Waiting room BP monitor – PMS Instruments

Identify More Hypertensives With A Waiting Room Blood Pressure Monitor

Guidance on preventing cardiovascular disease (CVD) was originally published in 2019 and was updated this year. Optimal treatment of AF, high blood pressure and raised cholesterol is highly effective in preventing CVD events.

Over 40% of people with high blood pressure remain undiagnosed and of those diagnosed with high blood pressure, only 67% are optimally managed.

How do we diagnose and manage more effectively?

GP Practices are encouraged to actively screen patients and seek out hidden hypertensives. To the average practice this could mean hundreds of extra appointments for a simple blood pressure measurement.

They need help in the form of the easy to use, clinically validated A&D Medical TM-2657P waiting room blood pressure monitor.

Originally the idea of allowing patients to measure their own blood pressure was greeted with scepticism by some clinicians, but practice managers were quick to see the advantages.

Ideally located in a quiet corner of the waiting room, this type of monitor is designed for professional high volume use and automatically prints a reading, with the date and time, on a small slip of paper.

The patient usually shows this reading to the doctor or nurse at the beginning of the consultation and if the readings are too high or low they can then re-measure. In some practices patients hand results to a member of the reception team, who record it electronically for later review.

For practice managers, they offer good management and effective use of resources freeing clinical staff for other roles where they may be better utilised. Some practices report they ‘save’ up to 100 appointments per month on average.

For patients the feedback is positive and the monitors promote understanding and compliance.

Recently we have been involved in a couple of projects looking to target patients who don’t visit a GP regularly or have access to another healthcare provider. TM-2657P blood pressure monitors have been placed in public access buildings like Libraries and Pharmacies.

They have identified new undiagnosed hypertensives with elevated blood pressure and helped manage existing hypertensive patients promoting medication compliance.

PMS Instruments. Expertise, Experience and Trust for service, calibration and support.

These are the key words our customers associate with PMS Instruments, as well as being the fundamental foundations of our calibration and service department.

Back in 2016 I posted an article with a picture of an A&D Medical TM-2655P waiting room blood pressure monitor that had recorded a staggering 103,366 readings since we originally supplied it in 2004!

Since then, we have calibrated and serviced a number of A&D Medical waiting room blood pressure monitors that have recorded in excess of one hundered thousand readings!

At PMS Instruments as an ISO-9001 Quality Assured company we keep detailed service and calibration records for every item of equipment we service and repair.

What’s the secret of this reliability and low cost of ownership?

I am convinced it is regular, preventative and routine servicing by PMS Instruments which extends the ‘in service’ life of the monitors and prolongs the investment our customers make in their equipment.

How does the service you get from PMS Instruments differ?

The A&D Medical TM-2655P and TM-2657P waiting room blood pressure monitors are specialist instruments, requiring specialist knowledge and test equipment.

With every service and calibration PMS Instruments carries out, each monitor is subjected to an approved individual ISO-9001 quality assured Work Instruction. This comprises a series of up to 70 detailed steps our service engineers must follow, and which the product must pass, in accordance with the manufacturer’s service manuals.

You get so much more from PMS Instruments than the basic 10 minute on site functional test some companies offer.

Our popular Fixed Price Service and Support Plan includes:

Annual calibration of your device and detailed calibration certificate issued.
Priority unlimited telephone and technical support.
Fixed price servicing cost.
Fast priority response for all servicing and repairs.
20% discount off non standard service items including pumps
Standard service parts and consumables including filters.
Replacement of the cotton cuff inner.
Supply of premium packing box and material included.
Courier collection and return included.
Priority turnaround time typically 3-5 working days from receipt of equipment.
Inclusive annual service and calibration to manufacturer’s specification.

You get what you pay for…

PMS Instruments’ service and calibration team are certified to ISO-9001 and use only genuine manufacturer approved spare parts.

Depending on the model it can take up to 90 minutes for our Service Engineers to adjust, calibrate and service an A&D Medical waiting room blood pressure monitor and we are the experts at it! Rapid turnaround time means minimum downtime and a full service and calibration certificate is issued.

Not convinced and still want to use another company?

Can the company you use tell you how many readings your waiting room blood pressure monitor has taken during its lifetime? If they can’t schedule your service and calibration with PMS Instruments and we will.

Disposable Hand and Arm Hygienic BP Covers

A&D Medical protective hand and arm covers are specially designed for use with the TM-2655P and TM-2657P waiting room blood pressure monitors.

They demonstrate to your patients that when they use your waiting room blood pressure monitor, you take any safety and hygiene concerns they may have seriously. This gives them the confidence to use the monitor after post COVID lockdown.

They are manufactured from thin polyethylene and cover the upper arm and hand to prevent a patients arm coming in to direct contact with the inside of monitor. These single patient use hygienic arm and hand covers are easy to apply and comfortable to wear.

With a length of 75cm they accommodate most arms and fit an arm circumferences of up to 44cm. Each overarm and hand cover is perforated making them easy to detach. Each batch/bundle of 200 has a convenient attachment string which means the covers can be hung neatly near the waiting room monitor or anywhere keeping the waiting room tidy.

They are designed for single patient use and are easy to apply. Simply pull one over sleeve off, insert your arm fully in to the cover, take a blood pressure measurement, remove the cover and dispose of. They are hygienic and cost effective providing effective protection to a patients arm. Free samples are available from PMS Instruments. Further information is available on our website https://www.pmsinstruments.co.uk/acatalog/A-D-Medical-Arm-and-Hand-Cover-for-TM-2655P-TM-2657P-703.html#SID=42

Life Goes On

It’s very easy to forget that life, although not as we knew it, is still going on. Covid 19 has dominated our lives for the last 6 months and it looks set to continue that way for at least the next 6.

Many GP surgeries have put a temporary hold on offering 24 hour ABPM services

Some are using waiting room BP monitors in place of face to face measurements. Others are not using them at all to reduce the number of patients in the waiting room.

Some are not using the waiting room at all requesting that their patients wait outside the surgery until called directly into the consulting room.

There are so many different ways and we are all trying to provide the best service we can during these strange unprecedented times.

Now could be the perfect time to get your Surgeries BP monitors serviced, if they are not currently being used, so they are ready for when things return to a more normal service.

Some surgeries have decided to wait until they feel comfortable in offering monitoring again.

Either way however you are dealing with the current pandemic we will continue to offer service and calibration of A&D Medical waiting room BP monitors, Meditech ABPM monitors and ECG monitors.

I am pleased to report that for the 27^th year running we recently passed the ISO9001 quality standard audit. We are registered to provide repairs and support services for a range of specialised medical instruments.

With us you can be assured that when your monitors are serviced they go through a comprehensive assessment of up to 70 tests carried out by our own manufacturer trained engineers.

As all monitors are collected and returned by our courier the engineer does not have to enter your premises, therefore maintaining all of your existing covid-19 safety measures.

Despite the Pandemic we are maintaining our fast turnaround time which remains at 3-5 working days. All it to takes to arrange is a quick call or email to us and we will do the rest.

Nothing is normal right now but life does go on and you can be assured we are still here offering you our support and service.

Cleaning Blood Pressure Equipment and Cuffs During COVID-19

As customers start to get ready for the new normal we’ve been receiving a number of calls and emails regarding the safe cleaning of blood pressure cuffs, including 24 hour ABPM cuffs.

Our advice is to use a disinfectant from a reputable brand which complies to the BS EN 14476 standard as this will ensure the spray is effective against a range of viruses including Coronavirus.

Different disinfectants have different contact times, the time the surface must remain wet for the product to be effective. If the solution is not left wet on the surface for the directed time it may not work as effectively.

Before disinfecting cuffs ensure they are dirt and grease free otherwise this may make the disinfectant less effective.

If you are using old style Meditech woven cloth material cuffs we recommend you upgrade to the new hygienic wipe style. ERKA and A&D Medical also have wipe able cuffs in their range.

Purchasing additional cuffs could also provide further protection by leaving time between patient uses.

Even before the outbreak of Covid-19 our TiDi blood pressure cuff barriers were popular. Since the outbreak they have become indispensable for many customers.

Intended for single patient use they are manufactured in latex free FABRICEL tissue fused with a leak proof polyethylene film. They wrap around the patients arm and the cuff is applied over the top ensuring the blood pressure cuff never comes in to direct contact with the skin.

They can be used with all ABPM, digital and manual blood pressure cuffs and are thin enough not to affect measurements.

They are available in 3 sizes

Adult (TID916114)- 300 barriers are supplied in 6 boxes of 50.

Large Adult (TID916115)- 150 barriers are supplied in 3 boxes of 50.

Paediatric (TID916113)- 300 barriers are supplied in 6 boxes of 50.

For waiting room BP monitors the same disinfectant complying with BS EN 14476 can be used. Single use protective overarm sleeves (AND093) protect the TM-2655P and TM-2657P inner from dirt and liquid and from coming into direct patient contact. Manufactured from latex free polythene they are 40cm long and fit an arm circumference of 38cm.

Save time and money one measurement at a time

At around £1,500.00 is the A&D TM-2657P waiting room blood pressure still worth the money?

Self patient blood pressure measurement devices like the A&D TM-2657P are not new and there are now several hundred in use in the UK since they were first introduced by PMS Instruments 17 years ago in 2002.

Sited in the waiting room, for many Practices they are an integral part of their long term medical conditions clinics allowing them to work smarter, not harder, whilst helping patients take ownership of their conditions and play a more active role in their treatment.

A number of GP practices have adapted established protocols whereby patients pass their blood pressure results to the reception team and are then advised as to whether there is a need for further clinical follow up.

The protocol needs to be easy to follow and comprehensive to ensure that the receptionist is taking no responsibility for a clinical decision. When implemented correctly, after suitable training the process works very well.

Why is all this relevant to Primary Care and the NHS?

When this type of service is introduced anecdotal evidence from PMS Instruments GP customers suggests that waiting room BP monitors are used by up to 240 patients every month and only 80 of them require any further intervention. This represents a potential “saving” of over 160 face to face GP clinical appointments.

Let’s do some maths!

According to NHS England, the average GP appointment costs £30 so in the example above that’s a saving of £4800 to the NHS every month.

So the payback period in terms of time saved and the initial £1500 cost of the monitor is established but what are the other benefits?

It’s about time.

According to a report published in Pulse in August 2019, over half of GPs have said the average waiting time for non-urgent appointments at their practice is now over two weeks.

Anything that can help reduce this must be a good thing and waiting room blood pressure monitors like the TM-2657P can.

With the protocol above Doctors and nurses who want to monitor a patient’s blood pressure ask the patient to use the waiting room BP monitor and they only need to see a Doctor if their readings move out of an agreed range. Patients can do this at any time the practice is open freeing up valuable appointment time.

Nurses who run chronic disease clinics can also ask patients to monitor their blood pressure before coming to their clinic. Apart from saving nursing time it gives an immediate focus to the consultation.

Public Health England and NHS England have agreed ambitions and a goal over a 10 year period to improve the detection and treatment of high blood pressure with the following targets

80% of the expected number of people with high BP are diagnosed by 2029
80% of the total number of people diagnosed with high BP are treated to target as per NICE guidelines by 2029

How do we achieve these objectives when Primary Care is already overstretched?

In this instance the technology, in the form of waiting room BP monitors, already exists we just need to encourage wider adoption and not be afraid to adopt new approaches.

Time is money as the saying goes and the A&D TM-2657P saves time and money one measurement at a time.

PMS Instruments. Expertise, Experience and Trust for service, calibration and support.

These are the key words our customers associate with PMS Instruments as well as being the fundamental foundations of our calibration and service department.

I recently posted on Facebook a picture of an A&D Medical TM-2655P waiting room blood pressure monitor that had recorded a staggering 103366 readings since we originally supplied it in 2004!

Having visited the R&D centre in Japan I know the engineering quality, research and development that A&D Medical put into the design and manufacturer of their products but was intrigued and asked one of our service engineers to give me the service history of the monitor over the last 12 years.

We keep detailed service and calibration records for every item of equipment we service and repair. The monitor had a new cuff mechanism fitted in 2007 which we replaced under warranty but other than that had had no other parts fitted just regular, routine and preventative maintenance.

What’s the secret of this reliability and low cost of ownership?

I am convinced it is regular, preventative and routine servicing by PMS Instruments which extends the in service life of the monitors and prolongs the investment our customers make in their equipment.

Why do I think this? There are any number of medical companies that visit GP surgeries in the UK offering to service and calibrate a wide range of blood pressure monitoring equipment. That may be the case but the TM-2655P and TM-2657P waiting room blood pressure monitors are specialist instruments, requiring specialist knowledge and test equipment.

So what are you actually getting from us and how does our service differ?

With our service and calibration service each monitor is subjected to an approved individual ISO-9001 quality assured Work Instruction. This comprises a series of up to 70 detailed steps our service engineers must follow and which the product must pass in accordance with the manufacturer’s service manuals. You get so much more from PMS Instruments than the basic 10 minute on site functional test some companies offer.

You get what you pay for?

Not convinced and want to use another company?

To ensure you are getting a proper and professional service for your A&D Medical waiting room blood pressure monitor and compare like for like ask your current service provider these questions.

Are you authorised by A&D Medical to work on this equipment?
Have the service engineers working on your equipment been on an A&D training course?
Do you follow a preventative service and maintenance schedule?
Do you perform an internal inspection of the equipment?
Do you check and replace routine original service parts?
Do you use an A&D Medical BP Checker?

Was it yes to all of these?

I was happy for the customer that their A&D Medical waiting room blood pressure monitor had provided so many years of reliable and trouble free service.

Has your TM-2655P monitor reached 100000 + readings during its lifetime yet? If your current service company can’t tell you call us on 01628 773233 and we will.

The secret by the way is Test Mode 41 or is it 42!

The missing 5.5 million with undiagnosed high BP.

A new resource – Blood Pressure – How Can We Do Better? – has just been launched and can be accessed at the British Heart Foundation website.

It has been developed by stakeholders including GPs, nurses and pharmacists working with organizations including NHS England, Public Health England, the British Heart Foundation, the Stroke Association and the Royal College of General Practitioners.

It is well known that high blood pressure affects one in four adults in England and is one of the leading causes of premature death in England. At least half of all heart attacks and strokes are associated with high blood pressure.

Treatment thankfully is very effective – for every 10mmHg reduction in blood pressure, the risk of a life changing heart attack or stroke is reduced by 20%.

What’s the challenge?

Finding undiagnosed hypertensives, around 25000 in the average CCG or 5.5 million in England, unaware of their increased risk and not receiving treatment is the challenge. It’s also worth remembering that of those diagnosed with high BP, one in three, are not treated to target.

GP Practices and Clinical Commissioning Groups (CCGS) need to do things differently to improve detection and increase opportunistic screening.

What practical steps should GP Practices take?

Think BP! Whether in routine consultations, or in nurse led clinics, like COPD, asthma and diabetes. Encourage opportunistic screening and ensure identification of poor BP control is the responsibility of all clinicians.

Think BP! In accordance with NICE CG127 guideline on Hypertension always offer ambulatory 24 hour blood pressure monitoring or when appropriate home blood pressure monitoring to confirm a diagnosis of high BP. Ensure BP equipment is serviced and calibrated regularly by reputable third parties with experience of the devices you use.

Think BP! Use clinically validated waiting room self-test BP monitors like the A&D Medical TM-2657P to make it easier to collect BP data, save appointment time and empower patients to actively use this equipment.

Think BP! Advise patients of the option to buy clinically validated low cost blood pressure monitors like the UA-767S from established suppliers so they can monitor their blood pressure at home.

There is also a role for Clinical Commissioning Groups (CCGs) who need to do things differently to improve detection, support GP Practices and increase opportunistic screening.

They can use the BHF website to see how many people in their CCG have undiagnosed high blood pressure.

How do we diagnose more patients with high blood pressure?

Time pressured consultations and other clinical priorities are a factor and simply mean in many instances there isn’t enough time to record a blood pressure. The answer is the wider adoption of technology like the A&D Medical TM-2657P waiting room BP monitor and doing things differently.

How does it work?

Patient self-measurement of blood pressure using A&D waiting room blood pressure monitors have been used in the UK since PMS Instruments introduced them in 2002. They are an established part of many GP Practices hypertension diagnosis and management pathways. Put simply the patient records their blood pressure which is printed on a paper slip. This is then shown to the clinician during the consultation. The readings can be input to the patient’s clinical record.

What does the future for detection and management of high BP hold?

With no extra capacity at present the situation won’t be improved by GP’s working harder. It may be improved by doing things differently, changing the system and the wider adoption of new technology. If you are a GP Practice, CCG or GP Federation and want to find out more about the latest BP measuring technology contact me.