State of Knowledge Among Nurses Regarding the Screening for Orthostatic Hypotension in Elderly Individuals in Acute Geriatric Medicine and Medical and Rehabilitation Services

Обзор

Orthostatic hypotension is a common geriatric syndrome associated with an increased risk of falls, syncope, functional decline and mortality in older adults. Current European recommendations provide standardized procedures for its detection, including blood pressure measurements in the supine and standing positions at specific time intervals. Despite these recommendations, variability in clinical practice and potential gaps in healthcare professionals' knowledge may limit effective screening. The aim of this study is to assess nurses' knowledge and practices regarding orthostatic hypotension screening within the geriatric department of Hôpital NOVO. The study hypothesis is that nurses' knowledge and practices regarding orthostatic hypotension screening are heterogeneous and may differ from current recommendations.

Подробное описание

Orthostatic hypotension (OH) is defined as a decrease in systolic blood pressure of at least 20 mmHg and/or a decrease in diastolic blood pressure of at least 10 mmHg occurring within three minutes of standing. It is highly prevalent among older adults and is associated with adverse outcomes including falls, syncope, hospitalization, loss of autonomy and increased mortality.

Recent recommendations from the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) emphasize the importance of systematic screening for orthostatic hypotension in older adults and other at-risk populations. These recommendations also describe standardized measurement procedures, including blood pressure assessment after a period of rest in the supine position followed by measurements after standing at defined time points.

Although these recommendations are available, several studies suggest that orthostatic hypotension remains underdiagnosed in routine clinical practice. Inadequate knowledge of diagnostic criteria, inconsistent measurement techniques and variability in screening indications may contribute to this under-recognition.

The present study is a monocentric observational study conducted within the geriatric department of Hôpital NOVO. It aims to describe nurses' knowledge and self-reported practices regarding orthostatic hypotension screening.

Data will be collected through an anonymous self-administered questionnaire developed from current recommendations. The questionnaire explores three domains: theoretical knowledge of orthostatic hypotension, practical aspects of blood pressure measurement, and clinical situations prompting screening.

The results of this study will help identify potential knowledge gaps and areas for improvement in clinical practice. Findings may support the development of targeted educational interventions, standardized protocols and quality improvement initiatives to enhance the detection of orthostatic hypotension in older adults.

Вмешательства

• Другое Administration of questionnaires on nurses' knowledge of orthostatic hypotension, its measurement, diagnosis and management
  Administration of questionnaires on nurses' knowledge of orthostatic hypotension, its measurement, diagnosis and management

Первичные конечные точки

• Assessment of the knowledge level of nurses working in geriatrics regarding orthostatic hypotension [Срок оценки: Through study completion, an average of 1 year]

Вторичные конечные точки (3)

• Evaluate the influence of the nurse's experience on their knowledge regarding the screening for orthostatic hypotension in the elderly. [Срок оценки: Through study completion, an average of 1 year]
• Evaluate the influence of experience in geriatrics on the RN's knowledge regarding the screening for orthostatic hypotension in the elderly. [Срок оценки: Through study completion, an average of 1 year]
• Compare the level of knowledge between RNs working in acute geriatric care (AGC) and in long-term care (SMR) [Срок оценки: Through study completion, an average of 1 year]

Критерии участия

Критерии включения

• State-registered nurses
• Working in the Acute Geriatric Medicine department (Pontoise site), or in the Medical Care and Rehabilitation department (SMR: Marines or Pontoise sites) of NOVO Hospital

Критерии исключения

• Patient refusal

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Франция · 1 центр

• Hopital Novo — Pontoise

Публикации

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• Whelton PK, Carey RM, Aronow WS, et al. Orthostatic Hypotension. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024
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• Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, Cheshire WP, Chelimsky T, Cortelli P, Gibbons CH, Goldstein DS, Hainsworth R, Hilz MJ, Jacob G, Kaufmann H, Jordan J, Lipsitz LA, Levine BD, Low PA, Mathias C, Raj SR, Robertson D, Sandroni P, Schatz I, Schondorff R, Stewart JM, van Dijk JG. Consensus statement on the definition of orthostatic hypotension, neurally mediated sy PMID 21431947
• Ricci F, De Caterina R, Fedorowski A. Orthostatic Hypotension: Epidemiology, Prognosis, and Treatment. J Am Coll Cardiol. 2015 Aug 18;66(7):848-860. doi: 10.1016/j.jacc.2015.06.1084. PMID 26271068

Идентификаторы

NCT: NCT07738666 · CHRD 1226

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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