S.L. 437.106 Art. 10Veterinary hospital.

No licence for the running of a veterinary hospital shall be granted unless the requirements of regulation 7 and the following minimum requirements are satisfied:

(1) Minimum structural requirements:

(a) waiting room large enough to accommodate clients according to workload; if possible, a separate waiting area should be provided for dogs and cats;

(b) office and reception facilities must be provided which are easily accessible to clients and staff as appropriate;

(c) at least two examination rooms which ensure the clients’ privacy, and equipped with hand basin and disinfection facilities. The size of these rooms should be sufficient for veterinary surgeon, nursing staff, patient and client, as well as allow for traffic to and from the rooms. They should also be equipped with an examination table capable of being easily disinfected. At least one examination room should be capable of being darkened. At least one room should be equipped with X-ray viewer;

(d) a pharmacy room containing a readily available adequate supply of medicinal products and materials used in the treatment of animals. An efficient stock control system shall be set up which includes a register and a secure, locked receptacle for the storage of controlled drugs. Medicines must be properly and safely stored in accordance with the manufacturers instructions;

(e) at least one operating theatre of adequate size shall be provided and used only for the conduct of surgical operations. Such operating theatres shall not be used for the pre-operative preparation of patients, or for any purpose which could compromise their use for aseptic surgery. There must be a high standard of surgical asepsis. Lighting suitable for the accurate illumination of surgical sites on the patient must be provided in the theatre. Floor or wall junctions in preparation and operating areas shall be adequately coved to ensure efficient cleaning. Floor and wall surfaces should be impervious and easy to clean. There should be positive air pressure in the operating theatre to reduce contamination and the incoming air should be filtered;

(f) a preparation room shall be provided, separate from the operating theatre, for the pre-operative preparation of surgical patients;

(g) scrubbing-up facilities shall be provided, with suitable elbow, foot, or electric-eye operated taps. The scrubbing-up facilities shall be separate from those provided for cleansing and disinfection, and outside the operating theatre;

(h) a recovery room where patients can be easily observed when recovering from anaesthesia;

(i) emergency treatment room, with separate entrance if possible;

(j) X-ray room: radiographs should be taken in a room used only for that purpose and properly designed to reduce to a minimum potentially hazardous radiation. The X-ray room, equipment and the handling of radiograph material should abide by the guidelines issued by the Radiation Protection Board;

(k) laboratory and post-mortem facilities shall be available as separate premises on site in a part of the hospital where they do not constitute a hazard to patients, clients or staff, or jeopardise the accuracy of laboratory analysis in any way. These premises should be easy to clean and disinfect. Protective clothing and disposable gloves shall be provided for staff performing laboratory tests. A recording system shall be kept for tests carried out in the hospital or by any outside laboratory. Suitable facilities for post mortem examination, including proper storage and, or disposal of carcasses. In both areas, adequate facilities for washing and disinfection of hands must be available;

(l) animal holdings shall contain a minimum of six cages or kennels and, or pens for the hospitalisation of animals. For equine hospitals there has to be a minimum of six stables and a readily accessible yard or paddock with safe and well-maintained boundary. The number and size of the animal holdings shall be adequate for the workload of the hospital. The animal holdings and their fittings shall be made of a non-permeable material so as to be easily cleaned and disinfected. There shall be suitable bedding materials for in-patients and adequate storage space for this material;

(m) washing and, or sterilisation facilities must be provided for staff, feeding utensils and bedding material. Suitable facilities for the storage and preparation of food as well as the availability of a variety of diets to meet the needs of in-patients. Feeding equipment must be capable of being sterilised or be disposable;

(n) facilities for the bathing, grooming and drying of in-patients; as well as adequate sanitary facilities for in-patients;

(o) isolation room for animals with transmissible disease with separate washing facilities, waste disposal, sewage, negative air pressure, and barrier nursing;

(p) facilities (room or area) for the intensive care of the critically ill patients including intravenous fluid therapy, blood transfusion and oxygen therapy;

(q) the rooms mentioned paragraphs (l) to (p) should have coving continuous with the floor covering and reach several centimetres up the wall;

(r) residential accommodation for use by the staff on the twenty-four hour duty. There should be reasonable and secure night-time access from the residential accommodation to the hospital facilities without leaving the premises;

(s) office, library;

(t) sufficient telephone capacity shall be provided to meet the workload of the hospital;

(2) Minimum technological requirements:

(a) emergency lighting shall be provided (backup generator, portable lighting units, or similar devices) to allow the hospital to continue to function, especially in the case of operative surgery, in the event of power cut or electrical failure;

(b) refrigerators;

(c) freezers for samples, carcasses of small animals;

(d) binocular microscope with mechanical stage, electric light source and oil immersion facility;

(e) if the veterinary hospital repacks medicine from bulk, or when medicines are prepared by the hospital, proper containers must be used for the dispensing, and all dispensed medicines are to be indelibly labelled with the following information:

(i) name and address of veterinary surgeon dispensing the medicine;

(ii) name and address of the hospital;

(iii) name and address of owner or keeper of animal;

(iv) the words "For animal treatment only" or "Keep out of children’s reach";

(v) the date of dispensing of medicine;

(vi) the words "For external use only" where appropriate;

(f) in addition, medicines dispensed from veterinary hospitals should be labelled with the following:

(i) the name and amount of the product;

(ii) directions for use;

(iii) precautions relating to the use of the product;

(iv) the name of the animal and its owner;

(v) the name of the veterinary hospital;

(g) all labels should be mechanically or machine produced. Hand written labels are not acceptable. Tablets and capsules must be dispensed in crush-proof and moisture-proof containers but paper board cartons may be used for sachets and for manufacturers’ strip or blister packed medicines. Child-resistant containers should be used unless otherwise requested. Paper or plastic envelopes are not acceptable for the dispensing of medicinal products;

(h) clear written instructions should be given to staff regarding the handling of medicines. There should be no ingestion of food where medicines are handled and hands should be washed immediately after handling drugs. The handling of hazardous drugs should be subject to special precautions and written emergency procedures should be available;

(i) proper provision is to be made for the safe disposal of expired or unwanted medicines according to current legislation;

(j) a good supply of surgical instruments, suture materials, sterile surgeons’ gloves and sterile gowns shall be provided. An X-ray viewer shall also be provided in the theatre;

(k) there shall be adequate facilities for sterilisation such as autoclaves and a recognised method of sterilisation of surgical material is to be employed. Sterile packs shall be provided in sufficient quantity to meet the hospital’s workload. Sterility indicators are to be used to monitor the efficiency of the technique. Sterile packs shall have an expiry date marked on them and sterile packs for emergency surgery shall be available at all times;

(l) an operating table of adjustable height which is capable of holding the patient in a tilted position shall be provided in the operating theatre. Proper means of restraint of the patient shall be available. A stretcher or trolley are to be provided for the safe transportation of heavy animals;

(m) a clock in the operating theatre;

(n) adequate facilities for the induction and maintenance of general anaesthesia in a range of animal species, the anaesthetic agent to be used being at the discretion of the veterinary surgeon. There shall also be an adequate means of monitoring anaesthetised patients and of supportive therapy (intravenous fluids, maintenance of body heat, etc,) under anaesthesia. A resuscitative pack shall always be kept readily available for instant use;

(o) facilities for intermittent positive pressure ventilation, either manual or mechanical, are to be provided and anaesthetic machines shall be serviced annually. Anaesthetic scavenging systems shall be used;

(p) oxygen therapy equipment with primary and reserve supplies;

(q) adequate surgical instruments for general and specialist surgery (dental, ophthalmic, and orthopaedic surgery as well as cryosurgery, electro-cautery and suction);

(r) radiographic facilities suitable and adequate for the needs of the hospital and readily available at all times. These facilities must be capable of producing radiographs of diagnostic quality. Evidence of radiological protection and safety precautions, including proper storage for radiation protection equipment, shall be provided and suitable arrangements are to be made for the processing, recording, viewing, filing and storage of X-ray films as well as records of the purchase, maintenance and repair of all equipment. The X-ray equipment and the handling of radiograph material should abide by the guidelines issued by the Radiation Protection Board;

(s) equipment for the permanent identification of X-ray films is required and a suitable exposure chart for the x-ray equipment. A light-beam diaphragm for the x-ray machine and a stationary or moving focused grid must be available. There should also be sufficient provision for non-human physical restraint of patients during radiography. The hospital is also required to update its radiographic facilities as techniques and equipment change;

(t) equipment for endoscopic diagnosis;

(u) equipment for echographic diagnosis;

(v) equipment for ECG monitoring and diagnosis. ECG recordings must be suitably filed and stored;

(w) equipment for haematological diagnosis (to include microhaematocrit);

(x) equipment for basic blood biochemistry (to include urinary refractometer);

(y) centrifuge;

(3) Minimum administrative requirements:

(a) communication to the general public of the name of the veterinary surgeons working in the hospital;

(b) notification of service hours and communication of the emergency service contact numbers to the public;

(c) presence of at least one veterinary surgeon at all times;

(d) there is to be a sufficient number of adequately trained lay staff for the needs of the hospital, at least one member of which must be a veterinary auxiliary;

(e) a person directly responsible for the nursing care of in-patients shall be on the premises at all times;

(f) a reference library of veterinary texts is to be provided;

(g) it must be possible for the veterinary surgeons on duty to contact the staff on the premises at all times;

(h) veterinary hospitals are expected to meet the standards necessary for the training of veterinary auxiliary staff;

(i) the hospital should encourage both veterinary surgeons and veterinary auxiliary staff to obtain further profession qualifications;

(j) there shall be an efficient system of recording treatments, clinical signs, and special instructions. Medical records are to be filed and located and so maintained that any veterinary surgeon on coming into the hospital may, by reading the record, be able to proceed with the continuity of care of the patient. Complete medical records should contain the following information where applicable:

(i) owner identification and address;

(ii) patient identification (name, species, breed, colour, age, sex, microchip number);

(iii) clinical information;

(iv) diagnostic investigations;

(v) diagnosis, provisional or definitive;

(vi) vaccinations-batch numbers and dates;

(vii) therapy, surgical and medical, including dosages and duration;

(viii) special considerations like an adverse reaction to drugs;

(ix) external communications, such as referrals, lab reports;

(x) consent forms and estimates;

(k) proper security arrangements should be made to protect medical records from loss, unauthorised alteration or unauthorised use. Copies of computerised records should always be kept and backed up daily and backup media should be kept at different premises;

(l) adequate means by which members of the public can communicate with the hospital (telephones, mobiles, emails, fax, websites and similar devices). SCHEDULE

Regulation 4(3)

required in an application for a licence for a veterinary establishment name and address, and veterinary professional qualifications of the the application is made on behalf of a company, society, association, or address of its registered office or principal place of business and the full addresses and professional or technical qualifications of partners.

name and address of the owner of premises and equipment, if he is applicant.

location of the veterinary establishment and its form of construction layout plan indicating the proposed use of each room to be attached).

Planning Authority (PA) permit (outline permit is acceptable).

type of veterinary establishment to be set up (veterinary consultancy veterinary clinic or veterinary hospital).

equipment and facilities provided or to be provided in the establishment.

specialised veterinary services that are proposed to be carried out, if name, qualifications, and experience of people to be employed in a professional, administrative or any other manner in the establishment.

Arrangements for waste disposal.

Arrangements for the provision of blood supplies, if applicable.

Arrangements for a twenty-four hour service.