420 ‘Weigh to go’ report of the British academy of childhood disability (BACD) national audit

• Published in: Archives of disease in childhood 2023-07, Vol.108 (Suppl 2), p.A38-A39
• Main Authors: Lau, Witney, Swales, Catherine, Lazenby, Sophia, Tuffrey, Catherine, Robinson, Kelly, Cadwgan, Jill
• Format: Article
• Language: English
• Subjects: Amoxicillin; Audit objectives; Charts; Childhood; Children; Children with disabilities; Disability; Down Syndrome; Down's syndrome; Health care; Measurement Equipment; Measuring instruments; Online Surveys; Pediatrics; Surveys; Training
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2023-rcpch.63

ObjectiveThe BACD launched the WEIGH TO GO! Initiative in November 2022.The aim of this national re-audit (five years post NCEPOD report), is to assess growth monitoring CYP attending clinical services; and resources available to weigh and measure all CYP including those who are vulnerable, physically disabled and neurodevelopmentally diverse.Methods1)Multi-centre case note audit of CYP presenting to children’s services in January 2023. 2)Online survey of participating trusts: growth monitoring resources, staff training, clinical audit of growth monitoring, available growth and nutrition support services for CYP.Results16 trust champions completed the audit and survey. (15 England, 1 Scotland)770 clinical encounters, including secondary and tertiary inpatient admissions, hospital and community out-patient clinics. 74% CYP were weighed, 62% were measured.Full analysis was possible on 554 encounters, of those 71% CYP were plotted on growth charts (mostly electronic). OFC measurement was indicated in 133 CYP – 72% and 66% were measured and plotted respectively. Down Syndrome specific growth charts were needed and available in seven trusts, but specific growth charts for other conditions were not available in all.5% CYP were neither weighed at this encounter nor in last 6 months: in this group one child had medication increased and one child was prescribed amoxycillin. In 13/16 trusts CYP were seen in an environment that did not have equipment or staff training to weigh and measure physically disabled children. 4/16 reported the same for vulnerable or neurodevelopmentally diverse children.The survey demonstrated diversity regarding staff training in growth assuming competence of medical and nursing staff. One trust reported training was part of trust induction. Only two reported appropriate weighing and measuring equipment for all children in every clinical setting, however in some trusts, CYP can be taken to an alternative location.In all but two trusts there were a range of feeding/nutritional clinics that CYP could be referred to if there was concern; skill mix of the professionals in these clinics varied.ConclusionFive years since the NCEPOD recommendations (growth monitoring for all disabled children, and appropriate resources for healthcare facilities) this audit shows recording growth for CYP at each clinical encounter is still not universal, and there remain healthcare resource challenges (time, staff training, equipment and appropriate charts.)The BAC