2. Blood Pressure Capture “How to” and Competition Details October 2015 Medical Assistant Blood Pressure Challenge

3. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Preparing the Patient 2 Prior to their visit, instruct your patients to: Avoid coffee. Avoid smoking. Avoid using any unprescribed drug prior to measurement. Avoid engaging in painful procedures and exercise within one hour. Patient should be sitting quietly for about 5 minutes prior to blood pressure reading.

4. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Proper Positioning of the Patient 3 Sitting position Arm and back are supported. Feet should be resting firmly on the floor. Raise patient arm so that the brachial artery is roughly at the same height as the heart.  If the arm is held too high, the reading will be artifactually lowered, and vice versa. Palm is facing up. The arm should remain somewhat bent and completely relaxed.

5. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Positioning the Cuff 4 Cuff applied directly over skin (clothes artificially raise blood pressure ) Position lower cuff border 2.5 cm above antecubital Center inflatable bladder over brachial artery.  Feel for a pulse from the artery coursing through the inside of the elbow. If it is too small, the readings will be artificially elevated. The opposite occurs if the cuff is too large.

6. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Technique of BP Measurement 5 If you immediately hear sound, pump up an additional 20 mmHg and repeat. Deflate cuff slowly at a rate of 2-3 mmHg per second until you can again detect a radial pulse. Listen for auditory vibrations from artery - "bump, bump, bump" (Korotkoff) Systolic blood pressure is the pressure at which you can first hear the pulse. Diastolic blood pressure is the last pressure at which you can still hear the pulse.

7. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Repeat Measurement 6 If BP is elevated it should be repeated. If possible, repeat manually. Allow the cuff to completely deflate. Allow patient to relax several minutes. If the BP is surprisingly high or low, repeat the measurement towards the end of your exam.

8. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. CMS – Controlling BP in HTN 7 Age 18-59 BP 139/89 or less Age 60-85 without Diabetes BP 149/89 or less Age 60-85 with Diabetes BP 139/89 or less

9. The Blood Pressure Challenge

10. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Challenge Details 9 Team consists of a maximum of 10 Medical Assistants We expect each team lead to train their teams on this material Each team will fax in a stack of medical notes containing blood pressure measures  Only United Medicare Complete AARP Patients.  At least 100 visit notes  The date of service must be between Nov 1 – Dec 31, 2015  Must be faxed in together as a mass fax to 844-604-8470. Only one stack is allowed per team  Fax received deadline is January 15, 2016 Scoring (on randomly selected notes)  3 points for controlled BP or 1 point per recheck up to 3 if not controlled

11. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Winner Receives 10 Dinner sponsored by Optum™  Top teams invited  +1 guest  Each invitee permitted to bring one guest. Winning Team  iPad Mini for each MA (up to 10)  Recognition in your local newspaper.  Plaque for display in your clinic.

12. Thank you.