STAMP instructions To be read before using STAMP for the first time For more information, and to download other materials, please visit www.stampscreeningtool.org Date of preparation: June 2010 RXNPD100349 Supported by an educational grant from Central Manchester University Hospitals
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Stamp instructions
to be read before using Stamp for the first time
For more information, and to download other materials, please visit www.stampscreeningtool.org
Date of preparation: June 2010 RXNPD100349
Supported by an educational grant from
Central Manchester University Hospitals
STAMP, the Screening Tool for the Assessment of Malnutrition in Paediatrics, provides a simple way of determining whether a child is at risk of malnutrition
STAMP also provides guidance to help you develop a care plan according to the child’s overall risk of malnutrition
STAMP is made up of 5 simple steps, which are detailed on the following page
Please note that STAMP is designed only for use with children in hospitals, and does not detect deficiencies or excessive intakes of vitamins and minerals
To complete a STAMP screening, you will need to print out a STAMP screening form and diagnosis table from www.stampscreeningtool.org – please keep these with the child’s medical notes
In addition to the screening form and diagnosis table, you will also find weighing and measuring instructions and centile quick reference tables on the website, which may be useful when completing a STAMP screening
You can also download a step-by-step guide to using STAMP from the website
However, before you conduct your first STAMP screening, please make sure that you read and understand the instructions on the following page
If you have any queries, please visit www.stampscreeningtool.org and click on the ‘Information’ or ‘Contact us’ buttons at the top of the web page
Does the child have a diagnosis that has any nutritional implications?
Score
Definitely 3
Possibly 2
No 0
Use the diagnosis table on the website, or locally developed criteria, to determine whether the child’s condition has any nutritional implications. Assign a score according to whether he/she has definite (e.g. dysphagia), possible (e.g. behavioural eating problems), or no (e.g. day case surgery) nutritional implications, and progress to step 2.
Step 2 – Nutritional intake
What is the child’s nutritional intake?
Score
None 3
Recently decreased/poor
2
No change/good 0
Use your knowledge of the child’s eating habits to determine their nutritional intake. If necessary, speak to other Healthcare Professionals and the parent/carer to find out more. Assign a score according to the child’s current nutritional intake, and progress to step 3.
Step 3 – Weight and height
Use a growth chart or the centile quick reference tables to determine the child’s measurements
Weigh and measure the child using the weighing and measuring instructions provided. Use the centile quick reference tables on the website or a growth chart to determine how many columns/centiles apart the height and weight are. Then progress to Step 4.
How to complete a Stamp screening form
Step 4 – Overall risk of malnutrition
Add the scores from steps 1–3 together to calculate the overall risk of malnutrition
Score
High risk ≥ 4
Medium risk 2–3
Low risk 0–1
Step 5 – Care plan
Develop a care plan based on the child’s overall risk of malnutrition
High risk Take action
Refer to a Dietitian, nutritional support team or consultant
Monitor as per care plan
medium risk Monitor nutritional intake for 3 days
Repeat STAMP screening after 3 days
Amend care plan as required
Low risk Continue routine clinical care
Repeat STAMP screening weekly while child is an in-patient
Amend care plan as required
Once you have calculated the child’s overall risk of malnutrition, develop a care plan for the child in accordance with local guidelines. Repeat screening as recommended on the STAMP screening form.
STAMP should be used in association with Trust referral guidelines and policies
Add the scores from steps 1–3 together to calculate the child’s overall risk of malnutrition.
Add up the scores from the boxes in steps 1–3 to calculate the overall risk of malnutrition
Score 1st screening 2nd screening 3rd screening
High risk ≥4
Medium risk 2–3
Low risk 0–1
Step 5 – Care plan
What is the child’s overall risk of malnutrition, as calculated in step 4?
Use management guidelines and/or local nutrition policies to develop a care plan for the child
High risk• Take action • Refer the child to a Dietitian, nutritional support team, or consultant• Monitor as per care plan
Medium risk • Monitor the child’s nutritional intake for 3 days• Repeat the STAMP screening after 3 days• Amend care plan as required
Low risk• Continue routine clinical care• Repeat the STAMP screening weekly while the child is an in-patient• Amend care plan as required
Please complete after each screening
Date Signature Initials
1st screening
2nd screening
3rd screening
STAMP screening formThis form can be used to screen a child up to three times – please date, sign and initial the space at the bottom of this sheet every time you do so.
STAMP should be used in association with Trust referral guidelines and policies
Weighing and measuring instructions
To be used to assign a score for step 3 of STAMP
Date of preparation: November 2012 RXANI120276
For more information, and to download other materials, please visit www.stampscreeningtool.org
Supported by an educational grant from
Central Manchester University Hospitals
How to weigh infants and children
Figure 2
Preparing to weigh an infant or child
Ensure the scale is on a flat, hard, even surface. Make sure the power source is turned on.
Explain all procedures to the parent/carer.
Infants should be weighed unclothed. Children should be weighed wearing minimal clothing.
Make sure the scale display reads ‘0’ prior to use.
All weights and measures should be checked for accuracy and calibrated regularly.
To maintain hygiene, wipe the scale down between weighings.
Tared weighing: for infants <2 years old or children who won’t stand still
The parent/carer should stand barefoot in the middle of the scale with feet slightly apart, and remain still until his/her weight appears on the display (Figure 1).
Note the weight of the parent/carer.
Hand the unclothed infant to the parent/carer.
When both the parent/carer and infant are still, record the weight to the nearest 0.1kg (Figure 2).
Subtract the parent/carer’s weight from this figure to obtain the child’s weight.
If the parent/carer is very heavy, e.g. more than 100kg, and the infant is relatively light, e.g. less than 2.5kg, the infant’s weight may not register on the scale. In such cases, ask a lighter person to hold the infant.
Weighing an infant alone: for infants <2 years old who will lie still
Place a thin piece of cloth or soft paper into a pan scale.
Lie the unclothed infant on the cloth or paper and wait for him/her to stay still, to allow the scale to settle.
Record the infant’s weight to the nearest 0.1kg.
Weighing a child alone: for children ≥2 years old who will stand still
The child should stand barefoot in the middle of the scale, with feet slightly apart, and remain still until his/her weight appears on the scale display (Figure 3).
Remove any accessories from the infant or child’s hair, e.g. clips and hairbands, and undo braids if they are likely to interfere with the length or height measurement.
If infant is <2 years old, remove his/her nappy.
Measuring length: for infants <2 years old or children who cannot stand
Cover the length board with a thin cloth or soft paper (Figure 4).
Ask the parent/carer to place the infant on the length board.
The infant should be laid on his/her back with his/her head against the fixed headboard, compressing the hair (Figure 5).
Make sure that the infant’s head does not move from side to side and is positioned with the infant looking up. Ask the parent/carer to keep the infant’s head in this position (Figure 5).
Ensure that the infant lies straight, with his/her shoulders touching the board. The spine should not be arched.
Hold the infant’s legs down with one hand and pull the footboard against the soles of his/her feet with the other (Figure 6).
Record the infant’s length to the nearest 0.1cm.
If the child is ≥2 years old, but cannot stand, measure length and subtract 0.7cm to convert it to height.
Measuring height: for children ≥2 years old or children who will not lie down to be measured
Ensure that the height board is on level ground, or appropriately secured to a wall.
Ask the parent/carer to kneel in order to get down to the level of the child.
Ask the parent/carer to help the child to stand on the baseboard with his/her feet slightly apart and the back of the head, shoulder blades, buttocks, calves and heels all touching the vertical board.
Position the child’s head so that it is facing forward, and ensure that it does not move from side to side (Figure 7).
If necessary, push gently on the knees to help the child stand at his/her full height.
Pull the headboard down to rest firmly on top of the child’s head and compress the hair (Figure 7).
Record the child’s height to the nearest 0.1cm.
If the infant is <2 years old, but will not lie down to be measured, measure standing height and add 0.7cm to convert it to length.