ABSTRACT
Low-molecular-weight heparin (LMWH), prescribed for prophylaxis of venous thromboembolism, is derived from porcine animal products. An audit in our Trust showed that most healthcare professionals (95%, n=58/61) did not consider religious or dietary preferences when prescribing LMWH. Focus groups with local stakeholders helped develop project aims. Quality improvement methods were used to develop, test and optimise interventions over two cycles in our medical unit. Interventions included written and audiovisual information for patients, a staff eLearning module, a policy to guide switching from LMWH to a synthetic alternative and a written prompt reminding doctors to consent patients before prescribing LMWH. The proportion of patients being appropriately consented for LMWH prescriptions increased following our interventions (from <5% at baseline to >80%). Patient and staff feedback was positive, with high demand for a non-animal-derived alternative to LMWH. Simple measures, increasing awareness and knowledge among staff and patients, can improve the number of patients being appropriately consented for LMWH prescriptions.
ABSTRACT
Unauthorised feeding and touching of the animals by visitors to zoos and wildlife parks pose serious threats to the health of both animals and visitors alike. We tested the efficacy of four different "do not feed" signs designed to prevent zoo visitors from feeding a group of meerkats. Signs consisted of one of two different written messages and imagery of either a pair of watching human eyes, or meerkat pawprints as a control. Covert observation of visitor behaviour in the presence and absence of the signs was analysed. Visitors were significantly less likely to feed the meerkats when signs were present, than when they were absent. The effect of the signs was specific to the targeted behaviour in that feeding was reduced, but attempts to touch the meerkats increased with the presence of the signs. We did not find that the presence of watching eyes or the different wording on the signs affected the likelihood of visitors feeding the meerkats. We also examined factors that influenced the likelihood of visitors attending to the signs. We found that children were more likely to attend to signs than adults which has important implications for the design of such signs. Together our findings show that signs are effective in reducing the unwanted behaviours they target but may also result in displacement of these negative behaviours and that children are more likely to attend to these signs than adults.
