Could establishing a culture of workplace safety be more effective than the use of pre-visit sedatives? A new JAVMA study presents some surprising — and some not-so-surprising — results in regard to preventing injuries of veterinary staff.
Editor’s Note: This is an excerpt from Research Wrapped, a free monthly newsletter that collects the latest scientific research relevant to small animal veterinarians and pulls out practical takeaways. To be the first to receive this newsletter each month, subscribe here.
The rate of nonfatal occupational injury and illness per full-time veterinarian was higher than all other industries in 2021, according to the U.S. Bureau of Labor Statistics. The AVMA Professional Liability Insurance Trust and HUB International (insurance brokerage) found that 48% of all claims were associated with an “animal attack” by a feline patient.
In a recently published study (online, ahead of print) in JAVMA, researchers assessed whether patient-handling methods in small animal veterinary hospitals and training/certification in stress-reducing care affected the injury rates of veterinary staff. The study considers data collected from a cross-sectional questionnaire from 113 small animal veterinary practices between October and November 2023.
Gene Pavlovsky, DVM, DABVP (Canine & Feline Practice), chief of staff for the Dr. John A. Coyne South Clinic and head of the Small Animal Primary Care Service at the University of Illinois Veterinary Teaching Hospital, spoke about the study and offered some key takeaways.
Q: The study found a significant relationship between certification in one of the stress-reducing care programs (Fear Free, Low Stress Handling, or a Feline Veterinary Medical Association Cat Friendly program) and injury rates; injuries were far less frequent in hospitals where 100% of the staff were certified in some form of stress-reducing care. Is that the primary takeaway from this study?
Yes, it is. We conceived the study based on a hypothesis that implementing stress-reducing patient-handling techniques could reduce injury to veterinary staff. Results of the study supported this and emphasized the importance of full-scale implementation of such an approach across the entire practice. We found that only practices that received practice certification or had all employees certified in stress-reducing care saw a significant decrease in patient-induced injuries. This distinction suggests that a cultural shift takes place when everyone in the practice is fully engaged in the common goal. This is vital in achieving the end result: reducing stress for our patients, which results in a safer experience for everyone involved.
Editor’s Note: This article is an excerpt from the Research Wrapped monthly newsletter. Subscribe here for free.
Q: The data did not reveal a significant relationship between the use of pre-visit anxiolytic medications/in-clinic injectable sedation and injury rates. Did that, or any other finding, surprise you?
That did surprise us a bit. We do think that the use of pre-visit anxiolytic pharmaceuticals and in-hospital sedation has become more common over the past 10 years or so. However, our theory on the lack of association with injury rates is that, in some cases, drugs may be used as an alternative to stress-reducing handling methods, not alongside them. In such cases, animals may still be stressed enough to engage in aggressive behavior and cause injury to the veterinary staff. Another somewhat surprising finding was the lack of correlation between specific methods of handling and injury rates; one might think that using less stressful methods of handling would lead to less injury. We believe that no single method or combination of handling methods is as effective for reducing injury as a highly functional team that believes in and consistently implements all aspects of stress-reducing patient care, beyond just patient handling. Training and certification of all individuals within the practice or the practice as a whole may help achieve this by instilling a lasting systemic change.
Q: The data highlight variability in postinjury protocols, which is a concern for the health of staff and staff retention. Have the results of this study changed your clinical or managerial recommendations for small animal veterinarians?
No, but as you mention, it did highlight the need for consistency in post-injury protocol implementation and accurate reporting.
Q: Do you have any ongoing or future studies that evaluate other effects of stress-reducing care?
Not at this time. However, a prospective study quantifying patient fear and stress behaviors and veterinary staff injury rates for a period of time before and after formal training in stress-reducing care may better identify patterns of injury and additional opportunities for intervention.
Q: Is there anything you would like our readers to know that has not been mentioned?
I want to emphasize that our study was limited in several ways, but the findings do suggest that the way we handle our patients has a direct impact on our well being. Veterinary professionals are busy and are often spread very thin. It is important to acknowledge that new approaches are always difficult to adopt, even if one is on board with the underlying philosophy. Research suggests that most veterinary professionals agree with stress-reducing care methods but are faced with various barriers that prohibit effective implementation. Resources for individual and team training are available and may help remove the barriers to providing this important building block of providing good quality medical care.
Read the full study
Practice-wide certification in stress-reducing animal care lowers the rate of patient-inflicted injuries to veterinary staff in small animal general practices.
Everett E, Pavlovsky G, Springer C, Albright J. JAVMA. doi:10.2460/javma.25.05.0325