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Updated: Nov 7, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Improving the rate of anthropometric measurements in the pediatric intensive care unit
Autumn Pace1, Amanda Zobel2, Laura Gearman2
1University of Minnesota Medical School-Twin Cities, Minneapolis, Minnesota, USA.
Insights
Improving nutrition status in pediatric intensive care units (PICUs) requires consistent anthropometric measurements. Process improvements increased the documentation of height, weight, and occipital frontal circumference (OFC) in critically ill children.
Area of Science:
- Pediatric critical care medicine
- Clinical process improvement
- Nutrition assessment
Background:
- Malnutrition affects 25% of pediatric intensive care patients, increasing morbidity and mortality.
- Accurate anthropometric measurements (height, weight, OFC) are crucial for assessing nutrition status.
- Current documentation and reporting of these measurements are often suboptimal.
Purpose of the Study:
- To implement and evaluate a multifaceted intervention to improve the documentation, reporting, and discussion of anthropometric measurements.
- To increase the frequency of obtaining height, weight, and occipital frontal circumference (OFC) measurements within 24 hours of admission and weekly.
Main Methods:
- A 1-month process improvement initiative was conducted in a pediatric intensive care unit (PICU) and a cardiovascular intensive care unit (CVICU).
- Interventions included staff education, nurse champions, process mapping, new equipment, and structured discussions during rounds.
- A proportions hypothesis test compared measurement frequencies across preintervention, postintervention, and sustainment phases.
Main Results:
- Both PICU and CVICU showed increased rates of height and OFC measurements postintervention.
- Weight measurements remained high in both units, with CVICU consistently at 100%.
- While sustainment phase rates showed some regression, they generally remained above baseline, with OFC reaching 100% in the PICU weekly.
Conclusions:
- The implemented interventions successfully increased the rates of anthropometric measurements in critically ill children.
- Sustaining these gains requires ongoing effort, as some regression was observed.
- Further interventions may be necessary to foster a unit culture prioritizing consistent nutrition status assessment.
Background:
Malnutrition occurs in approximately 25% of pediatric intensive care patients and correlates with increased length of stay, prolonged ventilation, and mortality. Anthropometric measurements should be obtained at admission and throughout hospitalization to evaluate nutrition status. We aimed to increase documentation, reporting, and discussion of anthropometric measurements, including height/length, weight, and occipital frontal circumference (OFC) within 24 hours of admission and weekly.
Methods:
A multifaceted process improvement model was implemented over 1 month. Interventions included education, recruiting nurse champions, process mapping, new equipment, and formal discussion of nutrition status during rounds. A proportions hypothesis test compared frequency of anthropometric measures obtained during each study phase: preintervention, postintervention, and sustainment.
Results:
In terms of admission metrics over respective study phases, the PICU had fluctuation in weights (91%, 98%, and 97%) and height (49%, 73%, and 71%) and increased rates in OFC (36%, 61%, and 65%). The cardiovascular intensive care unit (CVICU) had stable weights (100%, 100%, and 100%) and increased rates in height (87%, 94%, and 95%) and OFC (28%, 64%, and 86%), respectively. In terms of weekly metrics over study phases, the PICU had fluctuation in weights (91%, 89%, and 93%) and increased rates in heights (38%, 69%, and 76%) and OFC (45%, 76%, and 100%). The CVICU had increased rates in weights (98%, 100%, and 100%) and fluctuations in heights (50%, 83%, and 75%), and OFC (48%, 84%, and 75%).
Conclusions:
Interventions increased rates of measurements. During the sustainment phase, there was regression in rates, although these remained above baseline. Additional interventions may increase compliance and foster change in unit culture.
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