Therapy Animals: Infection Prevention, Safety and Impact on Patients and Staff

By Julie Miller, BSN, RN, CCRN Dec 07, 2020

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Seeing therapy animals connecting with patients is so cool, and volunteering with them is extremely rewarding.

Seeing therapy animals connecting with patients is so cool, and volunteering with them is extremely rewarding. Watching a patient’s tears turn to smiles, or feeling the stress leave a nurse who takes a minute to pet a therapy animal makes it absolutely worthwhile to bring these well-trained animals into the hospital setting. Take a look at these posts for a glimpse into the impact of therapy animals for patients and staff.

I’ve been volunteering with therapy dogs for over 26 years in critical care units, acute care hospitals, schools and community settings with an organization called Therapet. As a founding volunteer with Therapet and a critical care nurse, I’ve been deeply involved in the development and publication of safety and infection prevention protocols to provide animal-assisted interventions (AAIs) for patients.

I’m frequently asked how to keep patients and therapy animal teams safe when providing AAI in the hospital setting. It is essential before starting an AAI program to research best practices and have approved policies focused on infection prevention and safety. I discuss the comprehensive policies needed that focus on infection prevention, patient safety, outcomes, and volunteer and animal well-being and safety in the following 2020 publications: “Animal-Assisted Interventions: Impact on Patient Outcomes and Satisfaction,” in Nursing Management, and “Nursing Use of Animal-Assisted Interventions,” a chapter in the text Animal-Assisted Interventions for Health and Human Service Professionals.

One of the most important aspects to ensure best practices is to utilize certified therapy animal teams from a reputable organization that requires temperament evaluation, veterinary screening, and ongoing training and evaluation. Investigate the organization offering AAI services to ensure they can provide these essential components and are not just sending a mail order certificate. Once you identify where the certified therapy animals will come from, work with the hospital to collaboratively define policy and procedure.

Best practice essentials to include in a therapy animal policy are listed below. It is not an exhaustive list, and I encourage you to review the literature to ensure a comprehensive policy is developed.

  • Infection Prevention:
    • Ensure hand hygiene before and after for anyone who will pet a therapy animal.
    • Restrict therapy animals from interacting with patients who are on any type of isolation precautions.
    • Place a single patient-use barrier, such as a towel, on the bed where the therapy animal will rest their head or, if allowed, their paws. (Placing paws on the bed requires strict guidelines and is covered in the text chapter mentioned previously.) Following the visit the single-use barrier is discarded appropriately.
    • Therapy animals are discouraged from licking anyone or themselves.
    • Therapy animals must be bathed and inspected for parasites prior to entering the hospital.
    • Discourage anyone from sitting on the hospital floor in order to pet a therapy animal.
  • Safety:
    • Therapy animals are not allowed to offer their paws to “shake” to prevent transfer of microorganisms from their feet and to prevent patients’ skin injuries.
    • Therapy animals are always leashed and under the control of their handlers.
    • Prohibit visits with therapy animals for patients who are agitated or violent.
    • Position therapy animals in a way to ensure safety around patients’ equipment (IV pumps, ventilators, drains, etc.).

With the pandemic, many therapy animal programs stopped visiting hospitals due to the unknown disease risk for animals. Although there have been a few cases of animals being infected with COVID-19, the risk of disease transmission to animals remains low.

In recent weeks, I’ve seen more requests for therapy animal visits to reduce staff members’ stress and help them keep their sanity. Thankfully, therapy animals in many areas of the country have returned to meet this important need. With the return to visiting, I’ve been answering even more questions about patient, volunteer and therapy animal safety and infection prevention. The best practice essentials mentioned previously are even more important during the pandemic. A great resource is also available from the CDC on using therapy animals during the pandemic. Some quick tips from the CDC site:

  • People with symptoms of COVID-19 should not be around, touch or interact with therapy animals.
  • Practice social distancing for anyone and any other animals not participating in the therapy animal interaction.
  • Disinfect items such as leashes, collars, capes and bandanas after visiting the hospital and before going to another facility.
  • Handlers and the participants visiting with therapy animals should wear masks.
  • Do not put a mask on the therapy animal.
  • Do not use disinfecting wipes, hand sanitizer, alcohol, hydrogen peroxide or other harsh chemicals to bathe or wipe down the therapy animal.
  • There is no evidence that the virus can spread to people from the skin, fur or hair of animals.

Pet Partners is a reputable therapy animal organization that also offers resources regarding COVID-19. One of its unique offerings for those who are unable to participate with therapy animals in person is to provide virtual therapy animal visits. Pet Partners also provides a great resource to help understand the terminology that describes therapy animal interventions.

I’m often asked if it is safe for therapy animals to visit ICU patients. The answer is yes when protocols and policies are in force and followed. Therapet has 26 years of experience safely providing therapy animal visits to ICU patients. This article from Johns Hopkins shares compelling rationales to allow therapy animals in the ICU to “humanize” it. Also, I field questions about whether therapy animals enjoy what they do. I think this video showing Therapet Phoebe getting ready to volunteer about sums up the enthusiasm and excitement of therapy animals for the work they do.

I was recently interviewed for a radio program about therapy animals, their impact and the importance of training. Toward the end of the show I also shared a few special memories of patients my therapy animals have touched over the years. I hope you enjoy it.

I’d love to hear from you about the impact of safely using therapy animals!