blood Pressure Measurements in Pediatric Hemodialysis: a Collaborative Journey

Curr Hypertens Rep. 2023 Oct;25(10):329-334. doi: 10.1007/s11906-023-01255-3. Epub 2023 Jul 28.

Abstract

Purpose of review: This manuscript details the development and execution of a quality improvement (QI) initiative aimed at standardizing blood pressure (BP) measurement practices in pediatric hemodialysis (HD) units across a national dialysis collaborative.

Recent findings: Although there are recommendations for the detection and treatment of hypertension in the pediatric population, currently there is no data or recommendations specific to the methodology of measuring blood pressure in a pediatric hemodialysis setting. In 2016, the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) Collaborative assembled a dedicated working group to thoroughly examine BP measurement practices across participating pediatric HD centers and, drawing from current research, to establish a standardized best practice for BP measurement in pediatric HD patients both in-center and at home. Employing QI methodology, the working group devised a standardized "BP Bundle" and implemented it throughout the SCOPE Collaborative. This work led to successful practice improvement by establishing a consistent approach to BP measurement in pediatric HD patients cared for in SCOPE centers. With a standard best practice now in place and over 85% compliance with the BP Bundle across the SCOPE Collaborative, researchers and healthcare professionals can more accurately study and ultimately enhance the cardiovascular health of pediatric HD patients.

Keywords: Blood pressure; Hemodialysis; Hypertension; Pediatric; Quality; Standardizing care to improve outcomes in pediatric end stage kidney disease (SCOPE).

Publication types

  • Review

MeSH terms

  • Blood Pressure / physiology
  • Blood Pressure Determination
  • Child
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / therapy
  • Kidney Failure, Chronic* / therapy
  • Renal Dialysis / adverse effects