Auditing post-operative complications in dog castrate patients

I’m one of the RVNs at Highcliff Vets, part of the IVC group. I joined the practice in April 2024 and was given the opportunity to undertake a QI project as this is an area in which I have great interest. The practice uses the Microsoft Power BI program, which collects information from the program used on a day to day at the practice, and produces a report providing us with areas to focus when it comes to quality improvement.

The topic chosen for this audit was postoperative complication rates in our dog castrate and was based on the report as it showed that our current rate was higher than expected. The veterinary clinical audit cycle was used as a guidance and alongside findings from veterinary literature, a set of criteria which would be compared across patient was constructed. This included surgical approach, suture material used, the use of additional closure, prevention of patient interference, pain relief and additional notes were also made on individual patient temperament, veterinary surgeon operating and any poor adherence seen to follow postoperative instruction whilst patient was discharged and seen for their post-op check.

We decided to conduct this project as a retrospective clinical audit. And as this was our first cycle, we did not have previous data to compare against. The national audit for small animal neutering provided us with access to a large compilation of data and enabled us to use it as a benchmarking tool. Our conclusion highlighted that a multi-approach to improvement could result in positive outcome, and therefore we implemented the following.

We made a change to our discharge sheet, making more of an emphasis on the importance of buster colour and patch shirt in reducing risk of infection. We designed an illustration table to encourage staff to always complete the POA code when doing the post-op check. We introduced a local anaesthetic block for castrate patients. We also introduced the reusable surgical sheet to improve the data collection for our next cycle and also implemented the use of a handheld Hoover for patient prep only to reduce skin irritation. And we are currently gathering and analysing data for the second part of our auditing cycle, looking into whether the interventions that we implemented led to positive outcome. Thank you.