GROWTH MEASUREMENT GUIDELINE

Transcription

1 GROWTH MEASUREMENT GUIDELINE All healthcare professionals must exercise their own professional judgement when using guidelines. However any decision to vary from the guideline should be documented in the patient records to include the reason for variance and the subsequent action taken. Version: Provider Services Quality and Safety Committee March 2011 Ratified by: Provider Services Quality and Safety Committee Date ratified: 30 November 2010 Date issued: 15 February 2011 Expiry Date: November 2013 (Document is not valid after this date) Review date: March 2013 Lead Executive/Director Nate of originator/author Target audience: Marie McCurry Associate Director of Provider Services Jane Cahill Clinical Services Lead School Health WPCT staff and patients. If you would like this document in other languages or formats (i.e. large print), please contact the Communications Team on or Growth Measurement Guidelines WPCT Page 1 of 9

2 CONTRIBUTION LIST Circulated to the following individuals for comments Name Designation Original Organisation Marie McCurry Associate Director Provider services Helen Edwards Clinical Service Manager Della Lewis Clinical Governance Manager Catherine Whitehouse Nurse Consultant Safeguarding Juliet Wear Team Leader Julie Bragg Team Leader Alison Deacy Team Leader Approved by the Clinical Policies and Guidelines Group November 2010 Growth Measurement Guidelines WPCT Page 2 of 9

3 Contents Page 1.0 Introduction Scope of the Guidelines Competencies Required Training Equipment Monitoring Growth/Height and Weight Monitoring Height Measurement When to refer for Height Measurement Weight Measurement When to refer for Weight Measurement School Health Nurse Pathway 9.0 Confidentiality Clinical Audit References Equality Impact Assessment tool 9 Growth Measurement Guidelines WPCT Page 3 of 9

4 1.0 INTRODUCTION Living in a modern society means that it is more difficult to maintain a healthy weight. People are less active and do not eat as healthily as in the past. Being overweight or obese can have a severe impact on an individual s physical health - both are associated with an increased risk of type 2 diabetes, cancer and heart and liver disease. These illnesses put pressure on families and more broadly society and without action, the cost to society is forecast to reach 50 billion per year by Overweight children could also be affected by social issues such as: Teasing or bullying. Behavioural problems stemming from anxiety or depression. Avoidance of active play or learning opportunities in school and physical education. Missing school for medical appointments or treatment. The Government s Healthy Weight, Healthy Lives Strategy (DOH 2009) has made a real difference in pulling together activity across all parts of society to support everyone in reaching a healthy weight. The last Government has set a target to reduce the proportion of overweight and obese children to the levels in 2000 by 2020 and the latest data from the National Child Measurement Programme (NCMP) and Health Survey of England show that the rapid rise in children s obesity is levelling off, thanks to the hard work of families, schools, businesses and the NHS across England, supported by the Government. As well as the NCMP the school health service is committed to weigh and measure children that fall into other categories, including looked after children and children who need safeguarding, underweight children and all children undergoing a Health Assessment. These include being safeguarding, looked after children, underweight children and during a Health Assessment. 2.0 SCOPE OF THE GUIDELINES These guidelines apply to all School Health Nurses and Health Care Assistants working within the school Health Service for Worcestershire Primary Care Trust. 3.0 COMPETENCIES REQUIRED The practitioner must: Be appropriately qualified (ie undergone training in growth measurement). Be competent to carry out growth measurement ( Height and Weight). Be aware of the referral pathways and refer as necessary when required. Growth Measurement Guidelines WPCT Page 4 of 9

5 ONLY the school health nurse can make a referral to another agency. Have access to appropriate equipment and facilities. Have knowledge of the policies/guidelines/government documentation that support the measuring of children. 4.0 TRAINING All school health nurses, and healthcare support workers working within school health, should be trained in the technique of measuring height and weight and in the interpretation of body mass index charts (BMI) and growth charts (BPS 1995). This should be an integral part of the school nurse induction programme. All staff measuring children in school need to be trained to an acceptable standard and mechanisms put into place to ensure that the results are interpreted appropriately. 5.0 EQUIPMENT The Child Growth Foundation and Hall. (Elliman 4 th Edition 2003) recommends the use of a Leicester Height Measure and Tanita electronic scales. All scales should be calibrated annually. 6.0 MONITORING Annual programme for monitoring the accuracy of equipment (calibration of scales). Equipment that is faulty or broken should be reported immediately to the Team Leader. Follow the NCMP data collection process. 7.0 HEIGHT 7.1 Height Measurement: Children s height should be measured with a Leicester Height Measure Height should be measured and recorded to the nearest millimetre. Do not round up or down to the nearest centimetre (i.e cm and not 107cm) Children should remove footwear (tights and socks do not need to be removed) with feet flat on the base of the measure Hair accessories should be removed by the child The eyebrow should be in line with the top of the pinna Growth Measurement Guidelines WPCT Page 5 of 9

6 All measurements must be recorded and plotted on a School Nurse contact card.(this is later called a School Nurse Record Card, should they both be called the same?) A centile chart should be started for those children causing concern. Examples are:children who require referral. Children whose height falls below the 0.4 th centile. Children causing concern because of long standing physical, emotional or social difficulties. For all NCMP data, follow guidelines as recommended by the department of health. 7.2 Height Measurements that indicate referral to Community Paediatrician required All children whose height for age is below the 0.4 th centile should be referred to a Community Paediatrician for assessment unless a previous assessment by a Paediatrician has been completed. If child has crossed centile lines in the last two years but is not below 0.4 th centile and there are other concerns. Height Crossing 1 major centile. Major discrepancy between height and weight (4 major centiles). 8.0 WEIGHT 8.1 Weight Measurement Children s weight should be measured to the nearest 100 grams (i.e kg not 25 kg). Children should be weighed without shoes wearing a minimum of clothes. All weights should be recorded on a school nurse record card. A centile chart should be started for those children causing concern. 8.2 Weight Measurements that indicate a referral to Community Paediatrician Required Extreme differences between the height and weight centile measurements e.g. 4 major centile differences. 9 SCHOOL NURSE CARE PATHWAY Growth Measurement Guidelines WPCT Page 6 of 9

7 Over weight in the absence of ill health is best managed by following the school nurse pathway for overweight children. Removal of children individually from the classroom with a view to measuring may raise issues around self esteem. Alternative options should be explored. 10 CONFIDENTIALITY Staff must abide by the PCT s Code of conduct in Respect Of confidentiality and the Worcestershire Safeguarding processes. The issue of confidentiality must always be explained to the children and the young people as and when required. All data collected through the NCMP must not be shared with the child or school. A letter will be sent to the parents with their child s height, weight and BMI within six weeks of being seen. The parents will be given the opportunity to contact the school health nurse for any issues they may wish to discuss. 11 CLINICAL AUDIT Aspect % Exceptions Staff are trained in growth measurement 100% Appropriate equipment used, Leicester Height Measure and Tanita Electronic Scales 100% 100% Tanita Electronic Scales calibrated annually 100% Height and weight measured to nearest millimetre 100% and 100g, ie not rounded up or down Measurements to be recorded on School Nurse 100% Record Card Centile chart to be in use for children causing 100% concern Appropriate onward referrals made to Community Paediatrician Height, weight and BMI to be sent to parents within 6 weeks of measurements being taken Children already have Peadiatrician referral, diagnosis or intervention in place 100% 12.0 REFERENCES British Paediatric Association (BPA 1995) Health needs of school age children: Polnay Report. London: BPA. Department of Health (2004) National Service Framework for Children, Young People Growth Measurement Guidelines WPCT Page 7 of 9

8 and Maternity Services H.M.S.O. London Hall D.M.B (2004) Health for all Children Fourth Edition Oxford, University Press. Healthy Weight, Health Lives: National Child Measurement Programme Guidance for Schools 2010/11 Growth Measurement Guidelines WPCT Page 8 of 9

9 Equality Impact Assessment Report Template Your Equality Impact Assessment Report should demonstrate what you do (or will do) to make sure that your function/policy is accessible to different people and communities, not just that it can, in theory, be used by anyone. 1. Name of policy or function Growth Measurement Guidelines 2. Responsible Manager Jane Cahill 3. Date EIA completed November Description of aims of function/policy Guidelines for staff for monitoring growth measurement 5. Brief summary of research and relevant data 6. Methods and outcomes of consultation 7. Results of Initial Screening or Full Equality Impact Assessment Initial or Full Equality Impact Assessment? Equality Group Race Gender Disability Age Sexual Orientation Religion or Belief Human Rights Assessment of Impact 8. Decisions and or recommendations (including supporting rationale) 9. Equality action plan (if required) 10. Monitoring and review arrangements (include date of next full review) Department Schoool Health Nursing Directorate Childrens Services Director Marie McCurry Report produced by & job title Jane Cahill, Clinical Services Lead School Health Date report produced November 2010 Date report published March 2011 Growth Measurement Guidelines WPCT Page 9 of 9