P30 Improving the documentation of paediatric height/length for inpatients
Authors: Hutchinson-Jones Jane , Gage Susie , Bennet Sophie , Cox Annabel , Mann Amirah , Keevey Ailbhe 
Published: April 2022

Aim

Pharmacists and dieticians are among the health care professionals who have identified a problem relating to the inconsistent recording of heights in paediatric patient notes. The Trust’s guideline ‘Growth – Standard for the measurement of weight and height/length in children identifies that ‘all children attending hospital must have their weight and height/length measured’.1 Height is required to calculate a number of parameters, including renal function and risk of malnutrition. It is necessary for the calculation of adjusted prescribing weights for overweight or obese patients.

This project aimed to improve the percentage of heights being recorded in an appropriate place by introducing a poster to all wards within the hospital.

Method

All wards in the hospital were included in the audit. Baseline data was collected 8-9th February 2021. The poster was implemented from the 2nd March 2021 and a patient safety alert was circulated to staff during the week beginning 1st March 2021. Data was then recollected on 22nd March 2021.

As outlined in the trust guideline, data was collected from: the front of the drug chart; the ‘Core Screening Tools for Children and Young People for inpatients’ document; and the World Health Organisation (WHO) Growth Chart recorded on our electronic record ‘Evolve’.

Results

The percentage of patients with height recorded on the drug chart at baseline was 8.3%. This increased to 16% post-implementation. The percentage of patients with height recorded on the Core Screening Tool was 33.3%. This increased to 42.5% post-implementation. The percentage of patients with height recorded on Evolve at baseline was 22.2%. This decreased to 20.8% post-implementation.

Conclusion

The post-implementation data collected would suggest that the poster has had a positive effect on improving the number of heights recorded for paediatric inpatients. There was a 93% increase in the number of patients with height recorded on their drug charts and a 28% increase in the number of patients with height recorded on the Core Screening Tool following implementation of the intervention.

This shows an overall improvement in the recording of heights on drug charts and core screening tools, although there was a decrease in the percentage of patients with height recorded on Evolve. The use of Evolve was investigated during the data collection and it was identified that there is a lack of training on how to enter heights on the Evolve system and this may explain the low numbers of heights recorded using this system. Further Evolve training for staff would help to correct this issue and after consultation with the nurse education team, this has been added to the training programme for new nurses starting in the hospital.

Improvement has been shown over this short period of time, with the increase in the percentage of heights documented for inpatients, although we are still a long way from the target of 100%. Further work is being carried out within the hospital with the aim that this information is consistently provided, thereby improving patient care.

Reference

Tucker I, Elson R. Clinical guideline: growth - standard for the measurement of weight and height/length in children (version 1). Trust name. 2019 Available on request.