title: A training program for anthropometric measurements by a dedicated nutrition support team improves nutritional status assessment of the critically ill child.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  PICU--Lyon, France.
  
  
  METHODS
  PICU nursing and medical staff, and patients admitted in February 2011, 2012, and 2013.
  
  
  METHODS
  Training program.
  
  
  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.
authors.affiliation: 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.
authors.forename: Frederic V
authors.initials: FV
authors.lastname: Valla
authors.forename: Carole
authors.initials: C
authors.lastname: Ford-Chessel
authors.forename: Rosan
authors.initials: R
authors.lastname: Meyer
authors.forename: Julien
authors.initials: J
authors.lastname: Berthiller
authors.forename: Christine
authors.initials: C
authors.lastname: Dupenloup
authors.forename: Nathalie
authors.initials: N
authors.lastname: Follin-Arbelet
authors.forename: Anna
authors.initials: A
authors.lastname: Hubert
authors.forename: Etienne
authors.initials: E
authors.lastname: Javouhey
authors.forename: Noel
authors.initials: N
authors.lastname: Peretti
mesh_terms: D000328:Adult; D001132:Arm / Q000502:physiology; D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000451:nursing* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006257:Head / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000193:education*; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000502:physiology*; D018529:Nutritional Support / Q000592:standards*; D017410:Practice Guidelines as Topic; D015397:Program Evaluation / Q000592:standards*; D011446:Prospective Studies