7. What if Measures Exceed the Established Tolerance?

What if the two measures obtained in the clinical setting exceed the established tolerance for the measure?

For measures of weight for infants and children, the intra- and inter- observer reliability is generally very good. This assumes that the equipment is calibrated. If there is a measure that is an outlier, it is generally due to recording error or incorrectly reading the output on the scale.

Length, stature, and OFC measures are considered to be technically more difficult measures because of the importance of correct positioning on the measure. If two measures for these parameters are not within the established tolerance for the measure, then measure a third time. If two of the measures are within the tolerance, then take the average of these two measures.

In general, the guidelines are:

   If two measures are within the tolerance limits, use the mean of the two readings.
  If two measures are not within the tolerance limits, measure the child again.
  If two of the measures are then within the tolerance limits, use the mean of these measures.
  If none of the measures are within tolerance limits check your technique and plan a training session.