Abstract
PURPOSE
The purpose of this project was to improve the accuracy of newborn weight classification using a regional newborn growth reference (Olsen), an evidence-based method, to determine SGA, AGA and LGA in term infants compared to the current growth reference (Lubchenco).
DESIGN
Quality improvement methods using Lewin's Change Theory guided the process.
SETTING/LOCAL PROBLEM
At an academic medical center term infants were evaluated for weight-for-gestational age using the Lubchenco growth reference as well as other growth references based on provider preference.
PATIENTS
All term newborns (N = 314) admitted to the newborn nursery during one month following a 3-months implementation of the practice change.
INTERVENTION/MEASUREMENTS
Newborn nursery nursing staff and provider staff were provided education and training on using and interpreting the new growth reference.
RESULTS
Use of the Olsen regional growth reference identified more infants as small and fewer infants as large for gestational age. Post hoc analysis with a more global growth reference (Fenton) also identified more infants as small and fewer infants as large for gestational age. There was no statistically significant difference between the Olsen or Fenton growth references.
CONCLUSION
Use of either of these two updated growth references more accurately classifies infant weight for gestational age compared to the Lubchenco growth reference, potentially decreasing newborn health risks such as hypoglycemia.
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