Tag Archives: hygiene

Paw hygiene no reason to ban assistance dogs from hospitals

Over 10,000 people in Europe use an assistance dog; think of guide dogs for the blind and visually impaired, hearing or signal dogs for the deaf and hard of hearing, medical response dogs and psychiatric service dogs.

Assistance dog user Iris and her dog Sandy in the recovery room after surgery. After a severe epileptic seizure, Iris was not doing well and Sandy was brought to the hospital in the hopes she could help improve Iris’ condition, which was indeed the case. Sandy even accompanied Iris to the OR, where Iris had to undergo a major surgery. One year earlier, bringing Sandy along was not negotiable in this particular hospital. Photo: private photo of Iris and Sandy.

According to European law, these dogs are welcome in stores, hospitals and other public places. However, in practice, many assistance dog users and their dogs are regularly refused entry. In the Netherlands, four out of five assistance dog users indicate that they regularly experience problems with this.

Often, hygiene reasons are given as the main argument for refusing entry to assistance dogs. Research by Utrecht University now shows that the paws of assistance dogs are cleaner than the shoe soles of their users, and thus, paw hygiene is no reason to ban assistance dogs from hospitals.

To investigate this, Jasmijn Vos, Joris Wijnker and Paul Overgaauw of Utrecht University’s Faculty of Veterinary Medicine took samples from the paws of 50 assistance dogs and the shoe soles of their users. For comparison, they also investigated an equally large group of pet dogs and their owners. Vos and her colleagues examined the samples for poop bacteria (Enterobacteriaceae), which are very common outdoors, and for an important diarrhoeal bacteria (Clostridium difficile).

“The dogs’ paws turned out to be cleaner than the soles of their shoes,” says Jasmijn Vos, Masters student at Utrecht University. “This makes the hygiene argument that is often used to ban assistance dogs from public locations invalid.” Moreover, the diarrhoeal bacteria did not occur on the dogs’ paws whatsoever, and only once on a shoe sole.

81% of assistance dogs are refused

Dutch assistance dog users were also surveyed about their experiences. 81% are still regularly refused entry to public places with their dog, even though this is prohibited by law. This is mainly down to lack of knowledge on the part of the person refusing entry: lack of knowledge on what an assistance dog is, how it can be recognised, and about the rules of law.

The study also shows that assistance dog users constitute only a small fraction of the total number of patients in Dutch hospitals. Should they decide to bring their assistance dog to the hospital, or elsewhere, this should be made possible; assistance dogs are usually well behaved and are no more of a hygiene hazard than people!

Research publication
Vos SJ, Wijnker JJ, Overgaauw PAM. A pilot study on the contamination of assistance dogs’ paws and their users’ shoe soles in relation to admittance to hospitals and (in)visible disability. Int. J. Environ. Res. Public Health. 2021; 18(2): 513.
Full text: https://www.mdpi.com/1660-4601/18/2/513

Source: Utrecht University

Infection control guidelines for animal visitation

The use of dogs in hospitals and other therapy institutions is on the rise, as more medical professionals acknowledge the positive effects of dogs on human patients.

New expert guidance by the Society for Healthcare Epidemiology of America (SHEA) outlines recommendations for developing policies regarding the use of animals in healthcare facilities, including animal-assisted activities, service animals, research animals and personal pet visitation in acute care hospitals.

The guidance was published online in Infection Control & Hospital Epidemiology, the journal of SHEA.

“Animals have had an increasing presence in healthcare facilities,” said David Weber, MD, MPH, a lead author of the recommendations. “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.”

Guidance is grouped by the role of animals – animal-assisted activities (i.e., pet therapy and volunteer programs), service animals, research animals and personal pet visitation. Select recommendations include:

Animal-Assisted Activities

  • Facilities should develop a written policy for animal-assisted activities. An animal-assisted activity visit liaison should be designated.
  • Allow only dogs 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, and require that everyone who touches the animal to 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.

Service Animals

  • The policy allowing service animals of patients and visitors into the facility should be compliant with the Federal Americans for Disability Act (ADA), other applicable state and local regulations and include a statement that only dogs and miniature horses are recognized as Service Animals under federal law.
  • If an inpatient has a service animal, notification should be made to the Infection Prevention and Control Team, followed by discussion with the patient to make sure the owner of the service animal complies with institutional policies.
  • Healthcare providers or staff may ask the patient or visitor to describe what work/tasks the dog performs for the patient, but may not ask for a “certification” or “papers.”

Personal Pet Visitation

  • Pets should, in general, be prohibited from entering the healthcare facility.
  • Exceptions can be considered if the healthcare team determines that visitation with a pet would be of benefit to the patient and can be performed with limited risk. Even then, visitation should be restricted to dogs.
  • The patient must perform hand hygiene immediately before and after contact with the animal.

The authors of the guidance also note 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.

This guidance on animals in healthcare facilities has been endorsed by the Association for Professionals in Infection Control and Epidemiology (APIC), the leading professional association for infection preventionists with more than 15,000 members.

Source:  EurekAlert! media release

Previous blogs about therapy dogs include: