Week 1

Patient Assessment and Triage

The concept of triage

Preparedness

Primary survey

Secondary Survey

Emergency history

Learning objectives
After completion of this week, participants should be able to:

Understand the triage process and how it can be utilised to prioritise emergency care

Describe how to make their team and environment prepared for when the emergency patient arrives

List how to carry out a primary survey during the initial assessment of the patient

Explain how to carry out a secondary survey assessment in order to list their concerns with the patient

Discuss how to communicate with the client including telephone advice, informed consent and emergency history

Week 2

Shock

Classify shock

Emergency database

Blood pressure

Oxygen therapy

The use of multiparameter monitors

Learning objectives
After completion of this week, participants should be able to:

Identify a patient with shock and classify which type of shock they have

Explain which parameters may be tested during an emergency database and how these can help to identify shock in the emergency room

Understand the physiology of perfusion and ways in which blood pressure can be monitored in the emergency patient

List the different ways that oxygen therapy can be delivered to the emergency patient

Understand the uses and limitations of multiparameter monitors and their role in monitoring perfusion trends

Week 3

Fluid Therapy

Patient assessment

Identifying a fluid deficit or change in volume

What fluids are available

Managing a change in content

Identifying a change in fluid distribution

Learning objectives
After completion of this week, participants should be able to:

Explain how to assess the patient’s fluid status using clinical exam and blood work

Discuss how to create a fluid plan to treat a fluid deficit such as hypovolaemia or dehydration

List what fluid options are available and which fluid might be preferred in which situation

Understand how fluid selection or the fluid plan can be altered to account for an electrolyte abnormality

Describe how to manage the patient with fluid overload or peripheral oedema

Week 4

Neurological Emergencies

Neurological assessment

Coma scoring

Raised intracranial pressure

Seizures

Learning objectives
After completion of this week, participants should be able to:

Describe how to perform a neurological assessment of an emergency patient

Describe how to perform a coma score and understand how these may be used in neurological patients

Understand methods of identifying raised intracranial pressure and the physiology behind this

Recognise a seizuring patient and understand their management, from initial presentation and stabilisation of mild seizures through to the management of a patient in status epilepticus

Week 5

Approach to the Trauma Patient

Assessment of wounds

Wound management

Management of fractures

Other injuries associated with trauma

Analgesia

Learning objectives
After completion of this week, participants should be able to:

Identify different wounds based on the patient history and appearance of the wound

Understand the principles of wound management and common techniques used to flush and debride wounds

Describe how to identify and manage fractures in the trauma patient

List other common injuries associated with trauma and how these should be managed

Implement an analgesia plan for the trauma patient based on pain assessment

Week 6

Common Toxicities

Common toxins seen in emergency practice

Renal toxins

Hepatotoxins

Anticoagulants

Neurotoxins

Learning objectives
After completion of this week, participants should be able to:

Describe the different ways toxins can enter the body

List the most common renal toxins and understand the treatment of these patients

List the most common hepatotoxins and understand the different treatments for each of these

Understand the physiological effects of anticoagulant ingestion and the treatment of these patients

Identify the most common neurotoxins seen in practice and understand the treatment of these patients

Course Summary

Haemostasis is the process that the body uses to stop bleeding. If we know what is involved in this process it can help us to understand why things can go wrong and help us give our patients better care. In this 30 minute eCPD tutorial we will discuss the three main steps of haemostasis, tests used to assess haemostasis, disorders that affect haemostasis and some treatments that are given to animals with haemostatic conditions.

Course Tutor

Maddie Enderby ISFMDipFN CertVNECC FdSc RVN
ICU Nurse, Paragon Veterinary Referrals

Course Length

The course is worth 30 minutes of CPD for UK delegates and 0.5 AVNAT points  for Australian and New Zealand delegates

The course is provided with unlimited lifetime access for on-demand learning

Course Notes

Unfortunately, course notes are not available with this tutorial

Week 1

Setting Up and Running Nurse Clinics

Which clinics to run?

Charging for clinics

Standardisation of the clinics

Client compliance

How to increase client numbers

Making recommendations

Marketing and publicity

Building confidence

Reflective practice

Learning objectives
After completion of this week, participants should be able to:

Understand the consulting nurse’s pivotal role in practice

Appreciate the varying types of clinics nurses can offer

Learn how to increase numbers coming into clinics, and increase recommendations to the clinics

Understand how to increase client compliance in clinics

Know various ways to market and advertise the clinics on offer

Week 2

Consulting Skills

Communication in clinics

Consultation skills

Content of your clinic

Keeping to time

Learning objectives
After completion of this week, participants should be able to:

Understand the process of consulting

Understand the importance of communication, the customer journey and improving outcomes

Understand the importance of protocols for clinic content and the running of these clinics

Week 3

Lifestage Clinics

Puppy and kitten clinics

Senior clinics

Other lifestage clinics

What to include

Timings of clinics

Learning objectives
After completion of this week, participants should be able to:

Timings of clinics and how these will improve client education and binding to the practice

Understand the content for these clinics and what to discuss with clients at this time

Understand the elements of preventative healthcare

Understand the importance of nutritional assessments in all of the nurse clinics

Week 4

Obesity and Mobility Clinics

Content of mobility and obesity clinics

Nutritional requirements for obesity

Client motivation

Learning objectives
After completion of this week, participants should be able to:

Understand the content to include for each of these clinics

Calculate feeding amounts, what treats (if any) we can feed and exercise regimes

Understand how environmental adaptations can improve QOL for our pets with mobility issues

Understand the role of supplements in these cases

Discuss methods of how to motivate clients

Week 1

Pre-anaesthetic Assessment and Patient Preparation for Anaesthesia

Patient preparation

ASA status and patient assessment

Use of checklists

Breathing systems and checks

What are the aims of anaesthetic premedication

Practical considerations

What agents are available

Learning objectives
After completion of this week, participants should be able to:

Correctly identify an appropriate breathing system and safe fresh gas flow rates for individual patients

Confidently check an anaesthesia machine and breathing system to ensure they are safe to use

Have an understanding of the ASA grading system and be able to designate and apply which status is appropriate for their individual patients

Identify the benefits of using a peri-anaesthetic checklist and decide whether this can be advocated for their working environment

List the reasons for patient premedication and be able to identify practical aspects and factors within the clinic which may affect the efficacy of premedication

Identify the most common pharmacological agents used for sedation and anaesthesia

Week 2

Anaesthetic Monitoring – Neurological and Respiratory System

Basic, hands on monitoring (neurological system)

Respiratory monitoring

Other

Learning objectives
After completion of this week, participants should be able to:

Recognise what are normal physiological parameters with regards to the neurological and respiratory systems for individual patients undergoing anaesthesia

Name the most common pieces of monitoring equipment for the respiratory system and be able to recognise what is a normal value/trace for each of these pieces

Start to develop the skills to apply this knowledge to individual cases within the clinic with use of the available equipment

Week 3

Anaesthetic Monitoring – Cardiovascular System

Cardiovascular monitoring

Basic, hands on

Blood pressure

Pulse oximetry

ECG

Learning objectives
After completion of this week, participants should be able to:

Recognise what are normal physiological parameters with regards to the cardiovascular system for individual patients undergoing anaesthesia

Name the most common pieces of monitoring equipment for the cardiovascular system and be able to recognise what is a normal value/trace for each of these pieces

Start to develop the skills to apply this knowledge to individual cases within the clinic with use of the available equipment

Week 4

Principles of Perioperative Care including Anaesthetic Recovery

Anaesthetic risk

Airway management including tracheal intubation

Patient positioning

Eye care

Temperature

Fluid therapy

Patient recovery

Learning objectives
After completion of this week, participants should be able to:

Identify important factors which require attention and care during a patient’s anaesthetic in order to optimise the patient’s peri-anaesthetic experience

Accurately calculate fluid rates for individual patients and apply this to their clinical setting, whether this be with use of fluid pumps/syringe drivers or via gravity (calculating a drop rate)

List available methods for patient warming, with recognition of the need to counteract patient hypothermia and the potential risks associated with warming device use

Recognise the critical importance of patient monitoring during anaesthetic recovery.

Describe the potential difficulties that may be encountered during the anaesthetic recovery period

Week 5

Pain Assessment

Importance of pain assessment and management

Challenges of pain assessment in veterinary species

Pain assessment tools

Learning objectives
After completion of this week, participants should be able to:

Recognise the potential difficulties in performing pain assessment in veterinary species.

Name a number of pain assessment tools

Advocate a pain assessment tool that would be suitable for their working environment

Recognise when patients (cats and dogs) are deemed to be painful

Week 6

Analgesia for Acute Perioperative Pain

A brief overview on the pain pathway with introduction to the concepts of multimodal and pre-emptive analgesia

Analgesic options, including:

 A brief overview of the pharmacological means

Non-pharmacological methods

Learning objectives
After completion of this week, participants should be able to:

Explain why provision of analgesia is important for patient welfare

Describe the concepts of multimodal and pre-emptive analgesia, with emphasis on why these are important for patient analgesia

Explain why provision of analgesia is important

List potential analgesic options and apply this knowledge to consider appropriate therapeutic plans for individual patients

Have an appreciation of the important role that a veterinary nurse can play in providing non-pharmacological methods of analgesia and improving the patient experience

Week 1

An Introduction to Brachycephalics

Brachycephalic anatomy basics

Breeds commonly affected

Recent increase in popularity and the effects on the breed

Co-morbidities commonly seen in brachycephalics

Communication with owners

Learning objectives
After completion of this week, participants should be able to:

Recognise and discuss the anatomy of a brachycephalic patient

Understand the causes that can be attributed to clinical signs often displayed by patients suffering with BOAS

Identify co-morbidities often diagnosed in brachycephalic patients

Understand when and why communication with owners about brachycephalic pet ownership is vital

Understand the Cambridge BOAS assessment

Week 2

Brachy Breathing – Crisis and Management

Triage

Respiratory sounds

Blood gas analysis

Aspiration pneumonia

Oxygen therapy

Learning objectives
After completion of this week, participants should be able to:

Understand how to triage the brachycephalic patient

Recognise the difference between the various respiratory sounds

Identify the uses of blood gas analysis in respiratory conditions

Understand available treatments for aspiration pneumonia

Explain the different methods of providing oxygen therapy

Week 3

It’s a Hot Topic – Heatstroke Management

Heatstroke identification

Treatment options

Recovery process

Risks and complications

Learning objectives
After completion of this week, participants should be able to:

Identify a patient at risk of heatstroke

Explain how to care for the hot brachycephalic

Understand the risks associated with heatstroke

List the clinical signs to look out for in a recovering heatstroke patient

Describe treatments for the recovering heatstroke patient with a secondary condition

Week 4

Brachycephalic Anaesthesia

Balanced anaesthesia plans

Anaesthetic equipment

Anaesthetic monitoring

Learning objectives
After completion of this week, participants should be able to:

Understand how to perform a pre-anaesthetic evaluation

Design a patient specific anaesthesia plan, to include – premedication, induction, maintenance, and other medications to support the brachycephalic patient in the peri-anaesthesia period

Understand the approach to monitoring the brachycephalic patient under anaesthesia

Week 5

Managing a Difficult Airway

Pre-anaesthetic airway compromise and signs of potential difficult airways

Intubations, including tips and equipment aids

Ways to assist patient recovery from anaesthesia

Learning objectives
After completion of this week, participants should be able to:

Evaluate a patient prior to anaesthesia to determine severity of airway compromise

Identify the clinical signs to alert the anaesthetist to a potential difficult airway prior to induction

List the different intubation aids and how to maximise successful intubations, to maintain oxygenation and minimise hypoxia.

Understand how we can assist recoveries in the brachycephalic patient to achieve extubation and reduce incidence of post anaesthesia respiratory obstruction

Week 6

Head and Neck Surgery

Preparing the patient for surgery

Surgical techniques to correct common conditions – stenotic nares, elongated soft palate, everted laryngeal saccules, everted palatine tonsils, skin fold resection and tracheotomy/tracheostomy

Surgical techniques for conditions affecting the eyes – canthoplasty, grafting for ulceration, entropion etc.

Instrumentation

Learning objectives
After completion of this week, participants should be able to:

Prepare the patient for a range of procedures, including preparation of skin, eyes and mucous membranes

Correctly position patients for a range of surgical procedures involving the head and neck

Understand the most common surgical procedures, and explain these to owners

Tailor a post-operative care plan for each individual patient

Week 7

All the Other Problems Not in the Head and Neck!

Preparing the patient for surgery

Surgical techniques for a range of common conditions including caesarean sections, fracture repairs (humeral condyle), hiatus hernia, screw tail, hemilaminectomy and pulmonic stenosis

Instrumentation

Learning objectives
After completion of this week, participants should be able to:

Prepare theatre and the patient for a range of surgical procedures

Understand the most common surgical procedures, and explain these to owners

Tailor a post-operative care plan for each individual patient

Identify common surgical instruments and understand their use

Week 8

Ophthalmology

Corneal ulceration, exposure keratopathy and corneal pigmentation

Corneal sequestrums in cats

Entropion and Ectropion

Keratoconjunctivitis sicca (KCS)

Tear overflow and staining

Proptosis

Learning objectives
After completion of this week, participants should be able to:

Explain the common ocular conditions in the brachycephalic patient

Understand the treatment options for the above conditions

Feel more confident when nursing the ophthalmic patient and what specific considerations to bear in mind

Week 1

Toxicology Introduction

The top 10 commonly encountered toxins in small animal patients will be reviewed along with up-to-date evidence-based guidelines looking at treatment recommendations and options

We will review the reported antidotes as well as the use of intra-lipid emulsion and other supportive measures we may implement in patients suffering from intoxication

Common complications of the various intoxications we can encounter will be reviewed as well as discussion of how we may pre-empt and manage these

Learning objectives
After completion of this week, participants should be able to:

Recognise the main toxins we see in practice

Develop a systematic approach to the intoxicated patient

Discuss the evidence bases looking at use of activated charcoal, intra-lipids and other antidotes, along with supportive measures for the intoxicated patient

Appreciate the main complications we may encounter with an intoxicated patient Understand how to address and nurse intoxicated patients into recovery

Week 2

Central Nervous System Toxins

Detailed discussion of the toxins that commonly affect the central nervous system including recreational drugs, human medications, organic toxins, household, and environmental concerns

We will look at decontamination of these patients as well effective nursing care and monitoring for the patient with severe CNS depression associated with intoxication

Discuss when an antidote may be indicated and the systemic effects, we can see associated with CNS intoxications

Learning objectives
After completion of this week, participants should be able to:

Understand the effects of the main toxins affecting the CNS

Consider how to provide emergency treatment for these patients and also develop a plan for longer term care

Discuss whether decontamination is appropriate for patients when the CNS is depressed

Understand the complications and challenges we may encounter

Week 3

Renal System Toxins

Discuss toxins that affect the patient’s renal system including ethylene glycol, NSAID ingestion, Baclofen, raisins/grapes amongst others.

Consider how we can identify a patient with an acute kidney injury due to a toxin and the treatment options available, including peritoneal dialysis and haemodialysis amongst others

Nursing care for these patients is intensive and a focus on fluid balance and electrolyte status is vital, so this will be covered in detail

Learning objectives
After completion of this week, participants should be able to:

Understand the different toxins that affect the renal system and how we can approach nursing and monitoring these patients

Consider approaches to acid-base stabilisation and electrolyte abnormality management

Understand why volume overload occurs, and how we monitor, prevent and manage this condition

Week 4

Hepatic, Cardiac and Respiratory System Toxins

Round up of other common toxins including those affecting the hepatic system, cardiovascular and respiratory systems and other miscellaneous agents. We will look at identifying these patients as well as common sources of intoxication and approaches to management

Review of the process of gastric lavage and contraindications associated with this method of contamination

Specific concerns associated with other toxins, including xylitol, baclofen, beta blockers, paracetamol, garlic and onions

Learning objectives
After completion of this week, participants should be able to:

Discuss appropriate treatment options and interventions for the mentioned toxins

Confidently provide nursing care and monitoring for these patients

Discuss gastric lavage and when it may not be appropriate

Appreciate the long term effects these toxins may or may not have on our patients

Week 1

Diabetes Mellitus

In this first week, we will be looking at diabetic cats and dogs and how nutrition plays a very large role in stabilisation of blood glucose. In dogs, we will look at how manipulation of different types of fibre can influence it. Cats are completely different when it comes to diabetes, not just in what to feed them. We will look at low carbohydrate, higher fat and protein diets, and how these can be used for obesity control and aid with the diabetes

Learning objectives
After completion of this week, participants should be able to:

Understand how diets for dogs and cats differ for diabetic patients

Explain how specific nutrients affect metabolism and insulin requirements

Establish safe weight loss in the diabetic cat

Week 2

Cardiac Disease

In the second week, we will look at the ACVIM consensus statement and how we can build this into nutrition for dogs. We will look at the recent evidence for cardiac diets and how the heart cells have been shown to respond to different energy sources. We will also look at the evidence surrounding those dogs that are developing DCM on grain free diets

Learning objectives
After completion of this week, participants should be able to:

Understand the nutritional requirements for the cardiac patient

Describe how to prevent cardiac cachexia

Understand the issues with fad diets and DCM

Week 3

Hepatic Disease

Hepatic disease in cats and dogs can be very complex depending on the cause. We will look at the feeding of puppies with portosystemic shunts and why we use diets with specific nutrients.  We will then discuss those animals with raised liver parameters and how we can help them, using diets and supplements

Learning objectives
After completion of this week, participants should be able to:

Understand how certain nutrients can exacerbate the clinical signs of portosystemic shunts

Explain how supplements can be used in animals with liver disease

Describe the nutrient requirements of cats and dogs with liver disease

Week 4

Dermatological Diets

In this last week, we will look at all the different diets that are available for dogs and cats that have dermatological issues.  We will investigate nutrigenomic diets, novel protein diets and hydrolysed diets and discuss when to use each one

Learning objectives
After completion of this week, participants should be able to:

Understand the difference between diets aimed at animals with dermatological issues

Conduct feeding trials for dermatological cases

Explain how supplements can be used to improve skin conditions

Week 1

Triage Assessment and Stabilisation 

Carrying out an effective triage assessment and the RVN’s role

Major body system assessment

Approach to dysfunction of the cardiovascular, respiratory and neurological systems

Practical considerations for managing the emergency patient stabilisation

Learning objectives
After completion of this week, participants should be able to:

Correctly identify a patient with dysfunction of a major body system

Confidently triage and assess an emergency patient

Recognise the approach to dysfunction of different major body systems and stabilisation techniques utilised for emergency patients

Appreciate specific nursing considerations for the emergency presentation

Week 2

Urethral Obstruction

Identification of the patient with urethral obstruction

Stabilisation techniques

Evidence-based discussion on emergency management, fluid types and analgesia options

Learning objectives
After completion of this week, participants should be able to:

Participate in case based discussions

Identify the patient’s condition and the pathophysiology alongside potential complicating factors such as co-morbidities

Understand how to correct fluid deficits and identifying the difference between hypovolemia and dehydration

Participate in acid-base and electrolyte discussions, including how to address hypo and hyperkalemia

Appreciate the specific nursing considerations for patients with urethral obstruction

Week 3

Diabetic Ketoacidosis

Presentation and initial emergency management

Acid base balance and electrolyte abnormalities

Pathophysiology of diabetic ketoacidosis and complicating factors

Learning objectives
After completion of this week, participants should be able to:

Participate in case based discussions

Identify the patient’s condition and the pathophysiology alongside potential complicating factors such as co-morbidities

Understand how to correct fluid deficits and identifying the difference between hypovolemia and dehydration

Participate in acid-base and electrolyte discussions, including how to address hypo and hyperkalaemia

Appreciate the specific nursing considerations for patients with DKA

Week 4

The Acute Abdomen – Surgical Cases

Pre-anaesthesia stabilisation and assessment

Analgesia choices in the critically ill patient

Peri-operative and recovery periods

Nursing specific concerns post operatively

Learning objectives
After completion of this week, participants should be able to:

Develop a pre-anesthetic plan and discuss suitable stabilisation as well as attribute an ASA score

Complete with confidence a surgical checklist and identify areas of concern

Understand analgesia choices, the options we have including CRIS, local and regional techniques

Engage in cased based presentations, including abdominal foreign bodies and gastric dilatation and volvulus

Week 5

The Acute Abdomen – Medical Cases

Analgesia and pain scoring

Non-surgical versus surgical patients

SIRS and DIC

Nutritional support

Learning objectives
After completion of this week, participants should be able to:

Understand pain scoring and the importance of using validated methods

Understand analgesia choices, the options we have including CRIS, local and regional techniques

Decide if a patient is surgical or non-surgical, especially in the case of traumatic haemoabdomen

Understand the pathophysiology behind systemic inflammatory response syndromes and disseminated intravascular coagulation and how to identify the early indications of development of these syndromes

Week 6

Acute Gastrointestinal Disease

Haemorrhagic gastroenteritis including parvovirus

Fluid therapy

Antibiosis

Learning objectives
After completion of this week, participants should be able to:

Identify appropriate approaches to fluid replacement including discussion of the use of crystalloids and colloids in the patient with AHDS

Appreciate the importance of nutrition in the patient with acute gastro-intestinal disease and how we can provide that

Describe potential complications that may occur, including sepsis

Discuss the rational use of antibiotics, using evidence bases

Week 1

Making Rabbit Anaesthesia Safer

Pre-op advice for clients

ASA grading – what increases the risk?

Monitoring under general anaesthesia

Post-operative care

Learning objectives
After completion of this week, participants should be able to:

Recap rabbit anaesthesia and how you can help build up your confidence, including pre op, intra op and post op care

Identify signs to be monitoring under anaesthesia – including CO₂, SPO₂, reflexes, HR, RR and BP readings

Use the ASA grading system, to look at why rabbits may be at a higher risk, compared with dogs and cats when placed under GA

Understand the options for intubation and maintaining an airway

Week 2

Analgesia – Taking the Pain Away

The signs of pain

Causes of pain

Knock on effects of uncontrolled pain

Analgesia options

Learning objectives
After completion of this week, participants should be able to:

Identify the signs that rabbits show when in pain – these can be easily missed!

Learn how to use with the ‘Rabbit Grimace Scale’ in conjunction with clinical signs

Appreciate the secondary problems that pain can lead to, when it is not managed correctly

Know what analgesia options can be used in rabbits

Week 3

Preparing for an Emergency

Preparation at the practice

Triaging rabbits

Obtaining a capsule history

Assessment

Managing owner expectations

Learning objectives
After completion of this week, participants should be able to:

Appreciate that when the phone rings it is important to be prepared for the emergency rabbit case. Know what to do and what equipment to set up to be ready

Understand how to triage rabbits and when continuing to do so may be detrimental

Obtain a quick and useful history from the owner to enable treatment to commence

Conduct a full assessment of the rabbit – from head to toe

Communicate with clients, managing their expectations and keeping them informed

Week 4

Critical Care – Keeping them Alive!

What is and what isn’t an emergency

What to do when faced with a rabbit emergency

Stabilisation and oxygen therapy

Learning objectives
After completion of this week, participants should be able to:

Identify rabbit emergencies – they are not always obvious, and knowing what is and what isn’t an emergency is important

Understand the health conditions which are emergencies in rabbits, including gastrointestinal stasis/blockages, flystrike, liver lobe torsion and respiratory distress

Achieve the important goal of keeping stress to a minimum

Identify the signs of improvement and deterioration

Week 1

Patient History and Assessment

Taking a thorough history

Initial patient assessment

Anatomy

Neurological examination

Localisation

Learning objectives
After completion of this week, participants should be able to:

Successfully take a detailed history from owners and distinguish if the problem is neurological or not

Assess / triage the patient’s overall condition

Understand the neurological examination and describe what the findings may suggest

Discuss neurological lesion localisation and appreciate how this will allow planning of diagnostics tests

Week 2

Diagnostics

What do we need to know and when?

Blood tests

Urine

Imaging

MRI

CT

Radiography

Myelography

Ultrasound

Electrodiagnostics

Muscle and nerve biopsies

Learning objectives
After completion of this week, participants should be able to:

Understand if diagnostic tests are required

Know what tests should be prioritised – especially in emergency / critical cases or money sensitive situations

Understand what genetic tests are routinely carried out in neurology

Have a basic understanding of advanced imaging protocols and which ones should be used

Understand why and when electrodiagnostics are used in practice

Discuss why muscle and nerve biopsies may be taken

Week 3

Spinal Conditions

Intervertebral disc disease and other common spinal conditions

Medical versus surgical treatment

Hemilaminectomy surgery, ventral slot surgery and other surgical approaches

Fenestration and durotomy – what does it mean and why?

Atlanto-axial instability, fractures and other vertebral malformations

Learning objectives
After completion of this week, participants should be able to:

Display knowledge about common spinal conditions seen in practice and understands why surgery is or isn’t performed

Describe how surgery affects the patient’s anatomy. Understanding surgery allows for a more considerate approach to nursing these patients

Show an awareness of any likelihood of recurrence

Week 4

Brain Disease

Seizures

Meningoencephalitis of unknown origin (MUO)

Vestibular disease

Head trauma

Neoplasia

Toxins

Otitis media / interna

Learning objectives
After completion of this week, participants should be able to:

Explain primary and secondary seizures and potential causes, and understand when to start anti-epileptic treatment

Discuss the clinical signs of MUO, how it is diagnosed in practice, along with the treatment options available

Know how to triage the emergency head trauma patient and use the Glasgow Coma Scale

List other causes of disease that may cause patients to present similarly to brain disease patients

Week 5

Neuromuscular Disease

Common neuromuscular diseases seen in the UK

Myasthenia Gravis

Polyradiculoneuritis

Tetanus

Toxoplasmosis

Learning objectives
After completion of this week, participants should be able to:

Show an understanding as to how different neuromuscular diseases affect our patients

Discuss treatment options available to patients for these conditions and know the nursing care required to support them during their recovery

Week 6

Nursing the Neurological Patient

Nursing care required to successfully nurse patients in hospital

Bladder dysfunction and care

Nutritional / hydration needs

Handling techniques

Exercise

Complications

Complementary treatment options

Promoting good overall patient care in practice

Learning objectives
After completion of this week, participants should be able to:

Consolidate knowledge from the whole course to successfully produce nursing care plans for a variety of neurological conditions

Identify which bladder management technique is required for various patients

Understand appropriate handling techniques and when one should be used over another

Help support clients that have pets with ongoing neurological care needs at home

Discuss the long-term care and monitoring these patients may require

Week 1

Principles of Anaesthetising Critical Patients

Anaesthetic risk in the compromised patient

The importance of patient history and physical examination

Diagnostic tests

Patient stabilisation

Anaesthetic protocol, monitoring and recovery

Learning objectives
After completion of this week, participants should be able to:

Understand why critical patients are at an increased anaesthesia and sedation risk

Understand that improving patient safety requires a holistic, overall management process, not simply using “the best drug protocol”.  This will include consideration of:

What pre-anaesthetic tests may be required and the benefit they offer

What pre-anaesthetic stabilisation may be required

Recall an introduction into the type of patient monitoring which is required during the peri-anaesthetic period

Understand general principles for appropriate anaesthetic drug protocols for the critical patient

Week 2

General Approach to Adverse Events and Introduction to Anaesthetic Complications

Near misses and adverse events

Minimising adverse events by preparation

Checklists and non-technical skills

Common anaesthetic complications

Learning objectives
After completion of this week, participants should be able to:

Name the three steps necessary for approaching adverse events and discuss why they are important, including methods in which near misses and adverse events can be minimised in practice

Understand the role of human factors in patient safety and the value of checklist use in anaesthetic practice

Give an overview of what anaesthetist non-technical skills (ANTS) are and be able to begin using them in clinical practice

Know the most common anaesthetic complications encountered in small animal practice

Week 3

Cardiovascular Complications

Alterations in heart rate:

Bradyarrhythmias

Tachyarrhythmias

Alterations in blood pressure:

Hypotension

Hypertension

Learning objectives
After completion of this week, participants should be able to:

Recognise abnormal physiological parameters with regards to the cardiovascular system for individual patients undergoing anaesthesia

Understand the most common underlying causes for alterations in heart rate (bradyarrhythmias and tachyarrhythmias) during general anaesthesia

List some main treatments for the most common arrhythmias which present under general anaesthesia

Understand the most common underlying causes for alterations in blood pressure (hypotension and hypertension) during general anaesthesia

List some main treatments for the most common blood pressure alterations which present under general anaesthesia

Begin to apply this knowledge to individual cases within the clinic with use of the available equipment

Week 4

Respiratory Complications

Alterations in ventilation:

Hypoventilation

Hyperventilation (including tachypnoea)

Apnoea or respiratory arrest

Hypoxaemia

Respiratory obstruction:

Upper respiratory tract

Lower respiratory tract

Restrictive pulmonary disease

Aspiration (and regurgitation)

Learning objectives
After completion of this week, participants should be able to:

Recognise what are abnormal physiological parameters with regards to the respiratory system for individual patients undergoing anaesthesia

Understand the most common underlying causes for alterations in ventilation, including hypo- and hyperventilation, apnoea and respiratory arrest

List the main treatments for the most common changes in ventilation under anaesthesia.

Understand the difference between hypoxaemia and hypoxia, listing the potential causes for these and therefore be able to suggest methods to manage these conditions

Recognise the clinical signs of respiratory obstruction and restrictive pulmonary disease and describe what steps could be taken to alleviate the underlying problem

State why aspiration is a risk under anaesthesia and how to manage a case of gastro-oesophageal reflux in order to minimise patient risk

Begin to apply this knowledge to individual cases within the clinic with use of the available equipment

Week 5

‘Other’ Complications

Central nervous system:

Emergence delirium

Post anaesthetic blindness and deafness

Thermoregulation:

Hypothermia

Hyperthermia

Anaphylactic and anaphylactoid reactions

Embolism

Learning objectives
After completion of this week, participants should be able to:

Outline why cats are at particular risk for post anaesthetic blindness and deafness and describe methods which can minimise this risk

List available methods for patient warming, with recognition of the need to counteract patient hypothermia and the potential risks associated with warming device use

List risk factors associated with peri-operative hyperthermia and discuss steps which can be implemented to manage the hyperthermic patient

Recognise if an anaphylactic or anaphylactoid reaction is occurring and be able to suggest steps to manage the situation

Understand that embolisms are a rare, but potential complication during anaesthesia and be able to list the clinical signs associated with their occurrence

Week 6

Cardiopulmonary Resuscitation

Detecting cardiopulmonary arrest

Basic life support:

Chest compressions

Tracheal intubation

Ventilation

Advanced life support

Drug therapy

Oxygen supplementation

Intravenous fluid therapy

Correction of electrolyte and metabolic disturbances

Defibrillation

Monitoring during CPR

Post cardiac arrest care

Learning objectives
After completion of this week, participants should be able to:

Explain the purpose of cardiopulmonary resuscitation and describe its two main components

Recognise when cardiopulmonary resuscitation should be instigated

Understand the importance of regular CPR training within the practice team

Describe and demonstrate the method for effective chest compressions, tracheal intubation and ventilation during cardiopulmonary resuscitation

List what steps can be taken to provide advanced life support during cardiopulmonary resuscitation

Know what monitoring tools are recommended for cardiopulmonary resuscitation and be able to interpret the main waveforms that will be seen during a resuscitation event

Week 1

The Rabbit Consultation

Handling, examination and history taking

Preventative care

Making your clinic rabbit friendly

Learning objectives
After completion of this week, participants should be able to:

Appreciate the importance of stress reduction in rabbits, including during hospitalisation and examination

Understand essentials of preventive care of rabbits

Understand handling and therapeutic techniques in rabbits

Week 2

Anaesthesia of Small Furries

Basic anaesthesia

Reducing stress around anaesthesia

Learning objectives
After completion of this week, participants should be able to:

Describe a holistic approach to stress reduction in the peri-anaesthetic period to improve anaesthetic success rates

Prepare a patient for anaesthesia

Understand how to provide airway support for rabbits

Week 3

Examination of Parrots

Handling and examination of parrots

Basic husbandry of parrots

Routine grooming techniques

Learning objectives
After completion of this week, participants should be able to:

Achieve safe handling techniques for parrots

Understand the basic husbandry of pet parrots and how this relates to disease

Appreciate and apply the techniques of beak, nail and wing trimming and understand how issues with these adnexa may reflect systemic disease

Week 4

Avian Anaesthesia and Imaging

Basic anaesthesia techniques

Introduction to avian radiography and ultrasound

Learning objectives
After completion of this week, participants should be able to:

Appreciate basic anaesthetic techniques, including induction and intubation, to improve anaesthetic success rates

Take a well-positioned radiograph and interpret the image

Understand the indications for ultrasonography in birds

Week 5

Reptile Examination Techniques

Handling

Examination techniques

History taking, including the husbandry review

Learning objectives
After completion of this week, participants should be able to:

Achieve safe handling techniques of reptiles – snakes, lizards and chelonia

Perform a basic examination of these species

Appreciate the role of husbandry in reptile disease and how to conduct a full husbandry review

Week 6

Reptile Anaesthesia, Imaging and Hospitalisation

Basic anaesthesia techniques

Introduction to reptile radiography and ultrasound

Hospitalisation requirements for reptile species

Learning objectives
After completion of this week, participants should be able to:

Appreciate basic anaesthetic techniques, including the importance of ventilation and when to use it

Take a well-positioned radiograph

Perform ultrasonography in reptiles

Understand the hospitalisation needs of reptile species

Week 1

Diseases of the Upper Gastrointestinal Tract

Upper gastrointestinal tract (UGIT) anatomy refresher

UGIT hereditary and acquired abnormalities

Investigation of vomiting and regurgitation

Sedation and general anaesthesia considerations

Learning objectives
After completion of this week, participants should be able to:

List the main structures of the UGIT

Describe the normal function and processes of the UGIT

Identify the difference between vomiting and regurgitation and the common causes

Understand the diagnostic approach to patients with UGIT symptoms

Explain the reasons why patients with UGIT disease are higher risk for investigative procedures

Evaluate current methods used in practice to sedate patients with UGIT disease and analyse if modifications to practice would be beneficial

Week 2

Diseases of the Lower Gastrointestinal Tract

Lower gastrointestinal tract (LGIT) anatomy refresher

LGIT pathophysiology

Mechanisms and classification of diarrhoea

Investigative process for LGIT symptoms

Patient preparation for GI endoscopy

Supportive treatment for patients with LGIT

Learning objectives
After completion of this week, participants should be able to:

List the main structures of the LGIT

Describe the normal function and processes of the LGIT

Differentiate diarrhoea types and common causes

Understand the diagnostic approach to patients with LGIT symptoms

Evaluate current care plans used in practice to prepare patients for endoscopy and analyse if modifications to practice would be beneficial

Summarise the key therapeutic treatments for patients with LGIT

Week 3

Gastrointestinal Endoscopy

Anatomy and functions of the gastroscope

Cleaning and sterilising procedures

Endoscopy sourcing, storage, and auditing

Learning objectives
After completion of this week, participants should be able to:

Label the main components and list the functions of a gastroscope

Explain the bedside procedure for cleaning and then sterilising the gastroscope

Select the correct biopsy tools and materials for optimal sampling and histological value

Evaluate practice protocols to standardise in line with current best practice

Week 4

Interventional Endoscopy

Foreign body removal

Balloon dilatation

Injection of steroids and anti-inflammatory medications

Endoscopically placed feeding tubes

Learning objectives
After completion of this week, participants should be able to:

List the various interventional uses of gastrointestinal endoscopy

Select the correct forcep tool for foreign body retrieval

Describe the ballooning technique use for oesophageal strictures

Explain the indications, risks and technique for placing a PEG tube

Week 5

Nursing Patients with Gastrointestinal Disease

Nursing basics and care plans

Pain and emesis management

Oesophageal tube placement

Assisted feeding methods

Learning objectives
After completion of this week, participants should be able to:

List the essential care requirements for nursing patients with GI disease

Identify symptoms of pain and nausea

Compare patient assessment tools to monitor status and benchmark interventional treatment

Calculate energy requirements and feeding volumes for tube feeds

Week 6

Enteropathy Therapeutics and Nutrition

Terminology of diseases

Pathways and mechanisms of enteropathies

Medications and therapies

EBVM current information

Dietary needs

Learning objectives
After completion of this week, participants should be able to:

Differentiate between terms associated with chronic enteropathies

Analyse the treatments allocated to different types of enteropathy

Refer to updated resources and guidelines to further inform their knowledge and subsequently refer to it at a later date

Explain what a diet trial is

List the types of dietary allergen there are

Week 1

Traumatic Brain Injury (TBI)

Traumatic brain injury is a relatively common emergency presentation following road traffic accidents or other traumatic episodes. There are several priorities to consider when nursing these patients, which are vital to support their recovery.  We will discuss the initial approach to these patients including the use of mannitol and hypertonic saline, along with analgesia and specific nursing techniques that minimise intra-cranial pressure. Use of the Glasgow Coma Scale is very helpful in these patients and should be part of our toolbox. Ongoing patient care beyond the first 24 hours will be discussed, including options for nutritional support and continued management.

Learning objectives
After completion of this week, participants should be able to:

Determine the difference between a patient with TBI compared to those with facial trauma or altered mentation for another reason

Understand the difference between primary and secondary brain injury

Appreciate the interventions that will make these patients worse and how to mitigate that risk

Confidently conduct a neurological assessment to complete the Glasgow Coma Scale assessment

Understand the ongoing problems these patients may encounter and how to resolve them

Week 2

Heat Stroke

Despite several media campaigns, we continue to see patients presenting with heat stroke every year.  The nursing team are vital to the recovery and ongoing management of these patients and rapid recognition at triage can lead to improved outcomes. We will look at methods for cooling these patients, the issues we may encounter with them on presentation but also the potential for complications such as Systemic Inflammatory Response Syndrome (SIRS) and Disseminated Intravascular Coagulation (DIC).

Learning objectives
After completion of this week, participants should be able to:

Determine the difference between heat stroke, heat stress and pyrexia

Understand the priorities for treatment of these patients

Discuss effective cooling methods by reviewing the evidence bases available

Understand the complications associated with heat stroke including development of SIRS and DIC

Week 3

Common Intoxications

Intoxication is a common emergency presentation and the range of toxins our patients can encounter in the environment and the home is very variable. We will look at the toxins that are most encountered and how we need to approach and address these including nephrotoxins and CNS toxins.  We will look at treatment considerations including the use of intravenous lipid emulsion and the evidence supporting its use. Ongoing patient management and monitoring will be discussed in detail.

Learning objectives
After completion of this week, participants should be able to:

Understand the approach to the intoxicated patient and our priorities

Explain how intravenous lipid emulsion works and which patients it may be suitable for

Provide nursing care for the patient requiring prolonged sedation or anaesthesia due to intoxication

Effectively monitor the patient depending upon the toxin that has been ingested

Week 4

BOAS Crisis

We see an increasing number of brachycephalic patients presenting in respiratory distress. It is vital we are confident at managing these patients from initial admission to stabilisation and ongoing management. We will discuss the anatomy that leads to airway obstruction and the priorities when we are faced with a patient in a BOAS crisis. When to anaesthetise and intubate is a vital consideration as well as when we might consider placing a tracheostomy tube.

Learning objectives
After completion of this week, participants should be able to:

Understand the conformation issues and environmental factors that may lead to a BOAS crisis

Identify other complications associated with the syndrome and explain how to manage them, including regurgitation and hiatal hernia

Confidently manage a tracheostomy tube patient and understand the indications for placement

Week 1

Preparing to Feed Patients within the Veterinary Hospital

This week aims to identify the key pieces of information required from the pet owner, in order to give their pets the best chance of voluntarily consuming food whilst in the veterinary hospital.

Learning objectives
After completion of this week, participants should be able to:

Identify which information is vital to collect from the pet owner

Appreciate the who, how and when of information collection

Understand how to create the ideal eating environment for your patients

Understand all aspects of the hospital food kitchen

Week 2

Hospital Nutrition

Every effort should be made to get patients eating on their own. Choosing appropriate foods and timings will largely depend on the results of the nutritional assessment. Patients may not eat well whilst they are in the hospital, for a wide range of reasons, and nutritional support may be required; firstly we tempt them to eat and if unsuccessful, look at other methods of assisted feeding.

Learning objectives
After completion of this week, participants should be able to:

Understand how to feed appetent patients:

Communicate the nutrition plan

Select appropriate foods and feeding times

Offer a tailored approach to each individual patient

Understand how to feed inappetent patients:

Appreciate the available options

Identify environmental adaptations

Offer assisted feeding

Week 3

Critical Care Nutrition

Despite all efforts some patients may be either too unwell or unwilling to voluntarily consume any food whilst in the hospital, and assistance in the form of feeding tubes will be required.

Learning objectives
After completion of this week, participants should be able to:

Understand the process of feeding tube selection

Provide maintenance and care of feeding tubes

Confidently calculate nutritional requirements and food quantities

Week 4

Diabetic Patients

A diagnosis of diabetes can be very worrying and overwhelming for pet owners with many elements to consider. Nutrition plays a vital role in the management of both cats and dogs with diabetes. As the type of diabetes frequently seen in dogs and cats differ, a disease specific recommendation will be required.

Learning objectives
After completion of this week, participants should be able to:

Implement stable feeding routines for diabetic dogs

Describe the ideal food composition for diabetic cats

Understand how to manage concurrent obesity

Week 5

Multiple Concurrent Conditions and Difficult Decisions

As with many things in life, challenges rarely occur alone. Patients often present us with dietary dilemmas and decision making can be difficult. However, by knowing what to prioritise, where to compromise and where to go for help, a suitable nutritional solution can be found for all.

Learning objectives
After completion of this week, participants should be able to:

Explain nutritional care for end of life patients

Provide nutritional advice for patients with concurrent diseases

Understand what to do when no suitable diet exists

List sources of additional nutritional information

Week 6

Client Communication

Although much in known about providing nutrition in many different circumstances, excellent client communication is a key part of dietary plan implementation. Getting communication right means your recommendation is more likely to be followed, clients know who to trust and who they should talk to if problems arise. This is an excellent way to demonstrate the high level of care you are providing to their beloved pet.

Learning objectives
After completion of this week, participants should be able to:

Create the right environment for discussions

Gauge readiness of the client to discuss their pet’s diet

Approach information gathering to maximise responses

Understand what to do if the owner is feeding a nonstandard diet

Make clear recommendations and manage expectations

Monitor and make adjustments to the nutrition plan

Week 1

The Nurse’s Role in Medical Clinics – When, Why and How?

Why set up a monitoring clinic?

How to set up a monitoring clinic

Equipment needed for a monitoring clinic

Learning objectives
After completion of this week, participants should be able to:

Understand the importance of nurses being involved in the long term monitoring of cats with medical diseases

Visualise how they would be able to set up this type of clinic in their own practice

Feel ready to learn and revise common chronic feline disease and become up to date with the latest evidence

Week 2

Managing Chronic Kidney Disease

What is CKD?

What effects does CKD have on the body?

How to monitor CKD

Treatment aims for CKD

IRIS staging

Learning objectives
After completion of this week, participants should be able to:

Understand the pathophysiology of CKD

Identify parameters used to monitor the CKD patient

Understand the IRIS staging scheme

Understand what treatments are appropriate at which stage of disease

Use evidence based medicine to help educate your clients

Week 3

Managing Diabetes Mellitus

What is diabetes mellitus?

How to monitor diabetes mellitus

Treatment aims for diabetes mellitus

Owner support for cats with diabetes mellitus

Learning objectives
After completion of this week, participants should be able to:

Understand the pathophysiology of diabetes mellitus

Understand the difference between cats and dogs with diabetes mellitus

Understand how to monitor diabetes mellitus and the importance of blood glucose curves

Understand what treatments are available for diabetes mellitus

Counsel owners of cats with diabetes mellitus

Week 4

Managing Degenerative Joint Disease

How prevalent is DJD in cats?

How to assess cats for DJD

Treatments for DJD

How to engage owners in the treatment and monitoring of DJD

Learning objectives
After completion of this week, participants should be able to:

Understand the prevalence of DJD in cats and use that information in the nursing treatment and handling of the cat

Assess cats using a variety of methods both in the clinic and at home for DJD

Understand the different treatments available for DJD

Educate owners about the treatments and how the owner can assess the cat to

improve compliance

Week 1

The Orthopaedic Trauma Patient

Presentation

Triaging wounds

Initial wound management

Open fracture management

Learning objectives
After completion of this week, participants should be able to:

Prepare equipment for initial stabilisation of the trauma patient

Select dressings and materials for initial wound management

Understand the grading system for open fractures and how this affects management of these cases

Prepare all necessary items for treatment of open fractures

Week 2

Preparing the Patient for Surgery

Clipping and preparing the patient

Orthopaedic theatre nursing

Theatre set up

Instrumentation

Scrub nurse role

Cleaning and sterilising

Learning objectives
After completion of this week, participants should be able to:

Create an appropriate surgery schedule

Identify common orthopaedic surgical instruments and their use

Prepare and confidently check the theatre set up for a range of procedures, including equipment

Have a full understanding of orthopaedic equipment and how to care for it correctly

Understand the benefits a scrub nurse provides to the surgeon, the patient and the surgical procedure

Week 3

Orthopaedic Procedures – So Many to Choose From!

Surgery

Arthroscopy

Learning objectives
After completion of this week, participants should be able to:

Understand the options available for common orthopaedic conditions

Create a case study for a patient they have been involved in the nursing care of

Identify common surgical equipment, its use and how to prepare for surgery

Week 4

Fracture Repair – Internal Fixation

Fracture classification

Implants and consumables

Surgical instruments and equipment

Learning objectives
After completion of this week, participants should be able to:

Identify common surgical implants used in fracture repair

Understand how the method of repair used will impact on the care required for the patient post-operatively

Week 5

Fracture Repair – External Fixation

Implants and consumables

Surgical instruments and equipment

Learning objectives
After completion of this week, participants should be able to:

Identify common surgical implants used for external fracture repair

Understand the instructions required by owners for the ongoing care and management of patients with external fixators

Week 6

Recovery and the Post-Operative Period

Recovery from anaesthesia

Immediate therapy

Ongoing nursing care plans

Surgical complications

Learning objectives
After completion of this week, participants should be able to:

Create nursing care plans for post-operative surgical patients

Develop the team role for nurses in the rehabilitation of orthopaedic patients

Understand the key responsibilities for client communication and post-operative care

Identify common complications and how to ensure owners understand the potential consequences

Week 1

Recumbency Nursing

Common causes for recumbency

Nursing the recumbent patient

Common complications associated with recumbency

Learning objectives
After completion of this week, participants should be able to:

List some of the common causes for recumbency and how these conditions may be treated

Discuss the nursing considerations for the recumbent patient and how these can be implemented to help support the patient during their recovery whilst hospitalised

Describe the common complications associated with recumbency and how these can be prevented whilst the patient is hospitalised

Week 2

Nutrition in the Hospitalised Patient

Why is nutrition important?

Who needs nutrition?

When should nutrition be started?

Creating a nutrition plan

Assisted feeding options

Learning objectives
After completion of this week, participants should be able to:

Understand why nutrition is important for the recovery of hospitalised patients

Identify patients in needs of nutrition

Discuss when is the appropriate time to start nutrition in their hospitalised patient

Describe how to create a feeding plan including patient assessment, calculation of RER and implementation of the nutritional plan

List the common assisted feeding techniques and understand the indications and contraindications of each

Week 3

Sepsis

What is SIRS / sepsis?

How to recognise sepsis in dogs

How to recognise sepsis in cats

Sepsis bundles

Recent sepsis research in human medicine

Learning objectives
After completion of this week, participants should be able to:

Know the definitions of SIRS / sepsis and the difference between them

List the patient observations used to help us be able to recognise sepsis in the dog

List the patient observations used to help us be able to recognise sepsis in the cat

Understand what a sepsis bundle is, and when they can be used in practice

Understand the recent research into sepsis in human medicine and how this impacts us in veterinary practice

Week 4

Acid Base / Electrolytes

What is acid / base?

What are electrolytes?

Electrolytes – Sodium

Electrolytes – Potassium

Electrolytes – Calcium

Glucose

Learning objectives
After completion of this week, participants should be able to:

Explain acid / base status

Understand which electrolytes we can measure in veterinary practice and why

Identify when a patient may become hypo or hypernatraemic, and describe the treatments that may benefit them

Identify when a patient may become hypo or hyperkalaemic, and describe the treatments that may benefit them

Identify why a patient may be hypo or hypercalcaemic, and describe the treatments that may benefit them

Identify why a patient may be hypo or hyper glycaemic, and describe the treatments that may benefit them

Week 5

Infection Control

How to create an infection control plan for the clinic

Assigning an infection control champion

Identify and develop protocols

Make an assessment

Staff education and training plans

Surveillance and compliance

Learning objectives
After completion of this week, participants should be able to:

Identify an infection control champion in practice and understand their role in the infection control plan

Discuss the common infection control protocols required in practice to minimise the spread of pathogens

Understand how to make an assessment of the protocols already in place and identify their strengths and weaknesses

Explain the importance of staff education and training when implementing infection control protocols

List the common surveillance techniques to ensure compliance to the infection control plan

Week 6

End of Life Care and Clinical Governance

Euthanasia

Palliative care

Mental health awareness

Clinical governance in practice

Learning objectives
After completion of this week, participants should be able to:

Understand the reasons vets and clients consider euthanasia, and learn ways to ensure the experience can be made as peaceful and calm as possible in practice for all involved

Understand the reasons that clients may choose to consider palliative care, and how we can help ensure the patients are comfortable within our role as veterinary nurses

Understand the impact of euthanasia and how the death of a pet can affect both the family of the patient and the veterinary staff involved

Understand the mental health implications of veterinary medicine on the team, and ways in which we can help our team and ourselves to cope

Describe what clinical governance is, what is discussed and why it may be beneficial to start holding these meetings in your practice

Week 1

What are we Monitoring and Why?

What anaesthesia does to the patient and what we can do about it

Monitoring depth of anaesthesia

Temperature monitoring

Learning objectives
After completion of this week, participants should be able to:

Understand why good monitoring is essential for safe anaesthesia

Understand the challenges of monitoring depth of anaesthesia

Appreciate the importance of monitoring body temperature and the consequences of hypo- and hyperthermia

Week 2

Monitoring the Respiratory System

Capnography

Pulse oximetry

Learning objectives
After completion of this week, participants should be able to:

Understand the physiology involved in the formation of the capnograph trace

Interpret normal and abnormal capnograph traces

Understand the physiology behind pulse oximetry, and its limitations

Confidently troubleshoot abnormal capnography traces and pulse-oximetry readings

Week 3

Monitoring the Cardiovascular System

Physiology of heart rate and blood pressure control

The electrocardiogram

Blood pressure monitoring

Learning objectives
After completion of this week, participants should be able to:

Understand the causes of heart rate and blood pressure changes during anaesthesia

Describe how the electrocardiogram is generated

Interpret the electrocardiogram

Understand the different techniques for measuring blood pressure

Interpret blood pressure readings and understand causes of inaccurate readings

Week 4

Monitoring with Blood Work and Troubleshooting Equipment

Blood gas and acid-base

Glucose monitoring and other tests

Monitor-related artefacts and technical problems

Learning objectives
After completion of this week, participants should be able to:

Understand when blood gas analysis is useful

Interpret blood gas analyses in the light of the patient’s history and clinical problems

Decide when glucose monitoring and other tests during anaesthesia are important

Troubleshoot monitor-related issues

Week 1

From Conception to Weaning

Parent health prior to conception and how this may affect pregnancy, parturition, and offspring

Nutritional requirements during pregnancy

Nutritional adaptations required during lactation

Neonate nutritional requirements, including how to hand feed effectively

Weaning

Learning objectives
After completion of this week, participants should be able to:

Discuss how nutrition affects reproduction and key adaptations that are required

Have a clear understanding of how to promote health through nutrition during lactation

Identify the essential nutritional requirements for neonates

Understand how to hand feed neonates correctly

Week 2

Growth

Optimal growth

Effects of neutering

Nutritional considerations for large breed puppies

Learning objectives
After completion of this week, participants should be able to:

Correctly use growth charts to map growth

Identify when growth is not ideal and the necessary changes that are required to maintain a healthy weight to adulthood

Have a good understanding of the nutritional adaptations that will be required at the point of neutering

Week 3

Adult Maintenance

Promoting health in adults

Maintaining a stable weight

Treat management

Recognise key aspects of feeding working dogs

Learning objectives
After completion of this week, participants should be able to:

Understand nutritional requirements for adults and how these must be adapted for each pet’s circumstance

Identify points of concern and to make appropriate recommendations

Reflect on how nutritional requirement for working dog may differ from pet dogs

Week 4

Golden Oldies – Senior Pets

Defining ‘senior’ age as an individual process

Understanding age related changes and how these require nutritional adaptation

Environmental considerations for pets in their senior years

Learning objectives
After completion of this week, participants should be able to:

Confidently assess the needs of a senior pet

Identify environmental changes that may be required

Understanding of the dynamic changes to nutrition that are required for seniors to better support the pet and pet owner

Week 5

Diet Choices

Examination of the pet food label

Introduction to alternative diet types and how to have conversations with pet owners

How to manage pets fed an alternative diet within a hospital environment

Learning objectives
After completion of this week, participants should be able to:

Identify all key information on a pet food label and how this is used to determine a feeding amount

Have a broad understanding of the pros and cons associated with alternative diets that are now commonly fed

Appreciate methods for assessing the suitability of alternative diets and how to improve safety

Confidently talk to the pet owner who wish to feed an alternative diet type

Week 6

Maintaining an Ideal Weight

Assess ideal weight through body condition scoring and muscle condition scoring

Simple steps to ensure obesity does not occur, and what can help if it does

How to calculate a feeding quantity of dry, wet or mixed diet types

Learning objectives
After completion of this week, participants should be able to:

Confidently be able to body condition score and muscle condition score to identify an ideal weight and good health

Understand how simple food management in the home can prevent obesity occurring

Thoroughly understand calculations for determining a feeding amount to prevent over, or under feeding

Week 1

Dentistry Analgesia

Different analgesia drugs available

Dose selection

Routes of administration

Drug combinations

Local nerve blocks

Sides effects of drugs

Learning objectives
After completion of this week, participants should be able to:

Assist the veterinary surgeon in selecting appropriate analgesic drugs for different oral surgeries

Be aware of potential side effects of these drugs

Alongside the veterinary surgeon, create a tailored drug protocol for each patient to go home with

Comfortably calculate analgesic drugs at low doses

Be aware of what drugs are suitable as a combination

Understand the exclusion or reduced dose of some drugs, regarding co-morbidities

Use pain scoring methods and understand what analgesia the patient may need

Week 2

Anaesthesia – Airway Security and Hypothermia

How to maintain a patent airway

Patient positioning

To cuff or not to cuff?

Causes of hypothermia

Negative effects of hypothermia

Preventing and treating hypothermia

Learning objectives
After completion of this week, participants should be able to:

Understand different styles of ET tubes and their benefits and potential negatives

Understand appropriate ET tube cuff pressures and why this is so integral to protecting the airway

Appreciate techniques to protect the airway

Know the gold standard method to move patients under anaesthesia, whilst protecting their airway

List the common causes of hypothermia

Understand the negative effects of hypothermia

Have practical knowledge on how to prevent and treat hypothermia

Understand the risk of using some heating devices

Week 3

Anaesthesia – Managing Hypotension

Causes of hypotension

Negative side effects of hypotension

How to obtain accurate blood pressure reading

How to prevent hypotension

Fluid therapy

Anaesthesia drug choices

The use of vasopressors and anticholinergics

Learning objectives
After completion of this week, participants should be able to:

Obtain accurate blood pressure readings for cats and dogs under general anaesthesia for dentistry

Understand the limitations of blood pressure measurements and trouble shoot potential problems

Know what is deemed as an appropriate blood pressure reading under general anaesthetic

Know which drugs may interfere with maintaining blood pressure

Understand what could happen to our patients if left hypotensive

Feel more confident, alongside the veterinary surgeon, in making a treatment plan tailored to each individual patient, to treat any hypotensive episodes

Week 4

Post-operative Care

Immediate post op care once extubated

Care for patients in the recovery ward

Discharge instructions

Post op care at home

Post op checks

Learning objectives
After completion of this week, participants should be able to:

Maintain and monitor a patent airway in the immediate post-operative period

Understand the importance of close monitoring in recovery

Create a post-operative plan tailored to each individual patient

Feel confident to create discharge instructions for your patient

Confidently communicate with the owner about the anaesthesia and surgery the patient has received

Perform a thorough physical post-operative check, including the whole patient

Understand the best dental care an owner can provide at home, along with alternative options if these goals cannot be met

Week 1

The Immune System

Learning objectives
After completion of this week, participants should be able to:

Understand the specialised cells and molecules of the immune system

Recognise which organs are involved in the immune system and their function

Identify physical barriers that play a role in a patient’s immune system

Explain the difference between innate and adaptive immune responses

Explain the difference between humoral and cell mediated immunity

Understand the laboratory diagnostics in immunology

Understand thermoregulation in veterinary patients and differentiate hyperthermia vs pyrexia

Differentiate different types of immune system disorders

Week 2

Immune-Mediated Haemolytic Anaemia (IMHA)

Learning objectives
After completion of this week, participants should be able to:

Understand the pathophysiology of immune mediated haemolytic anaemia (IMHA)

Recognise the common clinical signs associated with IMHA

Understand the diagnostic tests performed during the diagnosis of IMHA

Perform in-house cytology as part of the diagnosis of IMHA

Understand the treatment options available for veterinary patients including long-term monitoring

Recognise the prognosis of the disease and negative prognostic factors

Consider the nursing considerations for these patients and the role of the RVN

Week 3

Immune-Mediated Thrombocytopenia (IMTP)

Learning objectives
After completion of this week, participants should be able to:

Understand the pathophysiology of immune mediated thrombocytopaenia (IMTP)

Define thrombocytopaenia and recognise what our platelets are

Recognise the common clinical signs associated with this condition

Understand the laboratory tests performed during the diagnosis of ITP

Review the manual platelet count

Understand the diagnostic tests performed during the diagnosis of ITP

Understand the treatment options available for veterinary patients including long term monitoring

Recognise the prognosis of this disease and negative prognostic factors

Consider the nursing considerations for these patients

Week 4

Immune-Mediated Polyarthritis (IMPA)

Learning objectives
After completion of this week, participants should be able to:

Understand the pathophysiology of IMPA

Differential erosive vs non-erosive forms of IMPA

Recognise the classification system of IMPA

Recognise the most common clinical signs associated with this disease

Understand the diagnostic tests performed in these patients (including infectious disease screening)

Understand the method of arthrocentesis and how to assist the veterinary surgeon

Understand the treatment options available to these patients

Recognise the differences in polyarthritis in feline patients

Understand the role of the RVN when caring for these patients

Week 1

Canine Hypothyroidism

Learning objectives
After completion of this week, participants should be able to:

Identify the clinical signs of canine hypothyroidism

Explain the role of hormones in the body

Explain the relationship between TSH and thyroid hormones

Describe what canine hypothyroidism is and why it occurs

Describe ways to support the client owning a canine with hypothyroidism

Week 2

Canine and Feline Diabetes

Learning objectives
After completion of this week, participants should be able to:

Name the 3 types of cell that contribute to the endocrine function of the pancreas

Name the two main types of insulin used in cats and dogs

Describe the reason dogs become diabetic

Describe the reason cats become diabetic

Explain some differences in the nursing considerations you would give cats compared to dogs and why

Week 3

Feline Acromegaly

Learning objectives
After completion of this week, participants should be able to:

Identify 3 major hormones that are lost when you remove the anterior pituitary gland

Explain how feline hypersomatotropism occurs

Discuss how excess growth hormone results in acromegaly

Explain the nursing considerations for a hypophysectomy patient

Explain the support that a client might need for a cat with FeHS

Week 4

Feline Hyperthyroidism

Learning objectives
After completion of this week, participants should be able to:

Discuss the clinical signs that a hyperthyroid cat might present with

Explain the effects of too much thyroid hormone on the body

Demonstrate an understanding of the treatment options available for the disease in order to support the client with the hyperthyroid cat

Describe the most commonly used test to diagnose feline hyperthyroidism and what that test is measuring

Explain the difference between free T4 and total T4

Week 5

Canine Hyperadrenocorticism (Cushing’s Disease)

Learning objectives
After completion of this week, participants should be able to:

Explain the reasons why canine hyperadrenocorticism (HAC) occur

Identify the clinical signs associated with a canine HAC patient

Discuss some of the common tests available for HAC and the reasons for their use

Identify 3 main forms of treatment for the canine HAC patient

Demonstrate an understanding of the nursing considerations for the patient with HAC

Week 6

Canine Hypoadrenocorticism (Addison’s Disease)

Learning objectives
After completion of this week, participants should be able to:

Explain the causes of canine hypoadrenocorticism

Identify some of the clinical signs that a patient may present with and why

Discuss the treatment options available to the client with the hypoadrenocorticism pet

Demonstrate an understanding of the nursing considerations for a canine with hypoadrenocorticism

Name some of the tests that a vet may ask you to carry out on the suspected hypoadrenocorticism patient and discuss why they may be required

Week 1

Nutrition and Husbandry at Home

Dietary requirements

Environmental needs

Incorrect feeding problems

Obesity

Tempting rabbits to eat hay

Learning objectives
After completion of this week, participants should be able to:

Discuss the nutritional requirements of rabbits and why these are important

Recognise problems related to incorrect or poor diet and the implications these have on health and welfare

Appreciate that rabbits need large enclosures, which allow them to exhibit normal behavioural patterns.  These are important from a health and welfare perspective. We will examine what rabbits need to be happy

Understand obesity and how to implement a weight loss programme for rabbits

List various methods to encourage picky rabbits to eat hay!

Week 2

Preventative Healthcare

Neutering – when and why

Vaccination – myxomatosis, RVHD1 and RVHD2

Endo and ectoparasites

Flea treatment

Worming treatment

Learning objectives
After completion of this week, participants should be able to:

Understand the best time to neuter rabbits

Appreciate why we should be neutering all rabbits – health, welfare and behavioural benefits

Know all the latest vaccination information and background on these fatal viruses

Know which endo and ectoparasites can affect rabbits and the clinical signs

Discuss if rabbits require prophylactic flea and worm treatment, and if so, when?

Week 3

Implementing Rabbit Clinics and Client Evenings in Practice

Setting up rabbit clinics

Running client evenings

What to discuss

Health checking

Benefits to the practice

Learning objectives
After completion of this week, participants should be able to:

Understand that client education is imperative but there is more than one way to deliver this

Discover the benefits of both rabbit clinics and client evenings

Know what should be discussed and the clinical examination to help detect problems

Appreciate why being a rabbit friendly practice is of benefit to you!

Week 4

Common Medical Diseases

Gastrointestinal stasis and blockages

Dental disease

Urinary tract disease

E. cuniculi

Myxomatosis and RVHD

Learning objectives
After completion of this week, participants should be able to:

Describe the common conditions that rabbits present to veterinary practices and require hospitalisation

Ascertain if a rabbit has gastrointestinal stasis or a blockage – differences and treatments

Identify clinical signs and causes

List the treatment options

Describe preventative measures to help ensure rabbits remain healthy

Week 5

Rabbits in the Practice

Reducing stress

Hospitalisation

Gold standard rabbit nursing

Medicating

Fluid therapy and blood sampling

Supportive feeding

Learning objectives
After completion of this week, participants should be able to:

Understand that everything that we do to rabbits whilst they are hospitalised induces some degree of stress.  Learn ways to reduce this, which are easily achieved in practice

Appreciate that hospitalised rabbits can require in-depth care which can be daunting. Learn how to effectively nurse rabbits to ensure optimum care

Learn how to medicate rabbits in an effective and safe manner is imperative, as well as how to syringe feed, deliver fluid therapy and acquire successful blood samples with minimal stress to the rabbit or nurse!

Week 6

Rabbit Anaesthesia and Analgesia

Signs of pain

Analgesia options

Making rabbit anaesthesia safer

Monitoring under general anaesthesia

Learning objectives
After completion of this week, participants should be able to:

Review rabbit anaesthesia and learn how to build up your confidence, including pre op, intra op and post op care. Anaesthetising rabbits can be overwhelming but doesn’t need to be!

Know the clinical signs rabbits show when they are in pain, and learn how to use the Rabbit Grimace Scale

Review the analgesics available for rabbit medicine

Understand the parameters monitored during anaesthesia – including CO_2, SPO_2,reflexes, HR, RR and BP readings

Week 1

What is Cancer?

Pathophysiology of neoplasia

Common causes of cancer in animals

Classifications of cancer types

The difference between benign and malignant disease

Learning objectives
After completion of this week, participants should be able to:

Understand the alterations in the cell cycle that results in neoplastic disease

List the different types of cancer based on tissue origin

Describe the different causes of cancer in small animals

Explain how benign disease is different to malignant disease and the risks associated with both conditions

Identify higher risk categories of patients and analyse the research available in line with evidence-based medicine

Week 2

Diagnosis and Prognosis

Fine needle aspirates

Cancer cytology

Cancer staging

Specialist tests for cancer

Learning objectives
After completion of this week, participants should be able to:

List fine needle aspirate methods to optimise cytological yield

Evaluate a cytology sample in-house to ensure sample is of diagnostic quality

Understand the commonly preferred methods for staging patients with neoplasia

Describe the types of specialist tests required to further categorise cancer

Analyse personal skill set and determine if any modifications to current practice would be beneficial

Week 3

Common Chemotherapy Agents

Overview of common chemotherapy drugs

Administering chemotherapy

Chemotherapy safety

Adverse effects with administering chemotherapy

Learning objectives
After completion of this week, participants should be able to:

Understand how chemotherapy agents work

Explain how to correctly administer chemotherapy agents

List what safety factors should be observed when administering chemotherapy in practice

Describe how to manage an extravasation injury and reduce risk of chemotherapy associated nausea and vomiting

Evaluate practice protocols to standardise and promote best practice in line with most current information

Week 4

Client and Patient Support

Introduction to oncology clinics

Nadir checks

Managing adverse effects following chemotherapy administration

The Cancer Journey

Learning objectives
After completion of this week, participants should be able to:

Describe how and why a nadir check is performed

Identify common adverse effects associated with chemotherapy

Understand preventive and interventional treatment protocols for chemotherapy associated adverse effects

Explain the causes for likely outcome of treatment failure and the physiology behind this

Reflect over professional skill set and evaluate how you can further enhance your personal development to support clients of patients with cancer

Week 1

The Physiology of Pain

Pain definitions

The mammalian pain pathway

Different types of pain

Principles of analgesia

Learning objectives
After completion of this week, participants should be able to:

Outline the definition of pain and associated terminology

Describe the different stages of the pain pathway and sites for analgesia intervention

Understand the concept of multi-modal analgesia and pre-emptive analgesia

Week 2

Analgesia for the In-patient

Review the analgesia agents used to treat acute pain conditions:

Opioids

NMDA antagonists

Local anaesthetics

Alpha 2 agonists

Learning objectives
After completion of this week, participants should be able to:

Be familiar with the different systemic and local options for treating acute pain

Discuss balanced multi-modal analgesia plans for patients in the veterinary practice

Understand the mechanisms of action, effects and side effects of the listed analgesic agents

Week 3

Analgesia for the Out-patient

Review the analgesia options for managing pain on a longer term basis:

NSAIDs

Paracetamol

Tramadol

Gabapentin

Alternative therapies

Learning objectives
After completion of this week, participants should be able to:

Be familiar with the different systemic and alternative therapies for treating chronic pain

Discuss balanced multi-modal analgesia plans for patients at home

Understand the mechanisms of action, effects and side effects of the discussed analgesic interventions

Week 4

Pain Assessment Methods

Review the different pain scoring options for both in-patients and out-patients

Canine pain scales

Feline pain scales

Grimace scales

Chronic pain scales

Pitfalls and problems with pain assessment

Learning objectives
After completion of this week, participants should be able to:

Have a better understanding of the different pain assessment types

Appreciate where pain assessments can be beneficial for managing conditions and allowing for appropriate analgesia interventions in the hospitalised patient

Provide owners with the tools to monitor and assess their pet’s pain and quality of life at home

Describe the indications and contraindications for pain scoring

Week 1

The Neurological Exam

Mentation

Posture and gait

Postural reactions

Cranial nerve evaluation

Spinal reflexes

Palpation

Localisation

Learning objectives
After completion of this week, participants should be able to:

Recognise the rationale for performing a neurological examination

Accurately perform a detailed neurological examination and determine if the case is neurological

Understand the findings of the neurological examination and how that leads to the localisation of the lesions

Week 2

Emergency Triage

Initial patient triage

Head trauma management

Acute spinal cord injury management

Emergency seizure management

Learning objectives
After completion of this week, participants should be able to:

Understand how to triage and assess neurological emergency patients

Recognise abnormalities and signs of raised intracranial pressure Assess and manage spinal trauma patients

Know what to prepare and how to manage an emergency seizure patient

Week 3

Intracranial Disease

Pathophysiology

Intracranial pressure

Meningoencephalitis of unknown origin (MUO)

Hydrocephalus

Vestibular disease

Neoplasia

Learning objectives
After completion of this week, participants should be able to:

Describe how to recognise and manage raised intracranial pressure

Discuss the clinical signs of hydrocephalus and be able to manage patients with this presentation

Know the presentation, diagnosis, management and outcome of patients with meningoencephalitis of unknown origin

Week 4

Spinal Cord Injury

Intervertebral disc disease

Fibrocartilaginous embolism (FCE)

Surgical vs medical management

Vertebral abnormalities

Nursing management

Learning objectives
After completion of this week, participants should be able to:

Know and understand the common causes of spinal cord injury and demonstrate an awareness of diagnostic and management options

Discuss the surgical options available to spinal patients Understand why medial management is an option for some patients

Know the nursing management required for spinal patients

Week 5

Neuromuscular Disease

Myasthenia Gravis

Polyradiculoneuritis

Myositis

Complications and risks

Nursing care

Learning objectives
After completion of this week, participants should be able to:

Understand the cause, presentation, diagnostics and treatment for the most common neuromuscular presentations

Describe the complications and risks associated with each of the diseases

Know the nursing care required for each of the discussed neuromuscular diseases

Week 6

Nursing Care for Neurological Patients

Bladder and faecal management

Skin care

Exercise considerations

Handling techniques

Physiotherapy

General nursing care for hospitalised patients

Learning objectives
After completion of this week, participants should be able to:

Describe bladder management techniques and how to manage overflow incontinence and faecal incontinence

Appropriately handle and move neurological patients with a range of conditions

Understand the most appropriate exercise techniques and aids to use with different patients

Discuss physiotherapy techniques and when one may be used over another

Advise and help owners with long term home care plans

Combine knowledge from each of the previous lectures to be able to successfully create care plans for a variety of neurological conditions

Week 1

Aetiology and Pathogenesis

Anatomy of the head

Tooth and periodontal anatomy, and oral soft tissues

Oral nomenclature

Tooth types, nomenclature and formulae

Eruption times

Occlusion

Learning objectives
After completion of this week, participants should be able to:

Identify tooth and periodontal structures

Explain the Modified Triadan System of numbering teeth in the dog and cat

Recognise normal occlusion

Week 2

Periodontology

Aetiology and pathogenesis of dental disease

Gingivitis

Periodontitis

Gingivostomatitis

Periodontal therapy

Scaling and polishing

Pocket control and therapy

Medications, homecare (brief), dental clinics (brief)

Learning objectives
After completion of this week, participants should be able to:

Describe how gingivitis develops and its progression to periodontal disease

Explain what gingivostomatitis is

Outline the process of safe ultrasonic tooth scaling and its purpose

Week 3

Oral Pathology and Treatment

Trauma and treatment options

Tooth fracture / discolouration / (sub) luxation

Dental diseases and treatment options

Tooth resorption / caries / periodontal disease

Malocclusion and treatment options

Traumatic / dental / skeletal malocclusions

Other conditions and treatment options

Enamel defects / dentigerous cysts / persistent deciduous / root dilacerations and abnormal morphology / tumours

Learning objectives
After completion of this week, participants should be able to:

Identify common pathologies associated with the teeth and oral cavity

Describe some potential treatment options for common pathologies

Week 4

Oral Examination and Charting

History taking and clinical examination – conscious oral examination

Pre-operative tests

Assessment under general anaesthesia – including anaesthesia induction, intubation, oral preparation, probing

Charting – what to fill in, disease scoring and making your chart work

Imaging and other investigations

Radiography – parallel and bisecting angle techniques

Biopsy

Learning objectives
After completion of this week, participants should be able to:

Confidently undertake a thorough conscious examination of a patient’s teeth
and oral cavity

Set up for and assist with assessment of the teeth and oral cavity in an anaesthetised patient

Accurately complete a dental chart which documents all pathology discovered upon examination

Week 5

Instrumentation and Dental Surgery

Instruments – use, care and maintenance

Dental machine and other powered equipment – use, care and maintenance

Ancillary equipment – use, care and maintenance

Preparation for and veterinary nursing assistance with surgery

Pre-, intra- and post-operatively, including analgesia

The role of intraoperative radiography

Learning objectives
After completion of this week, participants should be able to:

Differentiate between different instruments used for dental and oral procedures, and state what they are used for

Describe the proper use, care and maintenance of a range of dental instruments and equipment

Explain the benefits of oral radiography in veterinary patients and outline the basic, fundamental principles of the parallel and bisecting angle techniques

Week 6

Dental Clinics, Products and Homecare

What is an effective dental clinic

Types of patients attending dental clinics

Resources for dental clinic consultations

Products and interventions available to help with maintaining oral health

Oral homecare regimes

Effective dissemination of theoretical and practical oral hygiene advice

Client concordance and follow-up

Learning objectives
After completion of this week, participants should be able to:

Debate what makes a dental clinic effective

Explain the range of resources required to run an effective dental clinic, and the purpose of these resources

Describe how a range of products and interventions used to maintain optimal oral health work

Outline how to achieve and maintain client compliance with recommended oral homecare regimes

Week 1

Performance Reviews and Appraisals

This first week, we will look at how to conduct appraisals and performance reviews. We will look at the different styles of checklists and forms that can be used to conduct these sessions, and we will discuss how to give feedback, whether good or bad. We will look at how performance reviews can be used to help with staff members who are not performing at an expected level.

Learning objectives
After completion of this week, participants should be able to:

Know how to give constructive feedback

How to set performance action plans

Design an appraisal form, in order to conduct an appraisal

Week 2

Quality Improvement

QI is an important part of clinical practice and it often lands on veterinary nurses to conduct clinical audits. We will explore what QI involves, how to develop evidence-based practice, what a journal club is, and how to implement clinical audits.

Learning objectives
After completion of this week, participants should be able to:

Understand the concepts of clinical governance, quality improvement and clinical audits

How to implement a clinical audit

Understand how to start a journal club

Week 3

Disciplinary Issues

We will look at what to do if you have a situation when a staff member that doesn’t arrive to work on time, has performance issues, or doesn’t comply to rules. We will look at how you can manage these people, how to set reviews and action plans, along with what to do if they don’t adhere to these action plans.

Learning objectives
After completion of this week, participants should be able to:

Set action plans and how to review these

Know how to conduct an investigation into conduct

Understand what the disciplinary process involves

Week 4

Finances

Part of being a head nurse is also knowing how the business works – having a basic understanding of how your role as head nurse affects profit/loss is important. Stock control, purchasing, pricing and charging correctly are a vital part of this

Learning objectives
After completion of this week, participants should be able to:

Understand the importance of stock control and how to implement a simple system to aid your stock takes

Understand the importance of charging and how making a few changes can make a difference

Know why it is important to charge for your time

Week 1

Mammary Tumours

Mammary tumours are a common tumour in cats which are often malignant, yet a small percentage are benign. Early detection and intervention can have a positive outcome and some patients go on to live disease-free lives, others require continuous treatment and monitoring.

Presentation and behaviour of mammary tumours

Diagnosis and staging

Treatment modalities and monitoring considerations

Learning objectives
After completion of this week, participants should be able to:

Explain the potential causes of mammary tumours in cats

List what investigative procedures may be necessary to secure a diagnosis and what safety factors should be observed when sampling masses

Understand which treatment modalities are most useful for which form of the disease

Describe the patient and client care considerations when managing cases of feline mammary tumours

Week 2

Lymphoma

Lymphoma is a cancer of the lymphocytes and/or lymphoid tissue, which is present in many locations within the body; presentation and treatment of these cases is dependant on location. This week we will cover:

Manifestation of feline lymphoma and categories of disease

Diagnosis, staging and prognostic indicators

Treatment options for feline lymphoma

Chemotherapy protocols, client expectations and how to create a feline friendly environment

Learning objectives
After completion of this week, participants should be able to:

List the common manifestations of feline lymphoma and the patient groups most affected

Understand the value of staging and monitoring the disease

Describe the subtypes of feline lymphoma and the difference in treatment approaches

Explain the rationale of a multimodal chemotherapy protocol and how it may impact on prognosis

Analyse personal skill set and determine how you could support feline patients with lymphoma using your practice facilities

Week 3

Squamous Cell Carcinoma

Squamous cell carcinoma is the most common form of head and mouth cancer in cats; the behaviour of this neoplasm is sometimes unpredictable and can be very invasive. On week three we discuss the presentation, investigation and treatment options available for these patients and look at some practices which are novel to veterinary medicine.

Presentation, diagnosis and staging of squamous cell carcinoma, including lymph node mapping

Treatment options and impact on prognosis

Surgical interventions, nursing support and rehabilitation

Introduction to electrochemotherapy and photodynamic therapy

Learning objectives
After completion of this week, participants should be able to:

Describe the different imaging techniques used to evaluate feline squamous cell carcinoma

List treatment options and prognostic indicators for feline squamous cell carcinoma

Understand the mechanism of action behind novel techniques for feline squamous cell carcinoma

Describe the common surgical interventions and post-operative patient considerations

Week 4

Soft Tissue Sarcoma

Feline injection site sarcoma (FISS) is one of the most common soft tissue sarcomas of cats. The disease may present as a minor mass to the owner but often this is just the tip of the iceberg. Week 4 looks at FISS in more detail and brings the courses learning materials all together in this last week

Soft tissue sarcoma pathophysiology overview

Diagnostic and staging processes

Treatment options, radiation and surgical management

Adjuvant (post-operative) chemotherapy and restaging

Learning objectives
After completion of this week, participants should be able to:

Describe the diagnostic approach to determining cancer diagnosis and tumour burden

Explain typical neoplastic behaviour of FISS and the impact of intervention on survival time

Understand the fundamental reasoning for adjuvant chemotherapy and the options for post-operative care

Week 1

Nutritional Assessment and Calculations

How to perform a nutritional assessment

Calculate energy requirements and how much to feed

Treatment regimens for inappetence

Instigating nutritional support

Learning objectives
After completion of this week, participants should be able to:

Perform a nutritional history and assessment of the animal

Calculate BER and RERs and apply this to how much to feed

Identify when nutritional support is required and how to do this

Week 2

Clinical Nutrition – Renal, Urinary, Liver and Cardiac

Clinical nutrition for renal, urinary, liver and cardiac disease

Look at each of the nutrient requirements for each of these management regimes

Learning objectives
After completion of this week, participants should be able to:

Make recommendations for clinical diets for renal, urinary, liver and cardiac disease

Understand the nutrient specifications for these diets

Discuss the benefits of these diets

Week 3

Clinical Nutrition – Gastrointestinal and Pancreatic

Clinical nutrition for gastrointestinal and pancreatitis

Look at each of the nutrient requirements for each of these management regimes

Learning objectives
After completion of this week, participants should be able to:

Make recommendations for clinical diets for range of gastrointestinal and pancreatitis

Understand the nutrient specifications for these diets

Discuss the benefits of these diets

Week 4

Nutritional Supplements and Trends

Supplements

Nutritional trends (including raw and homecooked diets)

Learning objectives
After completion of this week, participants should be able to:

Make recommendations for supplements for the diseases discussed in weeks 3 and 4

Look at the nutritional evidence behind nutritional fashions

Discuss raw and home cooked feeding with clients