Applying the principles of disaster prevention to decrease adverse events in a research program.

In an animal care and use program in a research setting, events that have a negative impact on animal well-being do not typically occur spontaneously and arbitrarily. It takes the convergence of multiple missteps, miscalculations and misinterpretations of conditions for a serious accident to take place. Two concepts drawn from wilderness survival training can be applied to any research animal care and use program to reduce adverse events. The first, derived from the accident matrix model, is the concept of 'problem vectors,' or conditions, behaviors and policies that increase the likelihood of an adverse event. Identifying problem vectors and diverting them before they intersect to create an adverse event can considerably improve animal well-being and reduce the number of protocol violations and reportable events. The second concept is that of doing the 'next right thing' when an adverse event does occur in an animal program. The next right thing is a response characterized by unified directed action toward fixing problems without engaging in behaviors that might worsen the situation. Adopting an institution-wide approach of diverting problem vectors and pursuing the next right thing can result in better prevention and management of adverse events.

The 'Triad of Noncompliance' as a tool for understanding, preventing and correcting protocol and procedural noncompliance.

Noncompliance at research institutions can take many forms, including off-protocol use of animals and failure to follow institutional requirements such as wearing personal protective equipment. Working with investigators to achieve full compliance after protocol approval is a key responsibility of laboratory veterinary staff, compliance personnel and the ACUC. The author discusses three main factors that lead to most noncompliance incidents: (i) Lack of Information, (ii) Desperation and (iii) Disregard. Understanding these three concepts, collectively termed 'The Triad of Noncompliance', can provide insight into the source of protocol or procedural noncompliance and can assist ACUC members and veterinary staff in formulating specific strategies to prevent and correct such problems.

Coughing, mucus accumulation, airway obstruction, and airway inflammation in control horses and horses affected with recurrent airway obstruction.

OBJECTIVE: To investigate relationships between cough frequency and mucus accumulation, airway obstruction, and airway inflammation and to determine effects of dexamethasone on coughing and mucus score. ANIMALS: 13 horses with recurrent airway obstruction (RAO) and 6 control horses. PROCEDURE: 6 RAO-affected and 6 control horses were stabled for 3 days. Coughing was counted for 4 hours before and on each day horses were stabled. Before and on day 3 of stabling, tracheal mucus accumulation was scored, airway obstruction was assessed via maximal change in pleural pressure (deltaPpl(max)), and airway inflammation was evaluated by use of cytologic examination of bronchoalveolar lavage fluid (BALF). Effects of dexamethasone (0.1 mg/kg, IV, q 24 h for 7 days) were determined in 12 RAO-affected horses. RESULTS: To assess frequency, coughing had to be counted for 1 hour. In RAO-affected horses, stabling was associated with increases in cough frequency, mucus score, and deltaPpl(max). Control horses coughed transiently when first stabled. In RAO-affected horses, coughing was correlated with deltaPpl(max), mucus score, and airway inflammation and was a sensitive and specific indicator of deltaPpl(max) > 6 cm H2O, mucus score > 1.0, and > 100 neutrophils/microL and > 20% neutrophils in BALF Dexamethasone reduced cough frequency, mucus score, and deltaPpl(max), but BALF neutrophil count remained increased. CONCLUSIONS AND CLINICAL RELEVANCE: Because of its sporadic nature, coughing cannot be assessed accurately by counting during brief periods. In RAO-affected horses, coughing is an indicator of airway inflammation and obstruction. Corticosteroid treatment reduces cough frequency concurrently with reductions in deltaPpl(max) and mucus accumulation in RAO-affected horses.