Therapy Animals in Hospitals: Preventing Infection Risks

There is no question that pets provide a multitude of therapeutic benefits, to patients and medical staff alike. Many kinds of animals can be used as therapy animals—dogs, cats, bunnies, guinea pigs, even horses. We are only beginning to scratch the surface of the multiple ways therapy animals promote healing, as well as the immeasurable comfort aspects that their presence can provide. However, questions arise about health risks involved with bringing animals into a medical facility, especially with the onset of COVID-19.

“Some risks are associated with therapy animal visits, and the possibility of infection is something that always needs to be kept in mind,” Michelle Martonicz, the human half of a registered Pet Therapy Team at Phoenix Children's Hospital in Phoenix, Arizona, and Caymus, her 6-year-old Goldendoodle, told Infection Control Today^® (ICT^®). First and foremost, we must stay alert of our surroundings and the situations we can be exposed to when it comes to the type of patients we can be exposed to. The hospital takes great measures in proper signage on the doors to inform us whether the child is infectious or not.”

According to the American Association for Critical-Care Nurses, infection risks for COVID-19 in animals remain low. No animals should have any contact with patients infected with COVID-19. Other precautions can be taken to protect the risk of infections to patients, staff, and the pets themselves. These include:

• Handwashing. Just as with all other medical-related practices, the emphasis on hand hygiene cannot be overstated. Wash hands before and after handling animals and any equipment associated with them.
• Isolation. Therapy animals should not interact with any patient currently in isolation.
• Towels. A single-use barrier, such as a towel, should be placed anywhere the pet rests, including if it is just the animal’s head or paws. Paws require special attention. Guidelines are covered in Animal-Assisted Interventions for Health and Human Service Professionals.
• Licking. Pets are discouraged from licking patients or themselves.
• Contact. Patients and staff should not sit on the floor to interact with the animal.
• Hygiene. Animals should be bathed and checked for parasites prior to visiting the facility.
• Disinfect all leashes, collars and other equipment associated with the animals.
• Practice social distancing for those not involved with interaction. This counts for pets, too.
• Injuries. Animals should not visit if they have wounds or broken skin.
• Waste management.Animals should be trained to not eliminate indoors. But if they do, the handler must be prepared to clean up, and any waste disposal tools and materials must be disinfected prior to the visit, and then stored out of the area.

There are safety factors to be considered; mainly that the pet should be kept on leash, with an awareness of all tubes, monitors, and other equipment situated in the room. Dogs and other pets should not be encouraged to “give a paw” or “shake hands,” as the feet can be a harbinger for germs.

Martonicz explains the protocols that she and Caymus are required to follow. “We practice the following methods to help reduce the risk of infection for Caymus, myself, and the children we visit:

1. Caymus has a health screening done by his veterinarian confirming that he is free of transmissible disease, parasites, and is up-to-date on his vaccinations. It is a requirement at PCH for this to be done annually.
2. PCH has requirements for handlers to have certain vaccinations and TB tests up to date.
3. If he or I are not feeling well, we cancel our visit.
4. Caymus is not on a raw food diet as these food products carry the risk of infecting pets with parasites and foodborne illness, which they could pass on to the children during our visits.
5. It's mandatory that I bathe Caymus no more than 24 hours before a visit.
6. We use many barriers while visiting the children at PCH which include masks for everyone in the patient's room, clean sheets put on the child's bed, so Caymus can visit on the bed and standing outside of a child's room if they need to be free of droplets.
7. Hand hygiene is very important. We sanitize before and after visiting a patient as well as anyone petting Caymus; they sanitize before and after touching him.”

Martonicz told ICT^® that the safety of the patients, parents, staff, Caymus, and herself are always foremost in her mind. “The standards and policies at Phoenix Children's Hospital are specifically designed to minimize risks, including the risk of infection, and to help make therapy animal visits as safe as possible. PCH and all of their Pet Therapy Teams feel the benefits of the human-animal bond are significant, and we all want to be sure every visit with a PCH child is safe as well as effective."