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New Infection Control Guidance for Furry Hospital Care Providers

NEW YORK – Some of the most effective hospital care providers have fluffy tails and soulful eyes. Because hand washing – or more specifically paw washing – for this group usually involves their tongues, a national group now has developed model infection prevention policies for animals in healthcare facilities.

The expert guidance by the Society for Healthcare Epidemiology of America (SHEA) is designed to help acute care hospitals develop policies on the use of animals in healthcare facilities, including animal-assisted activities, service animals, research animals and personal pet visitation. The information was published online in Infection Control & Hospital Epidemiology, the journal of SHEA.

"Animals have had an increasing presence in healthcare facilities," said co-author David Weber, MD, MPH. "While there may be benefits to patient care, the role of animals in the spread of bacteria is not well understood. We have developed standard infection prevention and control guidance to help protect patients and healthcare providers via animal-to-human transmission in healthcare settings."

With little data on transmission of pathogens in healthcare facilities by animals, the SHEA Guidelines Committee developed the recommendations based on available evidence, practical considerations, a survey of SHEA members, writing group opinion and consideration of potential harm where applicable. The Association for Professionals in Infection Control and Epidemiology (APIC) also endorsed the guidance.

In terms of animal-assisted activities, SHEA recommends that hospitals should develop policies and designate a liaison with these provisions:

  • Only dogs should be allowed to serve in animal-assisted activities, such as pet therapy.
  • Animals and handlers should be formally trained and evaluated.
  • Animal interaction areas should be determined in collaboration with the Infection Prevention and Control team and clinical staff should be educated about the program.
  • Animal handlers must have all required immunizations, restrict contact of their animal to patient(s) visited and prevent the animal from having contact with invasive devices.
  • Everyone who touches the animal should practice hand hygiene before and after contact.
  • The hospital should maintain a log of all animal-assisted activities visits including rooms and persons visited for potential contact tracing.

As for service animals, the guidelines recommend that hospitals comply with the Federal Americans for Disability Act, other applicable state and local regulations and include a statement that only dogs and miniature horses are recognized as service animals under federal law. In addition, SHEA recommends that that infection prevention staff consult with each patient/owner to make sure the service animal complies with institutional policies.

More difficult issues can arise with personal visitation from patients’ pets.

While noting that pets, in general, should be prohibited from entering healthcare facilities, authors of the SHEA guidelines concede that exceptions can be considered with dogs if visitation would be of benefit to the patient and can be performed with limited risk. Hand hygiene is recommended immediately before and after contact with the animal.

The authors add that, as the role of animals in healthcare evolves, there is a need for stronger research to establish evidence-based guidelines to manage the risk to patients and healthcare providers.