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