Volume 4 Issue 7

The impact of CPD on our professional community

Welcome to all of the new readers seeing this issue at the BVNA Congress. We congratulate you on taking the time to continue your education and professional development. By joining your colleagues in this worthwhile event, you are making certain that the latest nursing, medical, and scientific advancements will benefit your workplaces, colleagues, clients, students, and patients. Your dedication will bring enthusiasm for the profession back to your local communities. The increased public awareness that results from your positive promotion of our expertise will foster respect and appreciation for the achievements of veterinary nursing and will encourage more people to join the field. It is you who are doing more than anyone else today to ensure that our profession continues to thrive, and you, who are making sure that the veterinary nursing profession has a bright future indeed.

Peripheral intravenous catheters: improving patient safety with the use of a care bundle

Objective: To introduce a peripheral intravenous catheter (PVC) care bundle as a tool to improve the management of PVCs and patient safety, and to audit staff compliance over a 9 week period. The long-term goal was to use data from the pilot study to implement the PVC bundle in other veterinary practices.Methods: Over a period of 9 weeks, a PVC care bundle consisting of 14 quality indicators was introduced into Abbey House Veterinary Hospital, Leeds. This was to assess 49 patients who had an intravenous catheter in situ for more than 24 hours. Staff were asked to record on the PVC care bundle sheet when a quality indicator had been completed. Percentage compliance was then calculated for the completion of the entire bundle and the individual quality indicators.Results: Over the 9 week period there was an overall decline in compliance for the entire bundle. It declined by 3% from an initial compliance of 94. Regression analysis was performed to calculate whether this value was significant using a p value of ≤0.05. There were improvements in some of the individual quality indicators, for example date and time of insertion and checking the insertion site and limb.Conclusion: It was demonstrated that there was a low mean percentage compliance with completion of the care bundle in the hospital environment studied. However with more research and further implementation, changes could be made to the bundle to increase the rate of compliance, and improve patient safety.

Everyday parasites in companion animals

Owning pets in the UK and Ireland is very beneficial for some, but does bring risks and responsibilities. Over recent years, parasites endemic to the UK have been overshadowed by exotic parasites. This article turns the reader's attention back to these ‘everyday parasites’, exploring the effects of infestation/infection, lifecycles, identification and control of fleas, ticks, mites, tapeworms and Toxocara spp. The diagnostic and control challenges faced by pet owners and veterinarians are explored from the perspective of the One Health initiative.

Gingivostomatitis: an update

Chronic gingivostomatitis is a relatively common problem in veterinary patients and can be very debilitating, significantly impacting on their daily lives. The term gingivostomatitis is more of a descriptive term than a diagnostic one and the condition has also been termed ‘lymphoplasmacytic gingivitis stomatitis’, which became apparent components of the disease histopathologically. This article aims to outline the aetiology and pathogenesis of the condition and discuss the presentation and findings on clinical examination of patients with chronic gingivostomatitis, while considering the potential treatment options and nursing care requirements to ensure optimal resolution.

Diagnostic approach to the pruritic cat

Managing cats with pruritic skin diseases can be challenging. Some owners do not believe that their cats are pruritic and they may present them to the practice for apparently spontaneous lesions such as eosinophilic plaques and alopecia. It is imperative to use a systematic approach to diagnosis. This article will describe the key points of the history and the clinical signs as well as the appropriate tests that can be used to rule out certain conditions and confirm the diagnosis. As a pruritic cat can take some time to reach a resolution, client communication is paramount. Regular contact during diagnostic food and flea trials with good follow up of treatment can substantially improve compliance, leading to better outcomes for the cat and their owner.

Chemotherapy: toxins and barriers

There are many instances in which the cancer patient and its nursing staff may be exposed to toxins and/or require barriers.Although the beneficial effects of chemotherapy against the cancer generally outweigh the potential side effects in skilled hands, almost all anticancer drugs have side effects. Toxicity is the most significant treatment-limiting factor in cytotoxic drug use.In addition, multiple studies have shown multiple potential dangers to staff handling cytotoxic drugs, including increased chromosomal alterations, hepatotoxicity and abnormal reproductive outcomes to be associated with exposure to various chemotherapeutic drugs. For these reasons, it is important that written safety protocols be established and followed in the any veterinary clinic administering chemotherapy. There must also be written instructions to pet owners for at-home administration, handling of drugs and for dealing with drug-contaminated excreta. Veterinary nurses have a vital role to play in the care of chemotherapy patients, and in maintaining the health and safety of both patient and staff. Careful administration of cytotoxics and subsequent patient monitoring should avoid many potential complications of using these drugs. If guidelines are followed, the safe use of cyto-toxic drugs should be possible for the majority of veterinary practices, with minimal risk to all staff involved. Practices and personnel should not become complacent with cytotoxic drug use and regular risk assessment, and updates to Control of Substances Hazardous to Health (COSHH) local rules.

Early enteral nutrition — principles and practice

This article has three major objectives: to review briefly the physiology and metabolism of the small intestinal mucosa; to summarise the evidence and recommendations regarding early enteral nutrition; and to discuss how to implement early enteral nutrition in small animal veterinary practice.The gastrointestinal tract has a high metabolic rate and is composed mostly of cells that have a short life. Early enteral nutrition (EEN) contributes to improved gastrointestinal (GI) function, decreased GI permeability and improved patient outcomes. EEN can be delivered starting on day 1 for even critically ill patients. A transition from simple to more complex foods over time results in fewer complications.

Safe delivery of anaesthetic agents in cats and rabbits

This article reviews the methods used to administer volatile anaesthetic agents to veterinary patients, particularly focusing on the difficulties encountered when performing endotracheal intubation in cats and rabbits, and the negative outcomes associated with these difficulties. The article focuses on the novel use of supraglottic airway devices, which up until recently had only been available for human use, discussing the benefits that the use of these devices may have over using ‘standard’ anaesthetic agent delivery techniques.

How to nurse the ageing small animal inpatient part 2 — ageing effects on body systems

Ageing in animals is associated with gradual deterioration in the delicate interrelationships among the body systems, which predisposes them to acquired disease. A common characteristic of ageing body systems is progressive and irreversible change. Such change may be hastened by disease, malnutrition, genetics, reduction in exercise, stress and the environment. Knowledge of the common pathologic changes associated with age and their effect on body function enables the veterinary nurse to implement specific nursing care for the ageing inpatient.

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