• Under the Equality Act 2010, Frimley Health NHS Foundation Trust is legally obliged to make reasonable adjustments to ensure equal access to services.

No animals should be brought into the hospital unless they are:

• Assistance/ working dogs (Section 5.1)

• Visiting their owners under exceptional circumstances (Section 5.2)

• Pre-arranged PAT animal visits to outdoor locations (Section 5.3)

This is a controlled document. If you are using a printed copy, check it against the guidelines site to ensure you are using the latest edition. Print copies must be destroyed after use.

Under the Equality Act 2010, Frimley Health NHS Foundation Trust is legally obliged to make reasonable adjustments to ensure equal access to services. Additionally, the Act requires that all reasonable efforts be made to accommodate people’s needs as long as patient and staff safety is not compromised.

The aim of this guideline is to minimise the restriction of access to working dogs, reduce stress to the person, dog, staff, and other patients, whilst reducing the risk of infection transmission from animals (zoonosis) to patients, staff, and visitors.

Assistance dogs can be used by people who have sight, hearing, and other disabilities to give greater independence and part of that independence is that a person may have to bring a dog onto a hospital site. Guide dogs, Hearing dogs and other Assistance dogs are working dogs that have been trained as a mobility aid for people with visual or other disabilities.

It is well documented that disease such as the following, can be acquired from animals, including domestic pets. It must also be remembered that not all people are pet lovers, and some people have allergies or phobias to animals, so their wishes must also be taken into consideration.

From dogs and cats

Salmonella enterica

Campylobacter sp.

Toxocara canis

Toxoplasma gondii

Pasteurella haemolytica

Ringworm

(Meticillin-resistant Staphylococcus aureus from dogs)

From terrapins Salmonella sp. (food poisoning)

From birds Chlamydia psittaci

Fish tanks Mycobacteria (skin infections)

This list is not exhaustive and only covers the most frequently recorded infection hazards.

• All animal visits to be approved by prior arrangement with the ward/ departmental Clinical Matron or Head of Nursing/ Midwifery, who will liaise with the Infection Prevention and Control Team (IPC Team).

• Any persons handling the animal during the visit must clean their hands after contact (see IPC05: Hand Hygiene policy).

• Animals visits are not considered suitable for the following (with exception to visits under sections 5.1 or 5.2 of this document):

• Intensive Care/ Critical Care and High Dependency Units

• Neonatal Unit

• Operating Theatres/Interventional or Diagnostic Areas

• Emergency Assessment Areas

• Areas in which food preparation takes place

• Patients in Source Isolation

• Patients in Protective isolation

• Patients who are neutropenic or who are receiving augmented immunosuppression (e.g. chemotherapy)

• Asplenic patients

• Anyone with known allergy to the specific animal

• Animals must not come into contact with patients who are eating, or during invasive procedures.

• Other patients in the ward who may come into contact with the animal should be consulted about the pet visit to prevent anxiety for patients with phobias and allergies.

• Animals must be appropriately immunised, and these immunisations must be up-to-date. Staff must check with the individuals responsible for the animals that this is the case.

• Should the animal be unwell or being treated for a veterinary condition, access to the hospital will be denied as a precautionary measure.

• The IPC Team may exclude an animal from hospital premises if it is suspected to be a source or vector of infection. The registered owner may be requested to have the animal examined by a vet before being allowed back into the hospital to ensure it is not a risk to patients or staff.

• The animal must be house-trained.

• Animals must be clean, well groomed, free of parasites and in good health.

• Exclude any animals which are aggressive or have a tendency to bite.

• No animal will be permitted without their owners/handlers, who are to remain with their animals at all times.

• Animals must be supervised at all time and suitably contained e.g dogs should be kept on a leash. Smaller animals must be caged but may be taken out for supervised handling.

• Pets belonging to staff are not allowed on Trust premises (exceptions can only be made with the approval of the Chief Executive Officer.)

No animals should be brought into the hospital unless they are:

• Assistance/ working dogs (Section 5.1)

• Visiting their owners under exceptional circumstances (Section 5.2)

• Pre-arranged PAT animal visits to outdoor locations (Section 5.3)

5.1 Assistance/ Working Dogs

Working Dogs will accompany the handler wherever their guidance is needed throughout the healthcare setting. The following principles apply:

• The dogs are instantly recognised by the harness they wear and the identification tag on their collar.

• Handlers should carry an identification card that displays the name of the relevant assistance dog charity they are associated with.

• The dogs will undergo rigorous health checks on a regular basis, have a strict set diet and be monitored regularly to ensure they meet the criteria of an assistance dog.

• The dogs are working animals therefore seek permission from their handler before touching.

• The dogs are trained to toilet on command and are therefore unlikely to foul in a public place.

• The dogs will sit or lie quietly beside their handler.

• The dogs will not wander freely throughout premises and movement should be restricted by keeping it on a lead and in harness.

• The dogs are highly trained working dogs and not pets.

• The dogs are working whenever the harness is in place, when removed this would indicate a rest period for the dog.

5.2 Exceptional Circumstances

There may be an exceptional circumstance (e.g. extreme distress, end of life care) where the opportunity for a patient to see a beloved pet (cat or dog) is thought to be necessary for the care or treatment of the patient. If this is the case, appropriate arrangements must be made as detailed below. If possible, the patient should be accompanied out of the hospital building to see their pet. Necessary arrangements include:

• Agreement and risk assessment for the visit from the Clinical Matron or Head of Nursing/ Midwifery for the inpatient area, and the IPC Team.

• Date and time of visit agreed.

• Name of person bringing animal in is provided.

• Name of member of staff who will accompany the patient to their pet, or if not possible, meet and accompany animal and friend/ relative from the entrance of the hospital to ward and then off the premises.

• Length of time needed for visit to fulfil the needs of the owner and pet.

• The animal visits the owner only.

• The nurse accompanying the patient is responsible for clearing up any fouling by the pet.

• Details of the visit to be documented in the patient’s notes.

5.3 Pets as Therapy (PAT)

PAT animals are not permitted routinely on hospital sites, however pre-arranged visits are possible, after discussion and documented risk assessment with the IPC Team.

• Visits should ideally take place in hospital gardens/ courtyards, however visits to inpatient settings are possible based on the outcome of risk assessment.

• Visits must be by prior arrangement and appointment only.

• It may be necessary to postpone visits if circumstances dictate on the day.

• Animals must have a record/ certification detailing their vaccinations, visits to the vet and state of health. They must be temperament assessed, fully wormed and covered by an insurance scheme. They will be well behaved and be under the control of registered owners.  

The following patient groups are advised not to take part in PAT visits:

• Patients who are severely immunocompromised

• Patients with known allergies to the specific animal

• Patients with wounds that cannot be covered

• Patients with infectious diseases (eg.being source-isolated, or in a ward undergoing outbreak investigation)

• Patients who are unable to clean their hands effectively after handling animals.

• Resident pets are not permitted within the hospital premises.

• Fish and birds, and exotic/ tropical pets

• Wild animals

This guideline will be monitored via reporting of incidents, and review of relevant complaints or concerns relating to non-adherence to the guidance.

DiSalvo H, Haiduven D, Johnson N, Reyes W, Hench C, Shaw R, Stevens D 2006 Who let the dogs out? Infection Control did: Utility of dogs in healthcare settings and infection control aspects American Journal of Infection Control 34 (5): 301-307.

Duncan SL 2000 APIC State-of-the-art report: The implications of service animals in healthcare settings American Journal of Infection Control 28 (2): 170-180.

Guay DRP 2001 Pet-assisted therapy in the nursing home setting: Potential for zoonosis American Journal of Infection Control 29 (3): 178-86

Khan MA, Farrag N 2000 Animal–assisted activity and infection control implications in a healthcare setting Journal of Hospital Infection 46 (1): 4-11.

Lefebvre SL et al. 2008 Guidelines for animal-assisted interventions in healthcare facilities American Journal of Infection Control 36 (2):78-85.

McMahon S 1991 The quest for synthesis: Human-companion animal relationships and nursing theories Holistic Nursing Practice 5 (2): 1-5.

Royal College of Nursing 2019 Working with dogs in Health Care Settings RCN, London https://www.rcn.org.uk/-/media/royal-college-of-nursing/documents/publications/2019/december/007-925.pdf?la=en

This guideline has been registered with the Trust. However, clinical guidelines are guidelines only. The interpretation and application of clinical guidelines will remain the responsibility of the individual clinician. If in doubt, contact a senior colleague or expert. Caution is advised when using guidelines after the review date. This guideline is for use in Frimley Health NHS Foundation Trust hospitals only. Any use outside this location will not be supported by the Trust and will be at the risk of the individual using it.

Version Control Sheet

Related Documents