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Applying clinical audit for quality improvement in canine dystocia cases seen at a UK primary-care emergency practice

O'Neill, Daniel; Leicester, Lucy; Reid, Aoife; Marshall, Racheal; Gilbert, Sophie


Daniel O'Neill

Lucy Leicester

Aoife Reid

Racheal Marshall

Sophie Gilbert


Dan O'Neill


Background: The paucity of published veterinary clinical audits suggests that
clinical audit is an under-used tool for quality improvement (QI) in the veterinary
profession. Therefore, a continuous QI process was designed and
implemented at a UK multisite small animal emergency practice, focusing on
audit of clinicalmanagement of canine dystocia.
Methods: Data collection phases were undertaken in 2014, 2019 and 2021,
with intervening knowledge dissemination activities. Nine variables relating
to clinical management of canine dystocia were selected as audit criteria in
the initial dataset, and 21 variables were measured in each subsequent phase.
Results: Between 2014 and 2021, statistically significant increases (p < 0.05)
were demonstrated in recording of bodyweight, use of diagnostic imaging,
use of ultrasonography, recording of fetal heart rates, use of calcium
gluconate, and use during caesarean section of intravenous fluid therapy,
multimodal analgesia, full agonist opioids, paracetamol and local anaesthesia.
Statistically significant decreases were demonstrated in median first
quantity and median first dose of oxytocin, and in the use of NSAIDs during
caesarean section. A clinical audit planning template was created for future
Limitations: Typical case presentation and management of canine dystocia
cases may vary between dedicated emergency and non-emergency primarycare
Conclusion: This study demonstrates the feasibility of large-scale veterinary
clinical audit and suggests that the application of the clinical audit process
promotes learning within the veterinary team and improved clinical


O'Neill, D., Leicester, L., Reid, A., Marshall, R., & Gilbert, S. (2023). Applying clinical audit for quality improvement in canine dystocia cases seen at a UK primary-care emergency practice. Veterinary Record,

Journal Article Type Article
Acceptance Date Dec 1, 2022
Online Publication Date Jan 11, 2023
Publication Date Jan 11, 2023
Deposit Date Jan 11, 2023
Publicly Available Date Jan 11, 2023
Journal Veterinary Record
Print ISSN 0042-4900
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Publisher URL
Additional Information Research group: VetCompass (can we add this to the list please)


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