Pre‐procedure

ActionRationale

1. 1.Show
   Position the scales for easy access and apply the brakes (if appropriate).
   To ensure that the patient can get on and off the scales easily and to avoid accidents should the scales move. E
2. 2.Show
   Ask the patient to remove shoes and outdoor garments. The patient should be wearing light indoor clothes only (see Figure 27.9).
   Outdoor clothes and shoes will add additional weight and make it difficult to obtain an accurate bodyweight. E

Procedure

1. 3.Show
   Weight: Ensure that the scales record zero then ask the patient to stand on the scales (or sit if using sitting scales). Ask the patient to remain still and check that the patient is not supporting any weight on any object, for example leaning on the wall, or having stick or feet resting on the floor.
   To record an accurate weight (NMC [201]).
2. 4.Show
   Note the reading on the scale and record immediately, taking care that it is legible. Check with the patient that the weight reflects their expected weight and that the weight is similar to previous weights recorded. This may require conversion of weight from kg to stones and pounds or vice versa.
   To check that the weight is correct. If the weight is not as expected, then the patient should be re‐weighed. E
3. 5.Show
   Height: Ensure that the patient has removed their shoes and then ask them to stand straight with heels together. If the stadiometer is wall mounted, the heels should touch the heel plate or the wall. With a freestanding device, the person's back should be toward the measuring rod.
   Shoes will provide additional height and make the measurement inaccurate. Standing with feet apart will make the measurement inaccurate. E

   To ensure that the patient is standing upright. If the person does not have their back against the measuring rod, then the measuring arm may not reach the head. E
4. 6.Show
   The patient should look straight ahead, arms by their side and with the bottom of the nose and the bottom of the ear in a parallel plane. The patient should be asked to stretch upwards to reach maximal height.
   To ensure an accurate height is measured. E
5. 7.Show
   Record height to the nearest millimetre.
   To record an accurate measurement of the patient's height (NMC [201]). C
6. 8.Show
   To estimate the height of a patient from ulna length, ask the patient to remove any long‐sleeved jacket, shirt or top.
   To be able to access their left arm for measurement purposes. E
7. 9.Show
   Measure between the point of the elbow (olecranon process) and the midpoint of the prominent bone of the wrist (styloid process) on the left side if possible (Figure 27.10).
   To obtain measurement of the length of the ulna. E
8. 10.Show
   Estimate the patient's height to the nearest centimetre, using a conversion table.
   To estimate the patient's height (BAPEN [30]). C
9. 11.Show
   Body mass index: Estimate the patient's BMI using a conversion table or online BMI calculator
   To estimate the patient's BMI (BAPEN [30]). C
10. 12.Show
    Waist circumference: To measure waist circumference, ensure that a tape of adequate length is available. The correct position for measuring waist circumference is midway between the uppermost border of the iliac crest and the lower border of the costal margin (rib cage). The tape should be placed around the abdomen at the level of this midway point and a reading taken when the tape is snug but does not compress the skin (see Figure 27.8).
    To obtain accurate measurement of waist circumference (National Obesity Forum [188]). C
11. 13.Show
    Document the measurement.
    To record an accurate measurement of waist circumference. C

Post‐procedure

1. 14.Show
   Document height, weight and waist circumference in the patient's notes.
   To record the accurate measurement of patient's height and weight (NMC [201]). C