School Nurse Procedure Manual - The School District of Philadelphia

SCHOOL DISTRICT OF PHILADELPHIASCHOOL NURSE PROCEDURE MANUALSUBJECT: MANDATED PROGRAMS NUMBER 104CLASSIFICATION:GROWTH SCREENING (SEP. O2)I. PurposeA. To assess physical growth.B. To assess nutritional status.C. To identify students with possible growth or nutritional problems.D. To standardize growth assessment and results.E. To standardize case management of the at risk student.II. FrequencyA. Bi-annuallyB. Growth above the 90th percentile or below the 10th percentile should be assessed annuallyIII. ProcedureA. Measure and weigh student without shoes and with indoor clothing.B. Measure with wall chart or stadiometer.C. Student should stand against wall with arms at sides and heels back against wall.D. Student should face forward with chin in neutral position.IV. Calculation of height to weight percentiles.A. For students in whom a problem is identified, initiate a graph growth record.B. Abnormal or questionable findings should be rechecked for accuracy and rechecked in threemonths.C. Complete documentation.1. Document results in screen H5 in Main Menu #2, Health Inquiry and Maintenance. Where HISis unavailable, use MEH-3.V. Interpretation of MeasurementsA. Measurements between the 25th and 75th percentiles are likely to represent normal growth.B. Measurements between the 10th and 25th, and the 75th and 90th percentiles may or may not benormal. Previous and subsequent measurements and genetic factors need to be considered.C. Measurements above the 90th and below the 10th percentiles should be checked for accuracy andreferral for further evaluation should be considered.D. Measurements above the 95th or below the 5th percentiles are of priority concern and warrantreferral and follow-up.E. Measurements indicating a percentile shift of 25 percentile or more should be rechecked. Carefullyevaluate for cause and refer appropriately.F. When there is considerable difference in height and weight percentiles, careful assessment of thestudent is warranted.September 1, 2002 Page 5