Improving assessment of child growth in a pediatric hospital setting
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RESEARCH ARTICLE
Open Access
Improving assessment of child growth in a pediatric hospital setting Priya M. Gupta1* , Emily Wieck2, Joel Conkle3, Kristina A. Betters4, Anthony Cooley2,5, Selena Yamasaki5, Natasha Laibhen-Parkes5 and Parminder S. Suchdev1,2,5
Abstract Background: Accurate anthropometric measurements are essential for assessing nutritional status, monitoring child growth, and informing clinical care. We aimed to improve height measurements of hospitalized pediatrics patients through implementation of gold standard measurement techniques. Methods: A quality improvement project implemented computerized training modules on anthropometry and standardized wooden boards for height measurements in a tertiary children’s hospital. Heights were collected preand post-intervention on general pediatric inpatients under 5 years of age. Accuracy of height measurements was determined by analyzing the variance and by comparing to World Health Organization’s defined biologically plausible height-for-age z-scores. Qualitative interviews assessed staff attitudes. Results: Ninety-six hospital staff completed the anthropometry training. Data were available on 632 children preand 933 post-intervention. Training did not increase the proportion of patients measured for height (78.6% preintervention vs. 75.8% post-intervention, p = 0.19). Post-intervention, wooden height boards were used to measure height of 34.8% patients, while tape measures and wingspan accounted for 42.0% and 3.5% of measurements, respectively. There was no improvement in the quality of height measurements based on plausibility (approximately 3% height-for-age z-scores measurements flagged out of range pre- and post-intervention), digit preference (13.4% of digits pre- and 12.3% post-intervention requiring reclassification), or dispersion of measurements (height-for-age z-scores standard deviation 1.9 pre- and post-intervention). Staff reported that using the wooden board was too labor consuming and cumbersome. Conclusions: Our findings suggest that efforts to improve anthropometric measurements of hospitalized children have multiple obstacles, and further investigation of less cumbersome methods of measurements may be warranted. Keywords: Child health, Growth, Anthropometry, Pediatrics
* Correspondence: [email protected] 1 Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not
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