Online Clinical Investigations

A Training Program for Anthropometric Measurements by a Dedicated Nutrition Support Team Improves Nutritional Status Assessment of the Critically Ill Child*

Valla, Frederic V. MD1; Ford-Chessel, Carole BS2; Meyer, Rosan PhD3; Berthiller, Julien MSc4,5,6; Dupenloup, Christine BSN1; Follin-Arbelet, Nathalie BSN1; Hubert, Anna MD1; Javouhey, Etienne MD, PhD1; Peretti, Noel MD, PhD7

Author Information

1Pediatric Intensive Care, Pediatric Department, Réanimation Pédiatrique, Hôpital Femme-Mère-Enfant, Lyon-Bron, France.

2Service diététique, Nutrition Department, Hôpital Femme-Mère-Enfant, Groupe Hospitalier Est, Lyon, France.

3Department of Paediatrics, Imperial College London, London, United Kingdom.

4Pôle Information Médicale Evaluation Recherche, Equipe d’Accueil 4129, Hospices Civils de Lyon et Université de Lyon, Lyon, France.

5Inserm, CIC201, EPICIME, RIPPS, CNRS UMR 5558 France.

6CHU Lyon, Hop L. Pradel, Service de Pharmacologie Clinique, Université Lyon, Lyon, France.

7Hépatologie Gastroentérologie et Nutrition Pédiatrique, Pediatric Department, Hôpital Femme-Mère-Enfant, Lyon-Bron, France.

* See also p. 301.

Supported, in part, by Groupe d’étude Francophone de Nutrition en Soins Intensifs Pédiatriques and D Brottes and A Huriez–Centre de Ressource et Gestion de Projets–Hospices Civils de Lyon.

Dr. Valla consulted for Baxter global; received grant support from Baxter, Fresenius Kabi, and Aguettant; lectured for Baxter; received support for the development of educational presentations from Baxter; and received support for travel from Nutricia, Fresenius Kabi, and Nestle. Dr. Meyer served as a board member for the Mead Johnson and Nutricia Paediatric Board; consulted for Danone, Nutricia, Mead Johnson, and Nestle; lectured for Danone, Nutricia, Mead Johnson, and Nestle; and received support for the development of educational presentations from Danone, Nutricia, and Mead Johnson. The remaining authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: [email protected]

Pediatric Critical Care Medicine 16(3):p e82-e88, March 2015. | DOI: 10.1097/PCC.0000000000000363

Abstract

Objectives: 

The cornerstone of an optimal nutrition approach in PICUs is to evaluate the nutritional status of any patient. Anthropometric measurements and nutritional indices calculation allow for nutritional status assessment, which is not often part of routine management, as it is considered difficult to perform in this setting. We designed a study to evaluate the impact of a training program by the PICU nutritional support team on the implementation of routine anthropometric measurements on our PICU.

Design: 

A prospective study was performed over a 2-year period, which included: a baseline evaluation of nutritional assessment, knowledge, anthropometric measurements (weight, height, and head and mid upper arm circumferences), and nutritional indices calculation in patient files. This was followed by a training program to implement the newly developed nutrition assessment guidelines, which included anthropometrical measurements and also the interpretation of these. The impact of this nutritional assessment program was reviewed annually for 2 years after the implementation.

Setting: 

PICU—Lyon, France.

Patients and Subjects: 

PICU nursing and medical staff, and patients admitted in February 2011, 2012, and 2013.

Interventions: 

Training program.

Measurements and Main Results: 

Ninety-nine percent of staff (n = 145) attended the individual teaching. We found significant progress in nutritional awareness and confidence about nutritional assessment following the teaching program. In addition, an improvement in staff knowledge about undernutrition and its consequences were found. We enrolled 41, 55, and 91 patients in 2011, 2012, and 2013, respectively. There was a significant increase in anthropometric measurements during this time: 32%, 65% (p = 0.002), and 96% in 2013 (p < 0.001). Nutritional indices were calculated in 20%, 74% (p < 0.001), and 96% (p < 0.001) of cases.

Conclusions: 

This is the first study, showing that a targeted nutritional assessment teaching program that highlights both the importance and techniques of anthropometrical measurements has successfully been implemented in a PICU. It managed to improve staff knowledge and nutritional practice.

©2015The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

Full Text Access for Subscribers:

Log in with your SCCM credentials.
Log in with your SCCM credentials.

Not a Subscriber?

Buy
Request Permissions
Become a Society Member

You can read the full text of this article if you:

Access through Ovid