Krishna Mistry

VetsforPets, Leeds, Birstall, United Kingdom

Objectives

To determine whether Resting Energy Requirements (RER) are consistently calculated and accurately recorded in hospitalised canine and feline patients, and to evaluate whether targeted quality improvement interventions can improve compliance within the first 24 hours of admission.

Methods

This study was conducted as a clinical quality improvement project using the Model for Improvement in a first-opinion small animal practice. The study population included all hospitalised canine and feline patients admitted for medical management, excluding day procedures.

Baseline data were collected via retrospective review of hospitalisation sheets to assess completion and accuracy of RER calculations. Interventions were introduced and tested using Plan-Do-Study-Act (PDSA) cycles, including pre-printed hospital sheets, visual prompts, and simplified calculation tools. Data were analysed over time using run charts to assess changes in documentation rates and accuracy.

Results

Baseline findings demonstrated inconsistent completion of RER calculations and frequent inaccuracies. Following implementation of interventions, the proportion of patients with documented RER increased. However, a minor reduction in calculation accuracy was observed. Variability was noted between staff groups, with student veterinary nurses demonstrating higher accuracy, and patients admitted overnight less likely to have RER recorded within the first 24 hours.

Statement: Impact/ Clinical Significance

This project demonstrates that simple, nurse-led interventions can improve the consistency of nutritional planning in hospitalised patients. It was an important lesson to accept that in some cases, speed (increasing volume) can be just as valuable as accuracy, especially when it doesn’t significantly compromise patient care.

The findings highlight the importance of accessible tools, staff education, and system-level support in embedding nutritional assessment into routine practice. It reinforces the pivotal role of veterinary nurses in leading quality improvement initiatives and optimising inpatient care.

The Model of Change highlighted the importance of being flexible and adaptable. I learned that adjusting my expectations (like tolerating minor inaccuracies) was sometimes necessary for achieving broader goals (like increased documentation).