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Comparison of Nurse versus Ordering Provider Perceived Barriers to Anthropometry Measurements in Critically Ill Children

Tuesday, 19 November 2013: 9:10 AM

Sharon Y Irving, PhD, RN, CRNP1
Vijay Srinivasan, MD2
Monica L Nagle, RD, CNSC, LDN3
Madeline Masucci Perkel, MSN, RN,4
Maria R Mascarenhas, MBBS5
Shiela E. Falk, RD, LDN6
Stephanie Seiple, RD, CNSC, LDN3
(1)Family and Community Health, University of Pennsylvania, School of Nursing, Philadelphia, PA
(2)Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
(3)Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA
(4)Critical Care, The Children's Hospital of Philadelphia, Philadelphia, PA
(5)Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
(6)Departiement of Clinical Nutrition, The Children's Hospital of Philadelphia, Phildadelphia, PA

Learning Objective 1: Identify perceived barriers to obtaining anthropometry measurements in critically ill children

Learning Objective 2: Describe the difference in perceived barriers between nurse and ordering providers

Methods:IRB-approved online survey using six intraprofessional list serves. Characteristics of the care environment, provider, and perceived barriers to anthropometric measurements were obtained. Chi-square was used for analysis.

Results: Of 258 respondents, 139 (54%) were nurses, 46% were OP’s.  Half (49%) worked in medical-surgical (non-cardiac) critical care environment. Most (72%) used parental estimates of anthropometry measurements, only 3% affirmed obtaining them on admission.  Both groups perceived barriers to obtaining Wt as extracorporeal life support (ECLS) (80%), hemodynamic instability (76%), and critical airway (69%); for S: hemodynamic instability (50%), medical devices (48%), and ECLS (47%); and for HC: medical devices (64%), nurse workload (38%) and ECLS (34%). Compared to nurses, more OP’s perceived barriers to obtaining Wt (47% vs. 40%, p < 0.001) and HC (28% vs. 20%, p <0.001). The OP perceived barriers to Wt included nurse workload (52% vs. 34%, p = 0.004), osteopenia (46% vs. 29%, p = 0.007), and lack of importance (33% vs. 12%, p < 0.001).  OP perceived barriers to head circumference included medical devices (72% vs. 57%, p = 0.01), brain trauma (42% vs. 24%, p = 0.002), and unimportance (48% vs. 17%, p < 0.001).  Nurse perceived barriers to S included obesity (26% vs. 15%, p = 0.04) and dialysis (21% vs. 9%, p = 0.01).  

Conclusions: Barriers to obtaining anthropometry measurements in critically ill children exist. OP’s perceived more barriers than nurses. These findings suggest a need for interdisciplinary education to overcome perceived barriers. 

 

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