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Day One Skills for veterinary nurses - Equine

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Section 1 – Legislation affecting practice

  1. Comply with Health and Safety requirements and local risk factors

    Guidance: Comply with legislative requirements

  2. Follow Standard Operating Procedures and manufacturer guidelines when using equipment and materials

    Guidance: No guidance

  3. Take appropriate action and report injury involving self or others

    Guidance: Complete the accident book/record in accordance with practice protocol

  4. Critically evaluate a risk assessment for one area of the practice and suggest appropriate action where necessary

    Guidance: No guidance

Section 2 – Communication

  1. Communicate effectively using a variety of different methods
    Refer to and consider supporting guidance: 5. Communication between professional colleagues

    Guidance: Communicate with clients, work colleagues, other veterinary professionals, and the public, considering their diverse needs and requirements.
    Communication models should be considered.

  2. Create accurate and legible written communications/documentation according to practice policy

    Guidance: Records to include: patient records and reports, laboratory reports, admission and consent forms, client home care plans and instructions.

  3. Access and store client and practice records according to practice policy and data protection laws
    Refer to and consider supporting guidance: 14 client confidentiality.

    Guidance: No guidance

  4. Admit patients
    Refer to and consider supporting guidance: 1. Referrals and second opinions, 9. Practice information, fees and insurance, 11. Communication and consent

    Guidance: Obtain written and verbal informed consent; Respond appropriately to economic status of clients to include insurance and referrals; develop care plans as appropriate.

  5. Conduct effective nursing consultations
    Refer to and consider supporting guidance:
    18. Delegation to veterinary nurses

    Guidance: History taking and appropriate examination; Identifying patients for referral to a veterinary surgeon or veterinary nurse; Application of treatments; Programmes of preventative medicine.

  6. Implant a microchip

    Guidance: This may be completed as part of a nursing consultation.

  7. Provide discharge information and guidance to clients

    Guidance: Discuss home care plans with clients, to include advising clients on safe and correct routes of administration and potential side effects; Demonstrate to clients safe techniques for administering medication; Advise clients on the storage and disposal of medication; Wound care advice; Bandage advice; advise clients on out of hours services.

  8. Complete appropriate documentation for referral and diagnostic services
    Refer to and consider supporting guidance: 13. Clinical and client records

    Guidance: To include laboratory samples, clinical histories and hereditary tests for example elbow and hip scoring, genetic testing, and blood tests.

  9. Review and discuss evidence-based nursing

    Guidance: Identify an area of practise for discussion with members of the veterinary team; Appraise literature; consider cases in accordance with reviewed literature; Discuss and disseminate findings with practice team.

  10. Identify and collaborate on quality improvement within the practice setting
    Review and consider supporting guidance: 5. Communication between professional colleagues, 17. Veterinary teams and leaders

    Guidance: Review definition of quality improvement and guidance provided by RCVS Knowledge, discuss unexpected medical or surgical complications with the veterinary team, examples of which may include serious complaint, accident or anaesthetic death; Consider circumstances; Ensure effective protocols are in place; Discuss proposed improvements with the practice veterinary team

  11. Demonstrate compliance with practice protocols in regard to health and wellbeing of personnel
    Refer to and consider supporting guidance: 15. Health Protocol

    Guidance: Discussion of health and wellbeing concerns which may be experienced by any member of the veterinary team, and the protocols in place to prevent and mitigate them. These should include reference to mental and emotional health concerns, as well as those relating to physical safety and health.

  12. Communicate effectively expressing appropriate empathy and sympathy
    Refer to and consider supporting guidance: 8. Euthanasia of animals

    Guidance: Prepare the owner for loss; Support the owner through the euthanasia process; Provide follow-up support for a bereaved owner; Maintain and adapt professional approach to the circumstances.

Section 3 – Handling and restraint

  1. Evaluate behavioural and environmental factors when approaching and handling animals

    Guidance: Recognition of and minimizing, fear and distress, utilising approaches which reduce stress. Handling techniques with reference to welfare for example, positive reinforcement.

  2. Select and use appropriate personal and patient protective equipment

    Guidance: No guidance

  3. Demonstrate techniques for approaching and handling patients

    Guidance: With due regard to patient needs and behaviours.

  4. Lead and move animals using the most appropriate equipment for the species and approved manual handling and lifting procedures

    Guidance: May include the use of hoists and slings.

  5. Use appropriate restraint methods suitable for the patient and situation with due consideration for animal welfare

    Guidance: Maintain patient’s emotional homeostasis and wellbeing; Recognise signs of distress and act accordingly to minimise this; Restrain for clinical examination, sample collection, administration of medicines.

Section 4 – Nursing care

  1. Interpret and use individualised care plans to deliver the nursing process for a range of disorders and diseases

    Guidance: Interpret nursing care plans and carry out appropriate nursing intervention.
    Consider cross-referencing to Section 2

  2. Critically evaluate a care bundle

    Guidance: This may be evidenced through research and a clinical discussion.

  3. Carry out a nursing assessment ascertaining information about the patient’s normal routine

    Guidance: Food and fluid intake; Urination and defecation; Behaviour (response to pain, strangers, commands etc); Mobility and exercise; Sleep and rest; stabling, turnout and companion requirements; Rugging.
    Consider cross-referencing to Section 2.

  4. Perform a clinical examination and record findings

    Guidance: To include temperature, pulse, respiration, weight and capillary refill times/mucous membranes, gut sounds and digital pulses.

  5. Provide husbandry to patients, considering accommodation, nutrition, and excretions

    Guidance: Consider age, species, condition, demeanour and enrichment. Calculate food requirements based on disease and life stage/lifestyle, manage assisted feeding to include hand feeding, oral hydration and managing and maintaining  stomach tubes.

  6. Maintain patients’ hygiene according to their needs

    Guidance: To include eyes, nostrils, hoof-picking and general grooming.
    Consider cross-referencing to Section 2.

  7. Assess, monitor, manage and report the status of wounds to the appropriate member of the veterinary team

    Guidance: No guidance

  8. Apply dressings appropriate to type of wound

    Guidance: Consider evidence-based techniques and materials.

  9. Apply bandages appropriate to condition

    Guidance: No guidance

  10. Administer medicines prescribed by the veterinary surgeon in accordance with instructions from the manufacturer

    Guidance: To include oral, topical, subcutaneous, intramuscular, and intravenous.

  11. Monitor for side effects and adverse medication reactions and alert veterinary surgeon

    Guidance: No guidance

  12. Provide fluid therapy to in-patients

    Guidance: Select appropriate fluids according to veterinary surgeon instructions; Select and prepare administration equipment; Place intravenous catheters into appropriate veins; Intravenous catheter management; Calculate amount and rate of fluid to administer; Observe and monitor patients receiving fluid therapy, reporting any concerns to an appropriate member of the veterinary team.

  13. Identify, assess, and evaluate pain and alert the veterinary surgeon

    Guidance
    Score and evaluate pain using a validated system; intensity of pain and associated anxiety and behaviour.

  14. Perform basic physical therapy techniques to aid mobilisation
    Guidance: To include passive movement and active exercise.
     
  15. Administer first aid for a range of situations within the limits of the law and the expertise of the student
    Guidance
    First aid is defined as care that can be carried out by a lay person.
     
  16. Assist with a range of emergency care techniques within the limits of the student’s expertise

    Guidance: Emergency care is defined as care delegated by the veterinary surgeon in an emergency scenario.

Section 5 – Laboratory techniques

  1. Discuss with the veterinary surgeon and prepare for an appropriate sampling strategy

    Guidance: Strategy to include: personal protective equipment (PPE), clipping and preparing sample site, preparation of patient and equipment; calibration of equipment. Strategies prepared for: blood, urine, faeces, skin/hair and tissue biopsies; peritoneal tap, synovial fluid sample.

  2. Safely and effectively take appropriate samples

    Guidance: Samples to include blood, urine, faeces, skin, hair pluck, bacterial swabs. Assist with the collection of peritoneal fluid; synovial fluid sample.

  3. Carry out haematological analysis

    Guidance: To include biochemistry, haematology, packed cell volume, total solids (protein) and smear.

  4. Carry out urinalysis

    Guidance: To include urine reagent strips, specific gravity, sediment analysis.

  5. Carry out faecal analysis

    Guidance: May include; gross visual analysis; microscopic analysis; quantitative examination; commercial test kits.

  6. Carry out skin and hair analysis

    Guidance: May include: hair pluck, skin scrapes, tape strips and coat brushings.

  7. Use a microscope to examine laboratory samples

    Guidance: To include: low magnification, high magnification and oil immersion. Record Vernier Scale readings.

  8. Prepare samples for external analysis

    Guidance: To include: accurate completion of documentation, correct packaging and labelling, correct preservation and storage in line with current legislation.

  9. Record laboratory test results and communicate accurately to the appropriate member of the veterinary team

    Guidance: No guidance

Section 6 – Diagnostic imaging

  1. Prepare and use radiography equipment to produce a diagnostic image

    Guidance: No guidance.

  2. Use appropriate personal protective equipment (PPE) and radiation monitoring equipment in accordance with practice local rules

    Guidance: No guidance.

  3. Position a patient to obtain a diagnostic image of the area of interest

    Guidance: A variety of positions would be expected. Positioning of equipment must also be referenced.

  4. Produce images according to practice procedure

    Guidance: No guidance.

  5. Record exposures and results of images according to practice procedure

    Guidance: Appraise the quality of the image.

  6. Prepare and support animals during endoscopy investigation

    Guidance: To include setting up equipment and assisting with passing an endoscope.

  7. Prepare and support animals during ultrasound investigation

    Guidance: To include setting up equipment.

Section 7 – Dispensing

  1. Ensure safe handling and management of pharmaceuticals in accordance with legislation and manufacturer guidelines

    Guidance: Store, handle and dispose of medicines in line with legislative guidelines and specific requirements found in the Summary of Product Characteristics (SPC) and with reference to their drug category.

    To include: Controlled drugs and hormone based medicines which require special handling and disposal.

  2. Interpret prescriptions and prepare medicines for dispensing

    Guidance: Calculate drug dosages and confirm with an appropriately qualified member of the veterinary team; Package and label in accordance with legal requirements.

  3. Maintain appropriate records

    Guidance: To include medicines records, Controlled drugs (CDs), withdrawal periods and hospital charts.

Section 8 – Infection control

  1. Recognise clinical signs of common zoonotic diseases and undertake strategies to prevent spread and infection

    Guidance: No guidance.

  2. Formulate and implement an appropriate infection control strategy according to practice protocol

    Guidance: Constitute appropriate cleaning and disinfectant solutions; Prepare, clean and maintain patient accommodation that maximises the welfare of hospitalised patients to include isolation accommodation; Prepare, clean and maintain examination rooms, preparation area and operating theatre to include periodic deep clean and after infected cases.

  3. Dispose of hazardous and non-hazardous waste, safely and correctly according to current legislation

    Guidance: To include recycling and correct disposal of medications.

  4. Ensure appropriate hygiene skills are followed before and after handling animals and equipment

    Guidance: Comply with the World Health Organisation hand washing method; Use and dispose of PPE.

  5. Carry out effective barrier nursing

    Guidance: Taking into account accommodation, PPE, equipment and patient condition to include reverse barrier nursing.

Section 9 – Theatre practice

  1. Maintain common surgical instruments

    Guidance: Identify, check, and clean common surgical instruments; Identify and report damage to equipment and instruments.

  2. Prepare, package, and monitor the sterilisation of instruments and materials

    Guidance: No guidance.

  3. Prepare the theatre for use based on patient, equipment, and procedure

    Guidance: No guidance.

  4. Position patients appropriately on the operating table in accordance with the planned procedure considering patient condition

    Guidance: Correct and safe use of the hoist. Consideration of lateral and dorsal recumbency and standing surgeries.

  5. Prepare the surgical site appropriately for the procedure in accordance with practice protocol

    Guidance: Consider cross-referencing to Section 2.

  6. Assist as circulating nurse

    Guidance: Open and pass sterile materials direct to scrubbed personnel; Prepare ancillary and powered equipment; complete surgical safety checklists.

  7. Prepare hands and arms using appropriate method

    Guidance: Consider cross referencing to Section 2

    To include pre-surgical scrub prior to donning gown and gloves.

  8. Prepare for surgical assistance wearing appropriate attire in accordance with practice protocol

    Guidance: To include Donning of gown and gloves (closed gloving method) in an aseptic manner.

  9. Put on surgical gloves (open gloving method) in an aseptic manner to assist with sterile procedures

    Guidance: Maintain sterility of self and others during procedures.

  10. Assist with draping patients maintaining sterility according to practice protocol

    Guidance: No guidance.

  11. Monitor and record materials during surgery

    Guidance: No guidance.

  12. Handle and pass instruments and equipment aseptically during surgery

    Guidance: No guidance.

Section 10 – Anaesthesia

  1. Assess the patient and identify the patient’s anaesthetic risks

    Guidance: To include ASA guidelines, behaviour and temperament, clinical assessment, and discussion with an appropriate member of the veterinary team.

  2. Prepare equipment for anaesthesia

    Guidance: Prepare the knockdown box. Check and prepare the anaesthetic machine in accordance with practice protocol; Select, check, and prepare breathing system/circuit and pollution control system in accordance with practice protocol; Select and prepare monitoring equipment according to the patient’s condition; Prepare materials and equipment required for induction of anaesthesia to include pharmaceutical agents (according to veterinary surgeon direction) and appropriate airway management device.

  3. Prepare patients for anaesthesia according to practice protocol

    Guidance: Starvation (if appropriate); determine patient weight; pre-operative clipping of the surgical site (if safe to do so); grooming, tail bandages, foot preparation including shoe removal; intravenous catheter placement and mouth washing, administer pre-medicants.

  4. Assist with induction of anaesthesia

    Guidance: Assist with physical stabilisation of the patient until recumbency and unconsciousness has been attained.

  5. Maintain and monitor the patient during the anaesthetic process

    Guidance: Refer to and consider supporting guidance: 18. delegation to veterinary nurses.

    Measure temperature, heart rate, peripheral pulse, respiratory rate; Monitor equipment (systems/circuits and tube, gases and volatile agents, patient monitors); Interpret and report observations to the directing veterinary surgeon (Inconsistencies, patient monitors); complete anaesthetic monitoring records. Calculate and administer inhalation anaesthesia under veterinary direction (Change the depth or level of inhalation anaesthesia under veterinary direction) disconnecting patient from anaesthetic equipment and materials;

  6. Assist with recovery from anaesthesia under continuous and direct supervision

    Guidance: Assist with: positioning patients for recovery; administration of 100% oxygen in the recovery room, if appropriate; removing airway management device at appropriate stage of recovery; assisted recovery if appropriate; assessing if the patient is ready to leave the recovery box and return to the stable. Maintain accurate recovery records; Communicate post-operative and/or anaesthetic recovery progress to the Veterinary Surgeon and other appropriate members of the veterinary team.