Blood Pressure Home Monitoring Care Plan

Key objectives

To provide patients with information on how to take their blood pressure (BP) at home and a place to track and record these readings. Clinical teams to check the patients PKB record for BP readings.

Outcome measures

Equip patients with the information they need for self-management of their high blood pressure and clinical teams to incorporate checking the patients PKB record for BP reading. Engagement stats to show patient and clinical logins, care plans added and edited. Replacing patients recording blood pressures on paper or over email.

Current Baselines

Patients are asked to track blood pressure at home and record the readings on paper then either email them to their team or take them with them to their appointments. Patients don't always remember the readings making appointments inefficient.

Workflow

Clinical team: Adds care plan to patients record

PKB: Notifies patient that a care plan has been added to their record

Patient: Logins and views care plan

Patients: Takes BP and adds results to BP care plan

PKB: Records BP reading

Clinical team: Reviews BP readings

BP Home Monitoring Care Plan Template

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<p>Your doctor or nurse has asked you to regularly check your blood pressure at home. This care plan will give you the information and support that you need to help you to do so.</p>

<h2>What is blood pressure?</h2>

<p>Blood pressure is the pressure of blood in your arteries - the vessels that carry your blood from your heart to your brain and the rest of your body. You need a certain amount of pressure to get the blood moving round your body.</p>

<p>Your blood pressure naturally goes up and down throughout the day and night, and it's normal for it to go up while you're moving about. It's when your overall blood pressure is consistently high, even when you are resting, that you need to do something about it.</p>

<h2>What is high blood pressure?</h2>

<p>High blood pressure is medically known as hypertension. It means your blood pressure is consistently too high and means that your heart has to work harder to pump blood around your body. High blood pressure is serious. If you ignore it, it can lead to heart and circulatory diseases like <a href="https://www.bhf.org.uk/informationsupport/conditions/heart-attack " target="_blank">heart attack</a> or <a href="https://www.bhf.org.uk/informationsupport/conditions/stroke " target="_blank">stroke</a>. It can also cause kidney failure, <a href="https://www.bhf.org.uk/informationsupport/conditions/heart-failure " target="_blank">heart failure</a>, problems with your sight and <a href="https://www.bhf.org.uk/informationsupport/conditions/vascular-dementia " target="_blank">vascular dementia</a>.</p>

<h2>What causes high blood pressure?</h2>

<p>There isn't always an explanation for the cause of high blood pressure, but most people develop high blood pressure because of their diet, lifestyle or medical condition.</p>

<p>Sometimes high blood pressure runs in families and can also worsen with age, it is also more common if you are of black African or black Caribbean descent. Even in these cases, you may still be able to improve your blood pressure by changing your diet and being active.</p>

<p>These can all increase your risk of getting high blood pressure:</p>

<ul>

<li style="list-style:inherit; margin-left: 15px;">Drinking too much <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating/alcohol " target="_blank">alcohol</a></li>

<li style="list-style:inherit; margin-left: 15px;"><a href="https://www.bhf.org.uk/informationsupport/risk-factors/smoking " target="_blank">Smoking</a></li>

<li style="list-style:inherit; margin-left: 15px;">Being <a href="https://www.bhf.org.uk/informationsupport/risk-factors/your-weight-and-heart-disease " target="_blank">overweight</a></li>

<li style="list-style:inherit; margin-left: 15px;">Not doing enough <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/staying-active " target="_blank">exercise</a></li>

<li style="list-style:inherit; margin-left: 15px;">Eating too much <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating/salt " target="_blank">salt</a></li>

</ul>

<p>In a very small number of people, the cause of high blood pressure can be identified. Doctors sometimes call this secondary hypertension.</p>

<p>Causes of secondary hypertension could include:</p>

<ul>

<li style="list-style:inherit; margin-left: 15px;">kidney disease</li>

<li style="list-style:inherit; margin-left: 15px;">diabetes, and</li>

<li style="list-style:inherit; margin-left: 15px;">some medicines, such as oral contraceptives and some over-the-counter and herbal medicines.</li>

</ul>

<p><b style="color:#cf2c2c;">High blood pressure rarely has noticeable symptoms. That's why it's so important to check your blood pressure.</b></p>

<p>The first step to managing your blood pressure is to 'Know Your Numbers!' Watch the video below to understand more about blood pressure and to see how to measure your blood pressure at home</p>

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<h2>Before you measure your blood pressure:</h2>

<p><b>Avoid things that can raise your blood pressure in the short term</b>. Don't measure your blood pressure within half an hour of eating, smoking, drinking caffeinated drinks such as coffee, or exercising. These can all raise your blood pressure temporarily. If you need to use the toilet, go before you measure your blood pressure.</p>

<p><b>Wear loose-fitting clothes</b>. Wear a short-sleeved t-shirt or something with sleeves you can push up easily, nothing tight. This is so that you can fit the cuff around your arm.</p>

<p><b>Rest for five minutes before you take your reading</b>. Sit down somewhere quiet, ideally at a desk or table. Have your back supported with your arm resting on a firm surface and your feet flat on the floor. Stay in this position while you take your blood pressure.</p>

<p><b>Make sure your arm is supported and at the same level as your heart</b>. Position yourself so that your arm is resting on a surface and is at the same height as your heart. Keep your arm and hand relaxed, not tensed.</p>

<p><b>Make sure you are relaxed and comfortable</b>. If you are anxious or uncomfortable, your blood pressure will rise temporarily.</p>

<h2>How do I measure my blood pressure at home using a home monitor?</h2>

<ol>

<li style="list-style:inherit; margin-left: 15px;"><b>Follow the instructions that came with your monitor.</b> Make sure you place the cuff around your arm as described in the instructions.</li>

<li style="list-style:inherit; margin-left: 15px;"><b>Place the arm cuff just above your elbow</b>. The cuff should be about 2cm above your elbow to make sure it can detect the artery in your arm, just under the skin. </li>

<li style="list-style:inherit; margin-left: 15px;"><b>Keep still and quiet while you take your reading</b>. Moving, chewing, talking and laughing can affect your reading. Make sure you don't cross your legs, as this will raise your reading too.</li>

<li style="list-style:inherit; margin-left: 15px;"><b>Take two or three readings, each about one to two minutes apart</b>. If your first reading is much higher than the next, ignore it and take an extra reading. Once you have two to three readings, you can work out the average. </li>

<li style="list-style:inherit; margin-left: 15px;"><b>Keep a record of your measurements</b>. <span style="color: #2b7d67;">Record all your readings in this PKB care plan by clicking the edit button and entering the BP to share with your doctor or nurse.</span></li>

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<p>Your doctor or nurse will advise you on when to measure your blood pressure and how often, and this can help you both to be clear about what you are doing and why. Don't forget to record your readings in this care plan so they can use it to review your treatment. It is a good idea to show your monitor to your doctor or nurse so that they can check that it is validated and accurate, that it fits properly, and that you know how to use it. They can show you if you're not sure.</p>

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<h2>What else can I do?</h2>

<p>Keeping your blood pressure healthy helps to keep your blood vessels and your heart healthy. Even small changes can make a big difference: lowering your blood pressure by just <a href="http://www.bloodpressureuk.org/your-blood-pressure/understanding-your-blood-pressure/what-do-the-numbers-mean/ " target="_blank">10mmHg</a> lowers your risk of a stroke or heart attack by a fifth. And there is support available. </p>

<h3>Healthy living </h3>

<p>Getting active, keeping to a healthy weight and stopping smoking are some of the best things you can do for your blood pressure. <a href="http://www.bloodpressureuk.org/your-blood-pressure/how-to-lower-your-blood-pressure/healthy-eating/ " target="_blank">See how to make healthy changes to lower your blood pressure</a>.</p>

<h3>Healthy eating</h3>

<p>What you eat can make a huge difference to your blood pressure quickly and naturally. Getting your-five-a-day while cutting back on salt and saturated fats will help. <a href="http://www.bloodpressureuk.org/your-blood-pressure/how-to-lower-your-blood-pressure/healthy-eating/ " target="_blank">Learn about healthy eating for high blood pressure</a>.</p>

<h3>Medications</h3>

<p>If you have been diagnosed with high blood pressure, your doctor might suggest taking medications to lower it. See the <a href="http://www.bloodpressureuk.org/your-blood-pressure/how-to-lower-your-blood-pressure/medications-for-high-blood-pressure/ " target="_blank">medicines for high blood pressure</a> and how to get the most from them.</p>

<h3>Monitoring your blood pressure at home</h3>

<p>Checking your blood pressure at home can help you see how well any changes you're making are working and feel more in control.</p>

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