Perceived barriers to anthropometric measurements in critically ill children

Abstract

Background: Anthropometric measurements are vital for safe care in pediatric intensive care units.

Objective: To identify barriers to anthropometric measurements and determine if perceptions of barriers differ between ordering providers and nurses.

Methods: A 21-item survey to elicit perceptions of barriers to obtaining anthropometric measurements was distributed via e-mail to societies with members who provide care in pediatric intensive care units.

Results: Most of the 258 eligible respondents (46% ordering providers) were from North America (90%). Although 84% agreed that anthropometric measurements are important, only 3% knew if these measurements were obtained upon admission to their unit. Estimates of patients' measurements by parents or caregivers were commonly used (72%) when actual measurements were not obtained. Leading barriers were presence of medical devices (57%), use of extracorporeal life support (54%), and unstable hemodynamic status (52%). More ordering providers than nurses considered osteopenia/fragile bones as a barrier to weight measurement (46% vs 29%; P = .007) and traumatic brain injury a barrier to measurement of head circumference (42% vs 24%; P = .002). More nurses than ordering providers perceived dialysis (21% vs 9%; P = .01) and obesity (26% vs 15%; P = .04) as barriers to measurement of stature. Ordering providers more than nurses perceived nurses' workload (51% vs 33%; P < .001) and lack of importance (43% vs 20%; P < .001) as barriers.

Conclusions: Barriers to obtaining anthropometric measurements exist in pediatric intensive care units; ordering providers and nurses have different perceptions of what constitutes a barrier.