Observer error in measuring shoulder-umbilical length in the newborn
Research type
Research Study
Full title
Using shoulder to umbilical length to estimate umbilical catheter insertion depth: does observer error impact accuracy?
IRAS ID
201642
Contact name
Helen Mactier
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Clinicaltrials.gov Identifier
16.YH.0042, Previous REC submission Ref
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Umbilical venous and arterial catheters (UVCs and UACs respectively) are commonly inserted to provide central access in new born babies requiring intensive care. Correct placement depth is vital as incorrect placement can result in serious harm. Correct UVC/UAC placement depth is estimated based either a weight-based formula (weight based) or anatomical landmarks (length based) with no consensus on which is superior. A recent trial comparing these two formulae (weight vs length) found no significant difference in correct UVC placement but numbers were small. Neither method was consistently accurate. In our own unit, we notice a large variation between healthcare professionals when carrying out length based measurements which could be significantly affecting the estimated insertion depth. We aim to test and quantify this observation scientifically by watching healthcare practitioners carry out shoulder to umbilical measurements on babies (only some of whom will require UVC/UAC insertion) and recording the measurement they take. We will then assess the degree of variability both between users and within the same user (repeated measurements). The primary purpose of this non-invasive study is variability in measurement and so we will include all babies admitted to the two level 3 neonatal centres in Glasgow (Princess Royal Maternity (PRM) and Queen Elizabeth University Hospital (QUEH)), which will give us larger number appropriate to determine variability in measurement. We will also determine accuracy of measurement in determining final UVC/UAC position in those babies who need umbilical lines inserted for clinical reasons.
If our study identifies significant observer variability when determining length based measurement, this would have clinical relevance in either demonstrating need to improve teaching of length measurement, or changing practice in favour of the more reproducible weight-based formula.REC name
South East Scotland REC 02
REC reference
16/SS/0100
Date of REC Opinion
23 May 2016
REC opinion
Unfavourable Opinion