Determination of body weight and height measurement for critically ill patients admitted to the intensive care unit: A quality improvement project

Abstract

Measuring body weight and height of critically ill patients in intensive care often challenge nurses. Estimated weight and height is thought to be inaccurate. This quality improvement project was to determine one effective method of how all patients in intensive care unit (ICU) could be measured and weighed accurately and cost effectively. The determined method also was to be Occupation Health and Safety safe, adhere to infection control standards and minimises risks of patient handling. The focus for this quality improvement was that the measurement methods were to be utilised in conjunction with a baseline patient assessment in the ICU. Six different types of weighing scales were compared. Three methods were tested in a workshop for accuracy. The results were compared to a 'standing scale' as the 'gold standard' for body weight. The second stage of the project was to determine the body height of patients in the supine position. The tools were designed by the quality improvement team (QIT) and manufactured by the hospital Departments. The methods were also tested in a workshop for accuracy. The measurements were compared to a wall mounted stadiometer as the 'gold standard'. The two height measurement tools displayed differences of -1.2 to +3cm. The first weighing results of three methods showed variations. The methods displayed differences from 0.8 to 25kg. The aluminium height measurement tools and the Mercury scale conformed to the standard agreed to by the QIT. Staff in the ICU required minimal training for the methods used. The uptake of a measured weight and height, in difference to estimation takes some time for staff to accept and use. Case exemplars that demonstrated an error rate with estimation were useful feedback towards the change in practice. It was found that critically ill patients could be weighed effectively and accurately with a scale usable for every type of bed available in this ICU. All supine positioned patients can also be measured effectively and accurately with one height measurement method. These methods do not require the patient to be moved. There is no need to disconnect lines or monitoring equipment at any time during the measuring procedures.