Effect of a standardized intervention on the precision of linear growth measurements

9.00
Hdl Handle:
http://hdl.handle.net/10755/148288
Type:
Presentation
Title:
Effect of a standardized intervention on the precision of linear growth measurements
Abstract:
Effect of a standardized intervention on the precision of linear growth measurements
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Lipman, Terri
P.I. Institution Name:University of Pennsylvania
Objective: The purpose of this nursing multicenter study was to assess linear growth measurement practices within pediatric primary care practices (PCP) across eight geographic sites within the United States and to evaluate the effect of a standardized intervention on measurement precision. Design: PCPs in each geographic area were randomly selected and assigned to the control (CG) or intervention group (IG). Pediatric endocrine nurses (PEN) skilled in growth monitoring received training in the delivery of a standardized didactic training session on linear growth and precise measurement techniques. The two-hour didactic training along with provision of state of the art equipment constituted the standardized intervention. PENs collected baseline data on growth measurement practices of staff (measurers) in all PCPs then delivered the didactic training session and equipment to measurers assigned to the intervention group. Precision was assessed through the PEN (blinded to the measurer’s measurements) re-measuring each child using accurate technique and equipment out of sight of the measurer. To evaluate the effect of the intervention, the PEN collected follow-up data on growth measurement practices in all PCPs at 3 and 6 months after baseline. Sample: Sixty-four Pediatric and Family Primary Care Practices were randomly sampled from respondents to a mail-out survey on linear growth practices; 8 PCPs were enrolled in each geographic area: Philadelphia, PA; Galveston, TX; St Louis, MO; New Orleans, LA; Tampa Bay and Broward Co., FL; Albany, NY; & Providence, RI. Practices were excluded if they had: (1) < 300 children in the practice; or (2) < 2 staff (measurers) who would be routinely performing linear growth measurements on pediatric patients in that practice over the next 6 mos. Two to four measurers were enrolled in the study in each practice. Setting: Data were collected while observing measurers in their primary care practice site. Names of Variables: Independent: Provider/measurer demographics, linear growth measurement technique, linear growth measurement equipment. Dependent: Linear measurement. Measures/Instruments: CG and IG measurers were observed while using linear growth measurement equipment and technique of their choice on at least 2 children per PEN visit (0, 3, & 6 months). After baseline, IG measurers were encouraged to utilize the provided wall-mounted, calibrated stadiometer and pediatric length board as appropriate based on the child’s age. A standardized observation record that included 20 descriptors of measurement technique and value was utilized by PENs. Findings: Forty-six PCP (23 IG, 23 CG) have been evaluated to date. PENs observed 89 measurers (49 IG, 48 CG) measuring 264 children (mo 0) and 221 children (mo 3). No baseline differences were found between IG and CG equipment, technique, or precision; 31% of measurements were imprecise (>0.5 cm from PEN). Measurements differed by as much as 12.1 cm from PEN. At 3 mo., IG measurers used correct technique and appropriate equipment significantly more often than CG (p<0.0005). Measurements were significantly more precise in the IG-differing from the PEN by a mean of 0.5 cm in the IG and 1.6 cm in the CG (p<0.0001). Six-month data collection is currently being finalized. Conclusions: We conclude that in PCP in the geographic sites sampled, children are measured with imprecise equipment and incorrect technique resulting in inaccurate measurements. Implications: These findings have important implications for the timely recognition of growth problems among pediatric populations. The intervention resulted in significantly more precise measurements, a strategy that could greatly improve detection and accurate diagnosis of growth disorders in children.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEffect of a standardized intervention on the precision of linear growth measurementsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148288-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Effect of a standardized intervention on the precision of linear growth measurements</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Lipman, Terri</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Pennsylvania</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lipman@nursing.upenn.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: The purpose of this nursing multicenter study was to assess linear growth measurement practices within pediatric primary care practices (PCP) across eight geographic sites within the United States and to evaluate the effect of a standardized intervention on measurement precision. Design: PCPs in each geographic area were randomly selected and assigned to the control (CG) or intervention group (IG). Pediatric endocrine nurses (PEN) skilled in growth monitoring received training in the delivery of a standardized didactic training session on linear growth and precise measurement techniques. The two-hour didactic training along with provision of state of the art equipment constituted the standardized intervention. PENs collected baseline data on growth measurement practices of staff (measurers) in all PCPs then delivered the didactic training session and equipment to measurers assigned to the intervention group. Precision was assessed through the PEN (blinded to the measurer&rsquo;s measurements) re-measuring each child using accurate technique and equipment out of sight of the measurer. To evaluate the effect of the intervention, the PEN collected follow-up data on growth measurement practices in all PCPs at 3 and 6 months after baseline. Sample: Sixty-four Pediatric and Family Primary Care Practices were randomly sampled from respondents to a mail-out survey on linear growth practices; 8 PCPs were enrolled in each geographic area: Philadelphia, PA; Galveston, TX; St Louis, MO; New Orleans, LA; Tampa Bay and Broward Co., FL; Albany, NY; &amp; Providence, RI. Practices were excluded if they had: (1) &lt; 300 children in the practice; or (2) &lt; 2 staff (measurers) who would be routinely performing linear growth measurements on pediatric patients in that practice over the next 6 mos. Two to four measurers were enrolled in the study in each practice. Setting: Data were collected while observing measurers in their primary care practice site. Names of Variables: Independent: Provider/measurer demographics, linear growth measurement technique, linear growth measurement equipment. Dependent: Linear measurement. Measures/Instruments: CG and IG measurers were observed while using linear growth measurement equipment and technique of their choice on at least 2 children per PEN visit (0, 3, &amp; 6 months). After baseline, IG measurers were encouraged to utilize the provided wall-mounted, calibrated stadiometer and pediatric length board as appropriate based on the child&rsquo;s age. A standardized observation record that included 20 descriptors of measurement technique and value was utilized by PENs. Findings: Forty-six PCP (23 IG, 23 CG) have been evaluated to date. PENs observed 89 measurers (49 IG, 48 CG) measuring 264 children (mo 0) and 221 children (mo 3). No baseline differences were found between IG and CG equipment, technique, or precision; 31% of measurements were imprecise (&gt;0.5 cm from PEN). Measurements differed by as much as 12.1 cm from PEN. At 3 mo., IG measurers used correct technique and appropriate equipment significantly more often than CG (p&lt;0.0005). Measurements were significantly more precise in the IG-differing from the PEN by a mean of 0.5 cm in the IG and 1.6 cm in the CG (p&lt;0.0001). Six-month data collection is currently being finalized. Conclusions: We conclude that in PCP in the geographic sites sampled, children are measured with imprecise equipment and incorrect technique resulting in inaccurate measurements. Implications: These findings have important implications for the timely recognition of growth problems among pediatric populations. The intervention resulted in significantly more precise measurements, a strategy that could greatly improve detection and accurate diagnosis of growth disorders in children.</td></tr></table>en_GB
dc.date.available2011-10-26T09:42:59Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T09:42:59Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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