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Affiliations

Advocate Good Samaritan Hospital

Presentation Notes

Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.

Abstract

Background

Research has shown linear growth, not merely weight gain, may improve neuro-development outcomes of neonates born less than 34-weeks gestational age. Noted in the literature, inter-rater reliability for consistency and accuracy of obtaining length measurements improve when utilizing length boards (LB) compared to tape measures.

Local Problem

In June 2021, the Neonatal Intensive Care Unit (NICU) at Good Samaritan Hospital was introduced to LB measurements for obtaining lengths and monitoring neonatal growth. A formal chart audit of infants admitted to the NICU was completed between July 2021 and December 2023. Results of the chart audit showed that the use and documentation of LBs declined every year. By 2023, the method to determine length was documented 51% of the time, and when reported, LB use was only 19%.

Method

A Plan Do Study Act (PDSA) Model was employed. A Microsoft Forms survey of nurses’ understanding and practices in length board use was given. Re-education was developed utilizing data from the nurse survey and evidence-based practices from the literature and presented in a staff meeting. A follow-up e-mail for length board use included a flyer with a QR code to a video. The video reiterates the importance of accurate measurements as noted in the literature and depicts a 2-person approach for utilizing an LB. The flyer is displayed on the unit and chart audits were planned for one- and two-month follow-up.

Results/Conclusions

From April 7th through May 8th, 2024, documentation of length method increased to 73% and length board use to 76%. Initial results demonstrate that the adoption of length board use is feasible.

Implications for Practice

Accurate length measurements are necessary to ensure adequate nutritional plans, contributing to growth and improved neuro-developmental outcomes, especially in the premature neonatal population. Continue monitoring sustainability, frequency of the 2-person approach, and nurses’ understanding and perceptions of length board use.

Document Type

Poster

Publication Date

11-13-2024


 

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Nov 13th, 12:00 AM

Going to Great Lengths: A Quality Improvement Project for Length Board Utilization in the NICU

Background

Research has shown linear growth, not merely weight gain, may improve neuro-development outcomes of neonates born less than 34-weeks gestational age. Noted in the literature, inter-rater reliability for consistency and accuracy of obtaining length measurements improve when utilizing length boards (LB) compared to tape measures.

Local Problem

In June 2021, the Neonatal Intensive Care Unit (NICU) at Good Samaritan Hospital was introduced to LB measurements for obtaining lengths and monitoring neonatal growth. A formal chart audit of infants admitted to the NICU was completed between July 2021 and December 2023. Results of the chart audit showed that the use and documentation of LBs declined every year. By 2023, the method to determine length was documented 51% of the time, and when reported, LB use was only 19%.

Method

A Plan Do Study Act (PDSA) Model was employed. A Microsoft Forms survey of nurses’ understanding and practices in length board use was given. Re-education was developed utilizing data from the nurse survey and evidence-based practices from the literature and presented in a staff meeting. A follow-up e-mail for length board use included a flyer with a QR code to a video. The video reiterates the importance of accurate measurements as noted in the literature and depicts a 2-person approach for utilizing an LB. The flyer is displayed on the unit and chart audits were planned for one- and two-month follow-up.

Results/Conclusions

From April 7th through May 8th, 2024, documentation of length method increased to 73% and length board use to 76%. Initial results demonstrate that the adoption of length board use is feasible.

Implications for Practice

Accurate length measurements are necessary to ensure adequate nutritional plans, contributing to growth and improved neuro-developmental outcomes, especially in the premature neonatal population. Continue monitoring sustainability, frequency of the 2-person approach, and nurses’ understanding and perceptions of length board use.

 

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