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6 Dec 2018

Eye on EBVM: taking the lead on quality improvement

This month, VN council vice-chairman Liz Cox throws down the gauntlet to fellow veterinary nurses to take the lead on quality improvement in practice for the benefit of all.

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Liz Cox

Job Title



Eye on EBVM: taking the lead on quality improvement

Liz Cox.

On professional registration we make the declaration that ends with “… and that, above all, my constant endeavour will be to ensure the health and welfare of animals committed to my care”.

The RCVS code of conduct states: “Veterinary nurses must ensure that clinical governance forms part of their professional activities.” You might even be collating information ready for an RCVS Practice Standards Scheme assessment and thinking: ‘‘How do I demonstrate compliance with clinical governance?’’

But do you understand the term “clinical governance”? You might be more familiar with it as quality improvement (QI), but whichever name, how does it relate to how nurses and the practice team work every day? Fear not: it’s likely you are doing it already – you just might not have realised it.

Figure 1.
Figure 1.

VNs are naturally driven towards QI – we are generally process driven – so are critical to QI success. No matter what size and type of practice, we have a common goal – to provide the best quality of care for our patients every time.

QI is a way to monitor, review and improve work. Figure 1 shows how QI fits together and each area supports the other. Still confused? Perhaps think about it differently. For example:

  • We are doing great things in our practice, but don’t know how we compare to others – benchmarking can tell you.
  • I’d like to prove to my manager the changes I’ve made are making a difference – audits can demonstrate it.
  • Does a better way of doing this exist? Guidelines and checklists provide a practical way to consistently follow the best evidence.
  • What happened today was awful. I want to make sure it doesn’t again – significant event audits help you get to the bottom of what went wrong.
  • I worry about patient postoperative temperatures; I think they are affected by anaesthetic times – do an audit and find out if you are right.

No matter what our practice role is, we all have a part to play in continually improving. But I’d like to challenge you, as a fellow VN, to take the lead. As well as improving our practice, we are encouraged to develop the nurse role. Now is your chance.

Think about what you would like to improve on or find out about, and one area will lead to the next. To help you along the way, plenty of free, easy-to-access tools, templates and training material on the RCVS Knowledge website are available.

Most nurses love that sense of marking off a task when complete. So here’s one you can now tick off below.

I’m ready to start making quality improvements in my practice.