title: Perceived barriers to anthropometric measurements in critically ill children.
abstract: BACKGROUND
  Anthropometric measurements are vital for safe care in pediatric intensive care units.
  
  
  OBJECTIVE
  To identify barriers to anthropometric measurements and determine if perceptions of barriers differ between ordering providers and nurses.
  
  
  METHODS
  A 21-item survey to elicit perceptions of barriers to obtaining anthropometric measurements was distributed via e-mail to societies with members who provide care in pediatric intensive care units.
  
  
  RESULTS
  Most of the 258 eligible respondents (46% ordering providers) were from North America (90%). Although 84% agreed that anthropometric measurements are important, only 3% knew if these measurements were obtained upon admission to their unit. Estimates of patients' measurements by parents or caregivers were commonly used (72%) when actual measurements were not obtained. Leading barriers were presence of medical devices (57%), use of extracorporeal life support (54%), and unstable hemodynamic status (52%). More ordering providers than nurses considered osteopenia/fragile bones as a barrier to weight measurement (46% vs 29%; P = .007) and traumatic brain injury a barrier to measurement of head circumference (42% vs 24%; P = .002). More nurses than ordering providers perceived dialysis (21% vs 9%; P = .01) and obesity (26% vs 15%; P = .04) as barriers to measurement of stature. Ordering providers more than nurses perceived nurses' workload (51% vs 33%; P < .001) and lack of importance (43% vs 20%; P < .001) as barriers.
  
  
  CONCLUSIONS
  Barriers to obtaining anthropometric measurements exist in pediatric intensive care units; ordering providers and nurses have different perceptions of what constitutes a barrier.
authors.affiliation: Sharon Y. Irving is an assistant professor, Department of Family and Community Health, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania; Pediatric nurse practitioner, Department of Nursing, Respiratory Care, and Neurodiagnostic Services and Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Stephanie Seiple, Monica Nagle, and Shiela Falk are clinical dietitians, in the Pediatric Intensive Care Unit at the Children's Hospital of Philadelphia. Maria Mascarenhas is medical director, Department of Clinical Nutrition, Children's Hospital of Philadelphia, and associate professor, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Vijay Srinivasan is an attending physician, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, and assistant professor, Perelman School of Medicine, University of Pennsylvania. ysha@nursing.upenn.edu.
authors.forename: Sharon Y
authors.initials: SY
authors.lastname: Irving
authors.affiliation: Sharon Y. Irving is an assistant professor, Department of Family and Community Health, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania; Pediatric nurse practitioner, Department of Nursing, Respiratory Care, and Neurodiagnostic Services and Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Stephanie Seiple, Monica Nagle, and Shiela Falk are clinical dietitians, in the Pediatric Intensive Care Unit at the Children's Hospital of Philadelphia. Maria Mascarenhas is medical director, Department of Clinical Nutrition, Children's Hospital of Philadelphia, and associate professor, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Vijay Srinivasan is an attending physician, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, and assistant professor, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Seiple
authors.affiliation: Sharon Y. Irving is an assistant professor, Department of Family and Community Health, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania; Pediatric nurse practitioner, Department of Nursing, Respiratory Care, and Neurodiagnostic Services and Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Stephanie Seiple, Monica Nagle, and Shiela Falk are clinical dietitians, in the Pediatric Intensive Care Unit at the Children's Hospital of Philadelphia. Maria Mascarenhas is medical director, Department of Clinical Nutrition, Children's Hospital of Philadelphia, and associate professor, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Vijay Srinivasan is an attending physician, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, and assistant professor, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Monica
authors.initials: M
authors.lastname: Nagle
authors.affiliation: Sharon Y. Irving is an assistant professor, Department of Family and Community Health, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania; Pediatric nurse practitioner, Department of Nursing, Respiratory Care, and Neurodiagnostic Services and Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Stephanie Seiple, Monica Nagle, and Shiela Falk are clinical dietitians, in the Pediatric Intensive Care Unit at the Children's Hospital of Philadelphia. Maria Mascarenhas is medical director, Department of Clinical Nutrition, Children's Hospital of Philadelphia, and associate professor, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Vijay Srinivasan is an attending physician, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, and assistant professor, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Shiela
authors.initials: S
authors.lastname: Falk
authors.affiliation: Sharon Y. Irving is an assistant professor, Department of Family and Community Health, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania; Pediatric nurse practitioner, Department of Nursing, Respiratory Care, and Neurodiagnostic Services and Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Stephanie Seiple, Monica Nagle, and Shiela Falk are clinical dietitians, in the Pediatric Intensive Care Unit at the Children's Hospital of Philadelphia. Maria Mascarenhas is medical director, Department of Clinical Nutrition, Children's Hospital of Philadelphia, and associate professor, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Vijay Srinivasan is an attending physician, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, and assistant professor, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Maria
authors.initials: M
authors.lastname: Mascarenhas
authors.affiliation: Sharon Y. Irving is an assistant professor, Department of Family and Community Health, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania; Pediatric nurse practitioner, Department of Nursing, Respiratory Care, and Neurodiagnostic Services and Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Stephanie Seiple, Monica Nagle, and Shiela Falk are clinical dietitians, in the Pediatric Intensive Care Unit at the Children's Hospital of Philadelphia. Maria Mascarenhas is medical director, Department of Clinical Nutrition, Children's Hospital of Philadelphia, and associate professor, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Vijay Srinivasan is an attending physician, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, and assistant professor, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Vijay
authors.initials: V
authors.lastname: Srinivasan
mesh_terms: D000886:Anthropometry / Q000379:methods*; D001291:Attitude of Health Personnel; D002648:Child; D064648:Critical Care Nursing / Q000706:statistics & numerical data*; D016638:Critical Illness; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D010371:Pediatric Nursing / Q000706:statistics & numerical data*