Infection control project shows audit and team culture drive lasting change across 60 veterinary practices

2xl

right-aligned

white

- Large-scale initiative demonstrates significant gains in infection prevention compliance and awareness through nurse-led audit and reflection -

A large-scale project involving 60 CVS small animal practices has demonstrated how structured auditing, team reflection and nurse-led leadership can strengthen infection prevention culture and improve infection control standards across veterinary practice.

The initiative, Enhancing the Culture of Infection Control in Small Animal Practice Through Audit, Education and Reflective Tools, was developed following a national roundtable involving more than 40 CVS veterinary colleagues, where infection prevention was identified as a key priority for the profession.

Recognising that infection control is influenced as much by behaviours, attitudes and workplace culture as by protocols and policies, the project set out to explore what interventions could best drive sustainable change across a diverse network of practices.

The study involved 60 CVS companion animal practices and used a cluster-randomised design to compare different approaches to infection prevention improvement over a four-month period. Practices were randomly allocated to control, low-intervention and high-intervention groups, with all teams completing regular infection control audits and surveys designed to assess compliance, behaviours and attitudes towards infection prevention.

The project was predominantly led by registered veterinary nurses, with each practice nominating a local lead responsible for coordinating audits and encouraging team engagement. Educational resources, reflective learning tools and active facilitation were introduced to support practices in identifying and addressing infection control risks within their own environments. High-intervention practices also received reflective training tools, including the use of germ-simulating products containing a fluorescent dye activated under ultraviolet light, helping teams visualise contamination risks and assess the effectiveness of cleaning processes.

Using an adapted version of the Bella Moss Foundation Hygiene Self-Audit Tool, teams measured infection prevention performance monthly, alongside surveys examining perceptions of cleanliness, hygiene and shared responsibility for infection control.

The results showed significant improvements in infection control performance across participating practices. Audit scores increased by an average of more than six points over the course of the project, with improvements observed across all intervention groups. Perhaps most notably, the greatest gains were seen in practices receiving relatively low-intensity interventions, suggesting that regular audit, team engagement and reflective discussion were more influential than the level of resource provided.

The project also delivered measurable cultural change. Teams reported greater awareness of contamination risks, stronger engagement with infection prevention processes and increased recognition that infection control is a shared responsibility across the entire practice, including clinical and non-clinical colleagues.

Importantly, the initiative moved away from a one-size-fits-all approach. Rather than prescribing specific actions, practices were encouraged to use audit findings and reflective discussions to identify solutions that worked within their own workflows, environments and team structures. As a result, practices introduced a range of locally relevant improvements, including refined cleaning protocols, changes to equipment use, improved communication processes and greater use of infection control reviews.

The findings also reinforced the importance of human factors in infection prevention. Project leaders found that team culture, communication and collective ownership were strongly associated with successful outcomes, highlighting the role of behaviour change alongside procedural compliance.

Michelle Farrow, Research Assistant and RVN, who led the project at CVS said:

“Infection prevention is fundamental to patient safety, team wellbeing and responsible antimicrobial use, but lasting improvement comes from culture rather than compliance alone. What makes this project particularly powerful is that it demonstrated how small, consistent actions, supported by audit, reflection and team engagement, can drive meaningful change at scale. I am incredibly proud of the veterinary nurses who led this work and of the practice teams who embraced shared responsibility for infection control as part of everyday clinical care.”

The impact of the project has extended beyond the participating practices. Learning from the initiative has informed the development of a dedicated CVS infection prevention digital workspace and educational resources available to colleagues across the organisation, helping to standardise best practice while allowing flexibility for local implementation. The infection control audit tools developed through the project are also now being used by veterinary practices in CVS Australia.

The success of the initiative has now been recognised nationally, with the project receiving a Highly Commended accolade in the RCVS Knowledge Awards, recognising its innovative use of quality improvement methodology to strengthen infection prevention culture and drive measurable improvements across 60 veterinary practices.

Project findings have also been shared with the wider profession through presentations at a leadership conference and the London Vet Show, supporting broader discussion around infection prevention, quality improvement and antimicrobial stewardship in veterinary practice.