Animal Use Self-Assessment

Animal Use Self-Assessment

This self-assessment includes a review of the approved Animal Ethics protocol, associated amendments, and observation/discussion of laboratory activities associated with approved protocols and/or licences.

Principle Investigator Name Principle Investigator Name * First Last
Principal Investigator Email *
Room/Lab Number *
For each of the items listed below, check “YES”, “NO”, or not applicable (N/A)
1. The AEEC and Personnel

Description *
Description	Yes	No	N/A
Personnel have obtained animal licenses from the Department of Health (DOH) specific to the species, procedure and location of the research	Personnel have obtained animal licenses from the Department of Health (DOH) specific to the species, procedure and location of the researchYes	Personnel have obtained animal licenses from the Department of Health (DOH) specific to the species, procedure and location of the researchNo	Personnel have obtained animal licenses from the Department of Health (DOH) specific to the species, procedure and location of the researchN/A
Personnel and procedures are current and approved by the AEEC	Personnel and procedures are current and approved by the AEECYes	Personnel and procedures are current and approved by the AEECNo	Personnel and procedures are current and approved by the AEECN/A
A current copy of the approved protocol (including amendments) is available in the lab and staff have read and understood the protocol	A current copy of the approved protocol (including amendments) is available in the lab and staff have read and understood the protocolYes	A current copy of the approved protocol (including amendments) is available in the lab and staff have read and understood the protocolNo	A current copy of the approved protocol (including amendments) is available in the lab and staff have read and understood the protocolN/A

2. Animal Usage

Description *
Description	Yes	No	N/A
Species and strain are consistent with the approved protocol	Species and strain are consistent with the approved protocolYes	Species and strain are consistent with the approved protocolNo	Species and strain are consistent with the approved protocolN/A
Number of animals used is consistent with the approved protocol, is recorded and current.	Number of animals used is consistent with the approved protocol, is recorded and current.Yes	Number of animals used is consistent with the approved protocol, is recorded and current.No	Number of animals used is consistent with the approved protocol, is recorded and current.N/A
Protocol number on the animal(s)’ cage matches the approved AEEC number	Protocol number on the animal(s)’ cage matches the approved AEEC numberYes	Protocol number on the animal(s)’ cage matches the approved AEEC numberNo	Protocol number on the animal(s)’ cage matches the approved AEEC numberN/A
The importation and usage of animals from outside sources has been approved by the Director of the LASEC	The importation and usage of animals from outside sources has been approved by the Director of the LASEC Yes	The importation and usage of animals from outside sources has been approved by the Director of the LASEC No	The importation and usage of animals from outside sources has been approved by the Director of the LASEC N/A

3. Non-Surgical Procedures

Description *
Description	Yes	No	N/A
Procedures performed are consistent with procedures in the approved protocol and amendments.	Procedures performed are consistent with procedures in the approved protocol and amendments.Yes	Procedures performed are consistent with procedures in the approved protocol and amendments.No	Procedures performed are consistent with procedures in the approved protocol and amendments.N/A
Unexpected morbidity, mortality or other problems are reported to vet staff or LASEC	Unexpected morbidity, mortality or other problems are reported to vet staff or LASECYes	Unexpected morbidity, mortality or other problems are reported to vet staff or LASECNo	Unexpected morbidity, mortality or other problems are reported to vet staff or LASECN/A
Medical/observation/treatment notes are properly documented in records	Medical/observation/treatment notes are properly documented in recordsYes	Medical/observation/treatment notes are properly documented in recordsNo	Medical/observation/treatment notes are properly documented in recordsN/A
Drugs, fluids, etc used are within expiration dates	Drugs, fluids, etc used are within expiration datesYes	Drugs, fluids, etc used are within expiration datesNo	Drugs, fluids, etc used are within expiration datesN/A

4. Anaesthesia

Description *
Description	Yes	No	N/A
Methods of anaesthesia are in compliance with the protocol (including dose, frequency, duration)	Methods of anaesthesia are in compliance with the protocol (including dose, frequency, duration)Yes	Methods of anaesthesia are in compliance with the protocol (including dose, frequency, duration)No	Methods of anaesthesia are in compliance with the protocol (including dose, frequency, duration)N/A
Anaesthetised animals are monitored according to the approved method in the protocol	Anaesthetised animals are monitored according to the approved method in the protocolYes	Anaesthetised animals are monitored according to the approved method in the protocolNo	Anaesthetised animals are monitored according to the approved method in the protocolN/A
Anaesthetic procedure / drug /dose /duration is properly documented on cage	Anaesthetic procedure / drug /dose /duration is properly documented on cageYes	Anaesthetic procedure / drug /dose /duration is properly documented on cageNo	Anaesthetic procedure / drug /dose /duration is properly documented on cageN/A

5. Surgical Procedures

Description *
Description	Yes	No	N/A
Surgery is performed in a location that has been approved by the AEEC	Surgery is performed in a location that has been approved by the AEECYes	Surgery is performed in a location that has been approved by the AEECNo	Surgery is performed in a location that has been approved by the AEECN/A
Location and method of animal preperation and recovery is appropriate and in accordance with the approved protocol	Location and method of animal preperation and recovery is appropriate and in accordance with the approved protocolYes	Location and method of animal preperation and recovery is appropriate and in accordance with the approved protocolNo	Location and method of animal preperation and recovery is appropriate and in accordance with the approved protocolN/A
Survival surgery is performed using sterile instruments, sterile gloves, a surgical mask and aseptic technique	Survival surgery is performed using sterile instruments, sterile gloves, a surgical mask and aseptic techniqueYes	Survival surgery is performed using sterile instruments, sterile gloves, a surgical mask and aseptic techniqueNo	Survival surgery is performed using sterile instruments, sterile gloves, a surgical mask and aseptic techniqueN/A
Incisions are closed in accordance with the approved protocol	Incisions are closed in accordance with the approved protocolYes	Incisions are closed in accordance with the approved protocolNo	Incisions are closed in accordance with the approved protocolN/A
Intraoperative care is provided in accordance with protocol	Intraoperative care is provided in accordance with protocolYes	Intraoperative care is provided in accordance with protocolNo	Intraoperative care is provided in accordance with protocolN/A

6. Post-Surgical Care

Description *
Description	Yes	No	N/A
Post-surgical care and monitoring is in compliance with the approved protocol	Post-surgical care and monitoring is in compliance with the approved protocolYes	Post-surgical care and monitoring is in compliance with the approved protocolNo	Post-surgical care and monitoring is in compliance with the approved protocolN/A
Methods of analgesia (dose, frequency, duration) are consistent with the approved protocol and are properly documented	Methods of analgesia (dose, frequency, duration) are consistent with the approved protocol and are properly documentedYes	Methods of analgesia (dose, frequency, duration) are consistent with the approved protocol and are properly documentedNo	Methods of analgesia (dose, frequency, duration) are consistent with the approved protocol and are properly documentedN/A
Post-surgical care is adequately documented on the cage	Post-surgical care is adequately documented on the cage Yes	Post-surgical care is adequately documented on the cage No	Post-surgical care is adequately documented on the cage N/A

7. Euthanasia

Description *
Description	Yes	No	N/A
Method of euthanasia corresponds with approved protocol	Method of euthanasia corresponds with approved protocolYes	Method of euthanasia corresponds with approved protocolNo	Method of euthanasia corresponds with approved protocolN/A
Death is assured by performing an appropriate physical method of euthanasia when required	Death is assured by performing an appropriate physical method of euthanasia when requiredYes	Death is assured by performing an appropriate physical method of euthanasia when requiredNo	Death is assured by performing an appropriate physical method of euthanasia when requiredN/A
Appropriate procedures are used for the final disposition of the animals	Appropriate procedures are used for the final disposition of the animalsYes	Appropriate procedures are used for the final disposition of the animalsNo	Appropriate procedures are used for the final disposition of the animalsN/A

8. Record keeping

Description *
Description	Yes	No	N/A
DOH FORM 6 is being completed at the end of each experiment	DOH FORM 6 is being completed at the end of each experimentYes	DOH FORM 6 is being completed at the end of each experimentNo	DOH FORM 6 is being completed at the end of each experimentN/A
DOH FORM 6 records are being kept in an organized way and easily accessible	DOH FORM 6 records are being kept in an organized way and easily accessibleYes	DOH FORM 6 records are being kept in an organized way and easily accessibleNo	DOH FORM 6 records are being kept in an organized way and easily accessibleN/A
Surgical log entries are current and complete (include: procedure, anesthesia, post operative care, and follow up).	Surgical log entries are current and complete (include: procedure, anesthesia, post operative care, and follow up).Yes	Surgical log entries are current and complete (include: procedure, anesthesia, post operative care, and follow up).No	Surgical log entries are current and complete (include: procedure, anesthesia, post operative care, and follow up).N/A
Laboratory log entries are current and complete (e.g. injections and sample collection)	Laboratory log entries are current and complete (e.g. injections and sample collection)Yes	Laboratory log entries are current and complete (e.g. injections and sample collection)No	Laboratory log entries are current and complete (e.g. injections and sample collection)N/A
Regulatory documents are complete and up-to-date (e.g. DOH licenses and AEEC approved protocols)	Regulatory documents are complete and up-to-date (e.g. DOH licenses and AEEC approved protocols)Yes	Regulatory documents are complete and up-to-date (e.g. DOH licenses and AEEC approved protocols)No	Regulatory documents are complete and up-to-date (e.g. DOH licenses and AEEC approved protocols)N/A
Number of animals used is recorded, current and complete (e.g. in excel format)	Number of animals used is recorded, current and complete (e.g. in excel format)Yes	Number of animals used is recorded, current and complete (e.g. in excel format)No	Number of animals used is recorded, current and complete (e.g. in excel format)N/A

9. Laboratory

Description *
Description	Yes	No	N/A
Housing of animals outside the AHC for greater than 12 hours has been approved by the Animal Care & Housing Committee	Housing of animals outside the AHC for greater than 12 hours has been approved by the Animal Care & Housing CommitteeYes	Housing of animals outside the AHC for greater than 12 hours has been approved by the Animal Care & Housing CommitteeNo	Housing of animals outside the AHC for greater than 12 hours has been approved by the Animal Care & Housing CommitteeN/A
Drugs, suture material and other items are properly labeled, dated, within expirations dates, and are properly stored.	Drugs, suture material and other items are properly labeled, dated, within expirations dates, and are properly stored.Yes	Drugs, suture material and other items are properly labeled, dated, within expirations dates, and are properly stored.No	Drugs, suture material and other items are properly labeled, dated, within expirations dates, and are properly stored.N/A
Controlled substances are stored and recorded appropriately	Controlled substances are stored and recorded appropriatelyYes	Controlled substances are stored and recorded appropriatelyNo	Controlled substances are stored and recorded appropriatelyN/A

I have completed this animal use self-assessment with my laboratory staff/students. All applicable items on the checklist have been found to be in compliance or have a plan in place to bring back into compliance.
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