Introduction: The Royal College of Paediatrics and Child Health1 highlights the importance of growth as a measurement of health and wellbeing in children. Growth measurements in children can only be evaluated if plotted on a growth chart. The use of growth charts was reviewed in Forth Valley Royal Hospital Paediatric department over 10 days in all clinics held in the paediatric outpatient department.
Method: Case notes of all children attending paediatric clinics over 10 days were reviewed. Information recorded was: type of clinic; consultant; age and gender of patient; height and weight in notes; growth chart completion.
Results: 25 outpatient clinics were reviewed, with a total of 164 patients. 57.3% were male. Patients age range was 17 days to 17.1 years. 78.6% of children had height and weight recorded. 51.8% of children had growth data plotted on the growth chart. If surgical clinics were excluded from the data, 98.6% of children had height and weight recorded in case notes at clinic visit. 62% of these children had a growth chart completed in clinic.
Discussion: Despite the height and weight being clearly documented in case notes of children attending clinics, less than two thirds of case notes had completed growth charts. Surgical clinics tended not to measure children. Other clinics where children were not measured were neurodisability clinics, where measurement of children is challenging. Growth chart use is part of general assessment of a childs health and well being. However, this audit demonstrated that in spite of this, growth chart use is significantly lower than was expected. Growth chart use can be improved by ongoing education of all clinicians, highlighting growth as an important aspect of a childs health assessment. Growth chart use may be improved by the introduction of electronic growth charts. However, having electronic growth charts in place does not necessarily imply that clinicians will look at the charts when assessing children. Ensuring ongoing education remains important.
References: 1. Royal College of Paediatrics and Child Health. What are growth charts and why do we need them? Available from: http://www.rcpch.ac.uk/child-health/research-projects/uk-who-growth-charts/uk-who-growth-chart-faqs/uk-who-growth-chart-faq#whenaretheyused [accessed March 2017]
2. Garza C, de Onis M, for the WHO Multicentre Growth reference Study Group (2004). Rationale for developing a new international growth reference. Food and Nutrition Bulletin, 25(Suppl 1): S5-S14.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology