Patient Observation Optional Standards 2018 – Practice Certification Dashboard

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Patient Observation

The maximum possible points 680. You must obtain a score of 410 or higher to pass this section.

7.1 Pre-Visit Preparation
Staff show knowledge of and/or demonstrate appropriate use of instructions to pet owners on how to deliver a calm pet to the practice. Practice must achieve at least nine (9) of the following to attain the 90 points. Example

Yes

check all that apply (at least 9 of 12)

Sharing any known FAS triggers with practice team member

Reacquainting pet with carrier where appropriate

Appropriately designed carriers for cats and small dogs (airflow, warming/cooling mats)

Transporting pets in carriers with covers (towel, blanket etc.) to reduce arousal

Bring the pet in hungry/fasted – if medically and emotionally appropriate

Options for pre-visit pheromone use

Options for pre-visit pharmaceuticals

Options for pre-visit nutraceuticals

Sound comforting during transport – white noise or appropriate music

Options for behavior management products e.g. compression garments

Preparing the vehicle for a comfortable temperature

Placement of pet in car, including non-slip surfaces

7.2 Arrival At The Practice
Staff show knowledge of and/or demonstrated welcoming experiences consistent with the Fear Free philosophy. Practice must achieve at least seven (7) of the following to attain the 90 points. Example

Yes

check all that apply (at least 7 of 9)

Ensuring pet and people interactions in lobby are not contributing to FAS

Option of moving pets directly into exam rooms

Option of having pets wait in cars with owners when environmental conditions permit

Option of specific hours for sensitive pets

Fear Free scheduling to avoid bottlenecks and even the appointment flow

Provide pheromone-impregnated bandanas/towels/cotton balls to patients upon arrival

Minimize interruption in the exam room: minimize in and out flow of staff

Minimize interruption in the exam room: minimize removal of patient from exam room for procedures unless medically indicated (e.g. imaging)

Minimize interruption in the exam room: preparing room in advance with needed supplies

7.3 Patient Records
Each patient has an emotional medical record which includes FAS scoring and client input. Practice must achieve at least three (3) of the following to attain the 80 points. Example

Yes

check all that apply (at least 3 of 4)

The emotional medical record is reviewed when the client calls to schedule an appointment and appropriate direction is provided by staff to the client regarding patient transport and arrival at the practice to reduce FAS.

The emotional record and FAS scores in the record are reviewed during the appointment and appropriate accommodations are made to minimize FAS.

All observed FAS scores during the visit are recorded in the medical record.

The client’s input is sought and recorded as to how the client felt the patient was in terms of FAS during all aspects in which they are involved.

7.4 Exam Room Experiences
Staff show knowledge of and/or demonstrate appropriate use of Fear Free methods, protocols, and procedures during the outpatient exam. Practice must achieve at least seven (7) of the following to attain the 90 points: Example

Yes

check all that apply (at least 7 of 9)

Touch gradient, gentle control, distraction

Use of high-value food treats or other distractors throughout the exam when appropriate

Appropriate location of exam chosen by patient, such as table, floor, carrier, chair or lap towels

Non-slip surfaces for examination, such as yoga mats, Fear Free exam tables or towels

Application of considerate approach to allow patient to acclimate to staff member

Calming music in the exam rooms

Touch gradient used throughout exam

Staff member responds appropriately to patient’s body language

For serial treatments or when distraction is not effective practice recommends a Fear Free Animal Trainer, other aversive-free trainer, or depending on the level of FAS, a board certified veterinary behaviorist or CAAB

7.5 Inpatient Practice Experiences:
Staff show knowledge of and/or demonstrate appropriate use of Fear Free methods, protocols, and procedures during inpatient care. Practice must achieve at least eight (8) of the following to attain the 90 points. Example

Yes

check all that apply (at least 8 of 13)

Visual blocks for cages such as hiding boxes, cage covers

Visual blocks for pets receiving treatments such as curtains, barriers

Masking noises in wards / housing facilities such as white noise, calming music

Non-slip flooring in cages and on treatment tables

Application of calming techniques and tools

Tools for gentle restraint such as toweling techniques, basket-type muzzles

Touch gradient during procedures and treatments

Knowledge of pre-visit pharmaceuticals (e.g. trazodone, benzodiazepines, gabapentin)

Knowledge of pre-visit nutraceuticals (e.g. alpha-casozepine, L-theanine)

Knowledge of compression garments

During stay, use high-value food items when appropriate to decrease FAS

Thoughtful placement of patients to minimize FAS

During stay, place familiar items from home such as bed, towels or favorite toys with patient and implement spot cleaning whenever possible

7.6 Inpatient Procedures
Staff show knowledge of and/or demonstrate appropriate use of calming protocol and products that reduce FAS during in-patient procedures.
Practice must achieve all three (3) of the following bullets to attain the 90 points: Example

Yes

all three (3) are required to meet this standard

Staff demonstrate use of calming techniques and products during commonly performed procedures

Staff demonstrate use of appropriate demeanor when in the presence of hospitalized patients

If during a procedure a rise in FAS is noted due to staff abilities, steps are taken to reduce FAS by employing a more experienced staff member to complete that procedure

7.7 Travel From Practice To Home
Staff showed knowledge of and/or demonstrated appropriate delivery of instructions to clients regarding how to transport patient home calmly. Practice must achieve at least five (5) of the following to attain 70 points. Example

Yes

check all that apply (at least 5 of 7)

Where applicable, guidance is provided to clients regarding reduction of FAS on arrival home

Efforts are made to send pet owners home prepared for next visit

Efforts are made to discuss reintegration of pets back into multi-pet households where applicable

When patient being discharged has been sedated, anesthetized or is compromised by a mechanical device, clear instructions are provided to client, regarding what to avoid so patient is not injured and so that FAS score does not increase (e.g. not to leave on a bed, by stairs, near pool)

Knowledge of medications, nutraceuticals and pheromones that might be used to ease pet back into the household and reduce FAS

Upon release the owner is provided with instructions and contact information if they can not reduce FAS once home and need to get further advice

Proper instructions are provided and staff confirm that client knows how to administer medications or treatments at home using Fear Free compatible techniques

7.8 General
Clients are made aware of Fear Free tools and techniques. Practice must achieve both bullets indicated below to attain the 80 points. Example

(80 points)

- Fear Free efforts are communicated throughout the practice visit
- Fear Free tools are accessible throughout the exam experience

Yes

Score 0 /410

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