Orthostatic Hypotension
Conditions
Keywords
orthostatic hypotension, aged patients, geriatry, nurses, acute geriatric care (AGC), long-term care (SMR)
Brief summary
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.
Detailed description
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.
Interventions
OTHERAdministration 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
Sponsors
Hôpital NOVO
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 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
Exclusion criteria
* Patient refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of the knowledge level of nurses working in geriatrics regarding orthostatic hypotension | Through study completion, an average of 1 year | The nurses' level of knowledge will be assessed using a questionnaire which they will complete either in person or online via the secure Microsoft Forms platform. This questionnaire consists of 3 parts: - Definition of orthostatic hypotension (Question 2.1) - Measurement methods (Question 3) - Diagnostic criteria (Questions 2.2 and 2.3) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the influence of the nurse's experience on their knowledge regarding the screening for orthostatic hypotension in the elderly. | Through study completion, an average of 1 year | Nurses' knowledge will be assessed using the study-specific questionnaire developed from current European recommendations on orthostatic hypotension screening. Professional experience will be assessed by self-reported years of practice as a registered nurse. The association between questionnaire responses and years of professional experience will be analyzed. |
| Evaluate the influence of experience in geriatrics on the RN's knowledge regarding the screening for orthostatic hypotension in the elderly. | Through study completion, an average of 1 year | Nurses' knowledge will be assessed using the study-specific questionnaire. Experience in geriatric care will be assessed by self-reported years of practice in geriatric settings. The association between questionnaire responses and years of experience in geriatrics will be analyzed. |
| Compare the level of knowledge between RNs working in acute geriatric care (AGC) and in long-term care (SMR) | Through study completion, an average of 1 year | Nurses' knowledge will be assessed using the study questionnaire. Questionnaire responses will be compared between nurses working in acute geriatric care and those working in geriatric rehabilitation (SMR). |
Countries
France
Contacts
CONTACTMathilde WLODARCZYK
PRINCIPAL_INVESTIGATORLila HIRED
Hôpital NOVO
Outcome results
None listed