This document summarizes the results of an audit of growth chart documentation. Measurements of weight, height, and head circumference were taken for 20 patients and recorded on growth charts. Documentation of centiles was found for about half of weight and height measurements and most head circumference measurements. The audit revealed a need for improved documentation of growth charts in patient notes. An action plan was proposed to measure growth parameters for all patients on admission and ensure appropriate equipment is available.

1. Growth Chart Audit
Benedictus Widaja FY1
21/3/2012

2. Introduction
 Growth chart is a basic assessment
tool of child health and development
 RCPCH recommendation
◦ Measurement of OFC, height and weight
when there is concern about child’s
weight gain, growth or general health

3. Methods
 Sample size: 20 random patients from
ward A, B and C
 Audit performed on two random days
◦ 30 January 2012 and 12 March 2012
 Documentation of OFC (if applicable),
weight and height in current notes and
their respective centiles
 Plotting of data on a growth chart
 Results are compared with previous
audit results

4. Growth chart in current notes
20 19
18 17
16
16 15
14
12
10 9 Yes
8
8 7 No
6
4
4
2
2 1
0
Aug-11 Oct-11 Nov-11 Jan-12 Mar-12

5. Weight measurement
30
25
25
20 19
16
15 15
15 Yes
No
10
5 4
2
1 1
0
0
Aug-11 Oct-11 Nov-11 Jan-12 Mar-12

6. Weight Centiles
25
22
20
15
12 Yes
11
No
10 9
8 weight not recorded
6
5 4 4
3
1 1
0
0
Oct-11 Nov-11 Jan-12 Mar-12

7. Weight - percentage
120
100 100
94 95
88 88
80 80
60 60
56 Weight
40 40
Centiles
20
0

8. Height measurement
18
16
16
14 13
12 12
12
10 9 9
8 8 Yes
8 7 No
6
4
4
2
0
Aug-11 Oct-11 Nov-11 Jan-12 Mar-12

9. Height Centiles
16
14
14 13
12
12
10
10 9
8 Yes
8
No
6 Height not recorded
4 4
4 3
2 2
2
0
0
Oct-11 Nov-11 Jan-12 Mar-12

10. Height – percentage
70
64
60 60
56
50 50
47
40
35 Height
30
25
20 Centiles
15
10
0

11. Head Circumference (<2 years
old)
12
11
10
8
8
6 6
6 Yes
5 5
No
4 4
4
2 2
2
0
Aug-11 Oct-11 Nov-11 Jan-12 Mar-12

12. Head Circumference Centiles
12
11
10
8
7
6 Yes
6
5 5 No
4 4 OFC not recorded
4
2
2
1
0 0 0
0
Oct-11 Nov-11 Jan-12 Mar-12

13. Head Circumference -
percentage
90
85
80
75
70
60 62
56 54
50
OFC
40 40
30
Centiles
20
10
0

14. Summary – percentage
(documented centiles)
100
90 88
80
70
60 60
56 56 Weight
50 50
Height
40 40
OFC
30
25
20
15
10
0
Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12

15. Discussion
 Growth charts
◦ Not present in most current notes
 Weight
◦ Weight measurement was done on most patients (80-
95%)
◦ Centiles was done on approximately half of the
patients
 Height
◦ Needs improvement
◦ Done mostly by COAU staff
◦ Lack of equipment to measure length on the ward
 Head Circumference
◦ Measurements done on approximately half of the
patients (<2 years old)
◦ Good centiles documentation
 Others

16. Action plan
 Ideally done on admission
 Ward job book
 Availability of appropriate equipment
on the ward