Do ‘CARE’ labelled canine patients get a lower standard of nursing care?

Abstract

Aggressive patients are labelled as ‘CARE’ within their clinical history and the quality of nursing care they receive may be compromised because of concerns for staff safety. The aim of this study was to investigate if a difference in the quality of nursing care exists between aggressive patients labelled as CARE and other patients not labelled as CARE, hoping to identify whether this suggested a breach of patient welfare. This study used a cross-sectional, observational survey distributed online via social media veterinary nursing community pages. Open invitations were also emailed to the first author's own practice, and the RVC's Queen Mother Hospital for Animals. UK-based registered veterinary nurses who had been in practice within the last 12 months participated. Likert response categories of 1-5 were used to question registered veterinary nurses about how likely they were to undertake certain nursing activities for both CARE and non-CARE canine patients. In total, 390 registered veterinary nurses completed the questionnaire. Pearson's chi-squared test was used to statistically analyse the data. An association was discovered between level of nursing care and CARE or non-CARE labelled patients. Statistically significant differences (P=0.05) in nursing care were found under every nursing category for CARE patients. The key categories identified were patient hygiene, feeding, pain scoring, exercise and restraint. The current study provides evidence that aggressive canine patients do get a lower standard of nursing care compared to other canine patients. Areas of concern are highlighted when these differences are discussed in the context of animal welfare. The authors hope these findings serve as a prompt for practices to examine their performance towards aggressive patients to ensure adequate standards of nursing care and patient welfare are sustained.