ADN111 – Advance15 – Inpatient Care

Advance15^TM Courses help you to develop your knowledge and clinical skills in a defined area of small animal practice. These fully flexible online courses include tutor support and interaction via an interactive discussion forum you can ask questions and join the discussion at any time, wherever you are in the world. There are no ‘real time’ sessions that you need to be available for, so this course is suitable for you whatever your time zone. All of your course materials are all recorded, and you have full access for a 12 month period. The course runs for a four week period, and you’ll get tutor support for a further 2 weeks in case you need to catch up. After that, you’ll still have full access although the tutor support will end. Complete your learning and get your CPD Certificate for 15 Hours of CPD.

Week 1

Webinar 1: Patient Safety       

What do we mean patient safety? Why is this important to consider? The main goal of assessing patient safety is obviously to keep the patient safe during their hospitalisation. This consideration may be unrelated to the reason for their hospitalisation. However, it is extremely important, that we as nurses consider the small changes we can make in our ward areas. I hope to promote new thinking, with regards to the individualised patient safety. Based upon the NHS 2022 National Patient Safety Guide, we will discuss the importance of some simple changes to make in wards to improve patient safety. Some of which you may or may not already be practicing. We will discuss:

• Safety Huddles, these were introduced in 2016 by the NHS, I will explain how these can help and how to implement these.
• Clinical governance
• Checklists
• Identify patients
• Use medicines safely
• Prevention of infection

Webinar 2: Approaches to inpatient care

It may be perceived that holistic nursing is an adjunct of different alternative therapies. However, this explains only a third of what holistic nursing entails. It may be described as an amalgamation of the Veterinary Surgeons Medical Model of care (RCVS, 1966), individualised nursing care and alternative therapies, if they are deemed necessary. It is often described as unnecessary extra work, designing and implementing a nursing care plan, however this is how the individualised nursing care is highlighted, achieved and implemented. In contrast it can be considered that nurses would be performing their jobs in anything but a haphazard way without use of a care plan and it can be difficult to discuss the difficulty in achieving holistic nursing without a care plan. Nurses may choose to use a published nursing care plan, one which includes all of the activities of daily living to ensure thoroughness. An example of such would be a human nursing care plan entitled ‘Roper, Logan and Tierney (2000) which may be adapted for use in animals. Nursing care plans do not need to be in depth and time consuming. They can be easily implemented using small changes to structure, routine and organisation. There is no benefit to implementing holistic planned nursing care if this means nurses have more paperwork and less time to deliver this planned care. Planned care can be achieved by using assessment, planning, implementation and evaluation of different key areas of patient care. The use of a planned 24-hour hospitalisation sheet is a good place to start to assist in delivering holistic individualised patient care. Surgical patients have a variety of needs pre-operatively and post-operatively. Assessing the basics such as demeanour, nutrition, pain, mobility, can create more nursing tasks that will ultimately improve patient care.

Week 2

Webinar 1: Ward Management    

To provide great patient care you have to have the correctly trained staff, provide consistent care, in a clean and organised environment. In this section I hope to inspire nurses, to introduce new protocols, re-structure and review all the current procedures you currently have in place. We will discuss:

• Management of staff training and standard of practice protocols
• How to monitor standards by reviewing these procedures using evidence-based research
• How to hold regular wards meetings for brain storming new ideas using a coaching approach
• The importance of having a structured daily, weekly, monthly staff tasks list to promote a good wards environment
• Clinical Handovers
• The importance of paperwork
• Management of client care

Webinar 2: Nursing care of the surgical inpatient

There is a vast amount of research concentrating on improving mortality rates in surgical patients. This is clearly shown by the Confidential Enquiry into Perioperative Small Animal Fatalities (CEPSAF) study carried out in 2006 which demonstrates the percentage of deaths in recovery is higher than that of pre-medication, induction and maintenance periods. The study identified the recovery period as the greatest risk during anaesthesia with most deaths occurring within 3 hours of the procedure. There is constant continuing research to try and minimise this risk, improving mortality rates in the post-operative surgical patient. The main area of focus concentrates on the close monitoring of the surgical patient in the recovery period with efficient nursing care during this time. Using the recommendations highlighted within this session it may be possible to reduce mortality rates while improving nursing care intervention.

Week 3

Webinar 1: Pain assessment tools     

Managing pain in all our inpatients is vital and as veterinary nurses we have a moral and ethical duty to mitigate pain to the best of our ability. This session will cover:

• The importance of managing pain
• Recognising the impact of pain if left untreated
• A multi-modal approach to pain
• Why we should be using a pain scoring system?
• We will evaluate the challenges of using a pain scoring system
• Where to start when implementing a pain scoring system
• How to implement acute and chronic pain scoring systems in practice

Webinar 2: A multimodal approach to pain in our patients  

A multimodal approach to pain is when two or more analgesic drugs from different classes are administered to inhibit nociception at different points along the afferent pain pathway. In this session we will cover:

• The physiology and terminology associated with pain
• The definition of pain
• The types of pain we see if our veterinary patients
• Why it’s so important to treat pain
• We will look at the analgesic drug options we have available to us
• Identify other non-pharmalogical alternatives to treating pain

Week 4

Webinar 1: Indwelling lines     

In wards there can be a variety of indwelling lines to care for. It is vital nurses feel confident to use, care for and be able to highlight possible complications of these indwelling lines. We will discuss the care and common complications of some indwelling lines.

• Intravenous catheter’s
• Indwelling urinary catheter
• Central line
• Arterial line
• Chest drains
• Tracheostomy tube
• Feeding tubes

Webinar 2: Nutrition  

There is a growing awareness of the importance of good nutrition on people’s health. As a result, it is also recognised that food may be associated with disease. This awareness is mirrored in the veterinary industry. Veterinary nurses are aware of malnutrition and the effects it may have on an animal; it is their duty of care to provide good nutrition to hospitalised patients. When pets are being fed as inpatients they are at their most vulnerable medically, increasing the need for good nutrition while they are hospitalised. By taking a systematic approach using Yura and Walsh’s assessment, planning, implementation and evaluation (APIE) techniques, veterinary nurses may be more successful in assisting patients to orally intake their resting energy rate. This will ultimately lead to shorter recovery times and hopefully increased job satisfaction. We will discuss assessment, planning, implementation and evaluation strategies in relation to nutrition.

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Tutor: Nicola Waring BSc (Hons) CVN RVN Dip CVN Dip AVN Dip Ed QTLS & Stacey Cox RVN HeDipCVN AVN

If you would prefer to reserve your place for 7 days whilst you arrange payment or check your commitments then click here