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Research Snapshot Theater: Quality and Patient Safety, Pediatric V

Weighing In: A Quality Initiative Project to Improve Daily Weight Capture in the PICU

Monday, March 23, 2026
2:30 PM - 3:30 PM Central Time
Location: Connections Central - RST 10
  • DS

    David A. Sheron, II, MD (he/him/his)

    Arnold Palmer Hospital for Children, Florida

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • JA

    Jonathan Alba, DO

    Pediatric Critical Care Medicine Attending
    Orlando Health - Arnold Palmer Hospital for Children

    Disclosure information not submitted.

  • KW

    Kelli Wilde, RN

    Assistant Nursing Operations Manager
    Orlando Health Arnold Palmer Hospital for Children

    Disclosure information not submitted.

Introduction: Accurate body weight measurement is essential in the pediatric intensive care unit (PICU) for safe, effective clinical management. It supports medication dosing, fluid management, and nutritional assessment. Weight changes may better reflect fluid status than fluid balance charts, which often miss undocumented and insensible losses. Fluid overload is linked to higher morbidity and mortality in critically ill children. The 2017 ASPEN/SCCM guidelines recommend nutritional assessments at admission and weekly thereafter. Despite its importance, daily weight is infrequently measured in the PICU, highlighting the need for reliable, routine monitoring.

Aim: Increase weekly average compliance with daily weight measurement from 7.5% to 50% in a 17-bed high-acuity PICU over 12 months.


Methods: We conducted a stakeholder survey and created a process map to identify barriers and guide interventions. Barriers included concerns about accuracy, risks of lifting critically ill children, and staffing limitations. Interventions addressed these issues and included: nurse education on the importance of daily weights; recruitment of nurse champions via the Nurse Practice Council; structured discussions on nutrition/fluid balance during rounds; “Weight Watcher Wednesday” for updating nutrition goals and dosing weights; and addition of a “Daily Weight” order to the standard PICU admission order set. We tracked daily weight compliance (averaged weekly) during a pre-intervention period and again six months post-intervention.


Results: In the pre-intervention period, daily weights were recorded in 5 of 67 patient-days (7.5%). Six months post-intervention, compliance rose to 26 of 43 patient-days (62.7%). No increase in adverse events—such as endotracheal tube dislodgement, vasopressor escalation, or clinical decompensation—was reported.


Conclusions: A multifaceted quality improvement initiative increased daily weight measurement compliance from 7.5% to 62.7% in six months, without added risk. Routine weight monitoring can be safely integrated into PICU care, supporting best practices and enhancing medication dosing, fluid management, and nutrition. Future efforts will focus on sustainability by embedding weight measurement into routine nursing tasks within Epic EMR.