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Recommended Citation
Burns West M, Esposito L. Heightened Awareness: A Quality Improvement Initiative to Optimize Ventilator Settings Through Accurate Measurements in the Pediatric Intensive Care Unit. Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Presentation Notes
Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Abstract
Background: Accurate height measurement is a critical component of patient care in the pediatric intensive care unit. In children with acute respiratory distress syndrome, appropriate ventilator settings improve clinical outcomes and reduce mortality. Ventilator tidal volumes are commonly based on predicted body weight, which is derived from patient height or length. Ensuring accurate and timely height documentation is essential for optimizing mechanical ventilation strategies for improved outcomes.
Local Problem: Ventilator settings were historically selected using patients’ actual body weight rather than the predicted body weight derived from their height. This approach did not align with pediatric acute respiratory distress syndrome management guidelines, which emphasizes the use of height-based predicted body weight for ventilator tidal volume parameters. This identified a need to enhance accuracy and consistency of height measurement documentation to ensure adherence to evidence-based management standards and improve ventilator setting optimization.
Method: A Plan Do Study Act model guided implementation. Barriers to height measurement were identified through nursing feedback. Point prevalence audits established baseline adherence and monitored progress. Interventions were multifaceted and leveraged electronic medical record integration of height fields, development of an admission checklist, designating measurement champions, visual reminders (signage and marker board in room), weekly data sharing on unit quality improvement board and messaging platforms. Tape measures were placed in every room and a length board was purchased to support accurate measurements across all age groups.
Results/Conclusions: Prior to intervention, the point prevalence of length or height documentation was 48%. Following implementation, documentation improved to 81% and continues to trend upward.
Implications for Practice: Accurate height measurement is essential for safe and effective care in the Pediatric Intensive Care Unit. Targeted, low-cost interventions can significantly improve documentation practices. These scalable strategies promote adherence to evidence-based guidelines and support improved outcomes in critically ill pediatric patients.
Document Type
Poster
Publication Date
11-12-2025
Heightened Awareness: A Quality Improvement Initiative to Optimize Ventilator Settings Through Accurate Measurements in the Pediatric Intensive Care Unit
Background: Accurate height measurement is a critical component of patient care in the pediatric intensive care unit. In children with acute respiratory distress syndrome, appropriate ventilator settings improve clinical outcomes and reduce mortality. Ventilator tidal volumes are commonly based on predicted body weight, which is derived from patient height or length. Ensuring accurate and timely height documentation is essential for optimizing mechanical ventilation strategies for improved outcomes.
Local Problem: Ventilator settings were historically selected using patients’ actual body weight rather than the predicted body weight derived from their height. This approach did not align with pediatric acute respiratory distress syndrome management guidelines, which emphasizes the use of height-based predicted body weight for ventilator tidal volume parameters. This identified a need to enhance accuracy and consistency of height measurement documentation to ensure adherence to evidence-based management standards and improve ventilator setting optimization.
Method: A Plan Do Study Act model guided implementation. Barriers to height measurement were identified through nursing feedback. Point prevalence audits established baseline adherence and monitored progress. Interventions were multifaceted and leveraged electronic medical record integration of height fields, development of an admission checklist, designating measurement champions, visual reminders (signage and marker board in room), weekly data sharing on unit quality improvement board and messaging platforms. Tape measures were placed in every room and a length board was purchased to support accurate measurements across all age groups.
Results/Conclusions: Prior to intervention, the point prevalence of length or height documentation was 48%. Following implementation, documentation improved to 81% and continues to trend upward.
Implications for Practice: Accurate height measurement is essential for safe and effective care in the Pediatric Intensive Care Unit. Targeted, low-cost interventions can significantly improve documentation practices. These scalable strategies promote adherence to evidence-based guidelines and support improved outcomes in critically ill pediatric patients.
Affiliations
Atrium Health WFB Brenner Children's Hospital