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

Seeing therapy animals connecting with patients is so cool, and volunteering is extremely rewarding. Watching a patient's tears turn to smiles, or seeing the stress leave a nurse who takes a minute to pet a therapy animal makes it so worthwhile to bring these well-trained animals into the hospital setting. Take a look at this Facebook post for a glimpse into the benefits of therapy animals for patients, families and staff.

I've been volunteering with therapy dogs for over 30 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 AAIs 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 for infection prevention, patient safety, positive 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 "Animal-Assisted Interventions for Health and Human Service Professionals."

One of the most important aspects to ensure best practices is to use 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 anyone pets a therapy animal.
• Do not allow therapy animals to interact with patients who have 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 linked above.) Discard the single-use barrier appropriately after the visit.
• Therapy animals are discouraged from licking anyone or themselves.
• Therapy animals must be bathed and inspected for parasites before 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" in order to prevent transfer of microorganisms from their feet and to prevent possible injuries to patients' skin.
• Therapy animals are always leashed and under the control of their handlers.
• Therapy animals will not visit patients who are agitated or violent.
• Position therapy animals in a way to ensure safety and enough room near patients' equipment (IV pumps, ventilators, drains, etc.).

"Animals in Health-Care Facilities" is a great resource from the CDC on using therapy animals.​​ The American Veterinary Medicine Association also provides AAI guidelines.

Pet Partners, a therapy animal organization, also offers resources on using therapy animals. They offer 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 policies are established and followed. Therapet has 30 years of experience safely providing therapy animal visits to ICU patients. "Animal-assisted intervention in the ICU: a tool for humanization," from Johns Hopkins, shares compelling rationales to allow therapy animals in the ICU to help "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 sums up the enthusiasm and excitement of therapy animals for the work they do.

I was recently interviewed for a KTBB radio program in Tyler, Texas, 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 helped over the years. I hope you enjoy it.

Share your stories about the benefits of safely using therapy animals in your practice.