Animal Visitation Service Animals Pet Dog Therapy Services Patient-Owned Pet Dog Visits

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1 Apprved by: Animal Visitatin Service Animals Pet Dg Therapy Services Patient-Owned Pet Dg Visits Vice President and Chief Medical Officer Crprate Plicy & Prcedures Manual Plicy N. VI-25 Date Apprved July 14, 2016 Next Review (3 years frm Effective Date) August 2019 Purpse T prvide guidance regarding animal visitatin in Cvenant Health acute care facilities in rder t ensure the safety f all patients and staff. Plicy Statement Cvenant Health Infectin Preventin & Cntrl (IPC) is cmmitted t patient safety at all levels f the rganizatin by supprting and prmting an envirnment that encurages infectin preventin and cntrl best practices fr service animals and pet dg visitatins. Applicability This plicy applies t all healthcare staff, physicians, vlunteers, students and t any ther persns acting n behalf f the fllwing Cvenant Health facilities; Banff Mineral Springs, Bnnyville Health Centre, Camrse St. Mary s, Castr Our Lady f the Rsary, Edmntn Grey Nuns, Misericrdia and Villa Caritas, Killam Health Centre, Vegreville St. Jseph s. This plicy applies nly t the acute care ppulatin if the abve facilities prvide bth acute and cntinuing care. Respnsibility Cvenant Health staff, physicians, vlunteers and ther service prviders are respnsible fr creating and sustaining an envirnment that supprts an infectin cntrl prgram that effectively prevents transmissin f pathgens frm visiting animals and ptential healthcare-assciated infectins. Principles Cvenant Health believes that animal visitatin during a hspital stay has therapeutic value and can enhance patient wellness. By fllwing the guidelines utlined in this plicy, reasnable precautins shall be taken t ensure the safety f individuals and t prevent transmissin f diseases frm animals t patients. Zntic infectins may be cntracted thrugh bites and/r scratches, frm aersl, direct cntact, animal secretins and excretins, vectr r fmites and cntaminated animal feed. 1.0 Service Animals Please refer t Alberta Service Dgs Act r Blind Persns Rights Act fr guidelines regarding service animals in health care facilities. Service animals may accmpany impaired patients r visitrs nt Cvenant Health premises. Service animals must be apprpriately harnessed r leashed fr their wrk and the wner/handler r designate must have cntrl f the dg at all times. ¹ Hereafter, all references t patients includes clients.

2 Animal Visitatin Plicy N. VI-25 Page 2 f 9 Whenever pssible, the patient care area shuld be ntified in advance f any patients and/r visitrs wh will be accmpanied by a guide r service animal. At anytime, Cvenant Health reserves the right t request prf that the guide r service animal has been adequately trained and immunized. Identificatin cards issued by the Gvernment f Alberta (fr Service dgs) r the Canadian Natinal Institute fr the Blind (CNIB) are acceptable fr guide animals. If n ther ptins are available and a service animal must remain with the patient during the patient s hspitalizatin: the patient and his/her guide/service animal must be placed in a private rm; the patient r patient s family/designate must make arrangements t feed and hydrate the animal and ensure that the animal has scheduled utdr time fr walks and t eliminate waste. Except in unanticipated r emergency situatins, the hspital will nt assume respnsibility fr the care and cntrl f the animal. Service animals are exempt frm the rest f the guidance in this plicy ( ). 2.0 Suitable Animals Suitable animals include dgs that meet criteria utlined in sectins 3.0, 3.1, and Fr all Pet Therapy and Patient-Owned Dgs Dgs must: be dmesticated (*see definitins) be clean and grmed (bathed within the past seven days); be apprpriately restrained with a shrt nn-retractable leash (less than tw meters in length) r in a clean crate r carrier; be huse-trained; be f even temperament; never lick r cme int cntact with a patient s pen wund, medical device r equipment; have been in a permanent hme fr at least six mnths (i.e. des nt cme frm an animal shelter); be mnitred and kept in cntrl by the handler at all times; nt be left alne with patients; nt have cntact with staff unless abslutely necessary. Hand hygiene must be perfrmed after cntact with the dg);

3 Animal Visitatin Plicy N. VI-25 Page 3 f 9 nt have been fed raw fds f animal rigins within the previus 90 days; be kept away frm patients, visitrs and/r staff with animal allergies r phbias; be bserved carefully by the handler during interactins and remved frm any stressful situatins; nt visit patients wh have wunds r medical devices that cannt be cvered; nt visit when a patient is eating r underging a medical prcedure; nt visit patients n additinal precautins (except under exceptinal and apprved circumstances eg. terminally ill patient); nt visit patients wh are immuncmprmised r neutrpenic (except under exceptinal and apprved circumstances (eg. terminally ill patient); nt be fed, given treats r prvided with water during facility visitatin. Dgs shuld be prvided water utside f the facility immediately prir t the scheduled visit. Pet dg visitatin privileges may be withdrawn at anytime at the discretin f the unit manager/supervisr/charge nurse r delegate if: there is a change in the patient s clinical status; there is an emergency situatin n the unit; r, if there is failure t adhere t pet visitatin guidelines. The handler and patient must be infrmed prir t visit that the dg shuld nt have been fed any raw fds f animal rigins within the previus 90 days and that may be asked t remve the dg frm the facility at any time. Animals are NOT permitted in: kitchen/pantry areas dishwashing areas fd preparatin and strage areas eating areas (i.e. cafeteria, snack bar and patient dining areas) Medical Device Reprcessing Department (MDRD) Operating Rm (OR) including recvery areas Labratry and Diagnstic Imaging (DI) areas Critical Care areas including ICU laundry areas siled utility rms medicatin preparatin areas patient/public washrms labr & delivery areas nenatal nurseries 3.1 Dg Health Dgs must be certified annually as healthy and free f disease. Dg must have current rabies vaccinatin and ther vaccinatins determined by the veterinarian in the best interest f the animal based n lifestyle,

4 Animal Visitatin Plicy N. VI-25 Page 4 f 9 risk assessment and whm the animal will be in cntact with. Owners/ handlers are respnsible fr making available up t date veterinarian and vaccinatin recrds when their pet visits a facility. Dgs are t be immediately remved frm the facility if they appear ill r sick during a visit. Dgs with any f the fllwing cnditins are excluded frm visiting fr ne week fllwing the reslutin f: vmiting sneezing, cughing antimicrbial, immunsuppressive therapy skin infectins bth pen and clsed, ear infectins, skin and sft tissue infectins (SSTI). Suspend visitatin until veterinary dcumentatin is prvided t shw the treated animal is free f Methicillin resistant staphylcccus aureus (MRSA). fleas, ticks, external r internal parasites (including wrms). diarrhea (if animal has been diagnsed with Clstridium difficile, Salmnella, Giardia r Txplasma gndii (the later is fund in cats), veterinary dcumentatin shuld be prvided t shw animal has been treated). 3.2 Animal Related Hygiene Practices Hand hygiene must be perfrmed as per Cvenant Health Hand Hygiene Plicy (VI-10). Patients shuld be assisted with hand hygiene as needed. Perfrm hand hygiene: patients - befre and after animal cntact handlers - between rms Dgs must be prvided with an pprtunity t urinate and defecate immediately befre entering the healthcare facility. Glves are t be wrn when dealing with eliminatin accidents. It is the respnsibility f the handler t clean up the excrement. Organic debris must be cleaned with a paper twel, placed in a plastic bag and dispsed f in a waste cntainer. Affected area must then be cleaned with COV apprved disinfectant. Hand hygiene must be perfrmed fllwing (as utlined abve). Where pssible, if a pet dg is allwed n a patient s bed, a barrier such as a dispsable clth twel r sheet must be placed between the animal and the patient s linen. The barrier is t be remved and discarded when the pet leaves. Any furniture that animals have been permitted n (chairs, benches, etc.) need t be cleaned and disinfected fllwing facility prcedures with COV apprved cleaner.

5 Animal Visitatin Plicy N. VI-25 Page 5 f 9 Licking shuld be discuraged as well as shaking paws, even if paws are clean as flrs may be cntaminated. Patients with indwelling venus r urinary catheters, pen r bandaged wunds, r ther indwelling medical devices must have these areas adequately secured and cvered, in rder t prevent the dg frm making cntact. Patients with wunds r medical devices that cannt be cvered must be excluded frm pet dg visitatin. 4.0 Pet Therapy Services Dgs that are brught in as part f visiting pet therapy services must be identified as a pet therapy vlunteer with a visible hspital tag. Dgs must be registered with a recgnized pet therapy prgram if they are visiting facilities as Pet Therapy Animals. Pet Therapy is crdinated thrugh Vlunteer Services. Vlunteer Services must ensure that all Pet Therapy vlunteers are cmpliant with the abve pints in 3.0. Animals shuld be re-evaluated yearly fr suitability. 5.0 Patient-Owned Pet Dg Visits Visits are a shrt-term interventin t help imprve patient s well-being. (Exceptins may be made by the unit manager/supervisr/charge nurse/designate in end-f-life situatins.) If visitatin must ccur in a multi-bed rm, ral permissin frm the rmmate (r rmmate s guardian) shuld be btained prir t the dg arriving. The handler and patient must be infrmed prir t the visit that they may be asked t remve the dg frm the facility at any time. Dgs must enter/exit thrugh facility main entrances and take direct rutes t the patient they are attending. Pet handler is t take respnsibility fr the immediate clean up f the animal waste, if an accident ccurs. Fr all patient-wned pet dg visits: Unit manager/supervisr/charge nurse/designate must ensure that arrangements are made fr the visit t take place in a private rm r ther apprved setting, as apprpriate.

6 Animal Visitatin Plicy N. VI-25 Page 6 f 9 Duratin f the visit will be agreed upn and cmmunicated t the dg handler by the unit/area manager, charge nurse r designate prir t the visit taking place: nly tw visits per patient per day are permitted, up t a maximum f ne hur per visit; nly ne pet visitatin is permitted at any ne time n a given patient care unit. There shall be nly ne family pet dg per apprved visit. Unit manager/supervisr/charge nurse/designate must ntify security when and where the dg will be visiting. Unit manager/charge nurse/designate must prvide the pet dg handler with a permissin nte (see Appendix A) and explain t them that they must present the nte at the infrmatin desk, in rder t btain a name tag that states "Visiting Pet," befre prceeding t the patient care area. Patient-wned pet dgs must nt interact with ther patients, visitrs, staff r ther patient-wned pet dgs. 6.0 Resident/Facility Animals r Pets Resident/facility animals are prhibited within Acute Care. 7.0 Animal Bites r Scratches Nursing staff are t be alerted immediately t ensure apprpriate treatment is given and dcumentatin ccurs. Animal is t be immediately remved/segregated/cntained. All incidents f biting r scratching are reprted t Envirnmental Public Health Inspectrs immediately by calling Health Link Alberta LINK (5465). If an emplyee is expsed this must als be reprted t Cvenant Health Occupatinal Health and Safety. 8.0 Outbreaks r Onging Micrrganism Transmissin When there is knwn, suspected r nging micrrganism transmissin, pet visits will be suspended. Definitins Dmesticated animal t adapt an animal t life in intimate assciatin with and t the advantage f humans. An animal that is nt wild and is kept as a pet. Handler the persn respnsible fr the animal including training and cntrl.

7 Animal Visitatin Plicy N. VI-25 Page 7 f 9 Persnal r Visiting Pet a dg wh visits the facility n an ad hc basis r limited time frame t prvide cmfrt t a persn in a health care facility. Als called animal visitatin. Pet an animal kept fr pleasure r cmpaninship. Pet Therapy/Animal-Assisted Therapy the use f trained animals (dgs nly) and handlers t achieve specific therapeutic gals. Als referred t as animal assisted activities. Service Animals any animal that assists a persn with disabilities with ne r mre daily activities. A service animal is nt cnsidered a pet. Rules regarding service animals in health care facilities are fund in the Alberta Service Dg Act and Alberta Blind Persns Rights Act. Zntic infectins any infectius disease that can be transmitted frm nn-human animals, bth wild and dmestic, t humans. Als referred t as animal-human disease transmissin. Related Dcuments Crprate Plicy #VI-10, Hand Hygiene. Hand Hygiene resurces References 1. American Jurnal f Infectin Cntrl (AJIC) Writing Panel f the Wrking Grup: Lefebvre, S., Glab, G., Christensen, E. et al. (2008). American Jurnal f Infectin Cntrl, 36(2), da Csta, P., Lureir, L. & Mats, A. (2013). Transfer f multi-drug resistant bacteria between intermingled exlgical niches: The interface between humans, animals and the envirnment. Internatinal Jurnal f Research and Public Health, 10, Darling, K. (2014). Animals visiting in healthcare facilities. In Assciatin fr Prfessinals in Infectin Cntrl and Epidemilgy (APIC) Text f Infectin Cntrl and Epidemilgy. Retrieved December 1, 2015 frm 4. Elad, D. (2013). Immuncmprmised patients and their pets: Still best friends? The Veterinary Jurnal, 197, Ernst, L. (2014). Animal-assisted therapy: An explratin f its histry, healing benefits and hw skilled nursing facilities can set up prgrams. Annals f Lng Term Care, 22(10). Retrieved December 2, 2015 frm 6. Infectin Preventin & Cntrl Canada (IPAC, 2014). Infectin preventin & cntrl audit fr animal visitatin and pet therapy. Retrieved December 16, 2015 frm 7. Gvernment f Alberta (2015). Blind persns rights act. Retrieved December 21, 2015 frm

8 Animal Visitatin Plicy N. VI-25 Page 8 f &display=html 8. Gvernment f Alberta (2015). Service dgs act. Retrieved December 21, 2015 frm &display=html 9. Gvernment f Alberta (2015). Frequently asked questins Service dgs act. Retrieved December 1, 2015 frm Llyd, D. (2007). Reservirs f antimicrbial resistance in pet animals. Clinical Infectius Diseases, 24 (Suppl 2), S148-S Sciety fr Healthcare Epidemilgy f America (SHEA) Expert Guidance: Murthy, R., Bearman, G., Brwn, S. et al. (2015). Animals in healthcare facilities: Recmmendatins t minimize ptential risks. Infectin Cntrl & Hspital Epidemilgy, Revisins May 13, 2013 Nvember 2010

9 Animal Visitatin Plicy N. VI-25 Page 9 f 9 APPENDIX A ACUTE CARE PET/THERAPY VISITATION PERMISSION SLIP T Infrmatin Desk Persnnel: Please prvide with a (Name f persn accmpanying dg) "Visiting Pet" name tag and direct this persn t bring the pet t Patient Care Unit n. (Indicate date f visit) Signed: Pet meets the fllwing criteria: clean and grmed f even temperament huse-trained nt fed raw fds f animal rigins within the previus 90 days been in a permanent hme fr the past 6 mnths certified annually as healthy and free f disease. Rabies vaccinatin current as well as ther vaccinatins as determined by veterinarian n a shrt nn-retractable leash handler aware that they will be respnsible fr clean up during the visit handler aware that they will be in cntrl f the animal handler aware that they will assume liability fr the animal behavir while at the site cpy f vaccinatin recrd prvided (Signature f Manager r Designate) (Print Name) (Date) (Unit Phne Number)

C.A.R.E. Pet Adoption Application & Contract

C.A.R.E. Pet Adoption Application & Contract This sectin fr C.A.R.E. Use Only Puppy Dg Kitten Cat Pet s Name: Estimated DOB (r age): Breed: Clr: Micrchip #: Male Male/Neutered Female Female/Spayed Adptin Fee: $ Ntes: Cntact Infrmatin First Name: