Accessibility – Service Animals, Pet Visitation and Therapy Dogs

Title: Accessibility – Service Animals, Pet Visitation and Therapy Dogs
Policy No: 2.3.4
Original Issue Date: January 21, 2010
Manual: Administration Last Review Date: June 5, 2014
Last Revision Date: March 14, 2019
Department: Corporate Policy Lead: Director Quality and Interprofessional Practice
Approved By: Leadership Committee

1. POLICY

Quinte Health Care (QHC) has a responsibility to be responsive to an individual’s needs in a manner that protects their dignity, enables independence, and ensure access to services that enhance the quality of the patient experience. This policy recognizes QHC’s obligation to facilitate the implementation of the Accessibility for Ontarians with Disabilities Act 2005 (AODA), and all regulations pursuant to the Act.

If a person with a disability is accompanied by a guide dog or other service animal, QHC will permit the person to enter the premises with the animal and keep it with him or her, unless the animal is otherwise excluded by law from the premises. If the service animal is excluded by law from the premises, QHC will look to other available measures to enable the person with a disability to obtain, use or benefit from QHC’s services.
Pet visitation at QHC will be facilitated where possible. In the interest of patient safety, staff safety and infection control requirements, some restrictions will be necessary when bringing an animal into the hospital for visits.

Therapy Dog Services is a regular part of the therapeutic recreation program for some areas at QHC and is an option to patients periodically during their stay.

This policy provides guidelines for when animals belonging to a patient or their visitors, or those animals within QHC’s Therapy Dog Services program are on hospital premises for the purpose of supporting a patient or visitor.

A: Service Animals

A service animal is an animal specifically trained to assist people with disabilities in their activities of independent living (i.e. Guide Dog for those requiring support for safe mobility). A service animal is not considered to be a pet but rather an auxiliary aid similar to the use of a cane, crutch or wheelchair. A service animal sometimes can also be called an assistance animal.

The following are some examples of a service animal:
• A guide animal trained for individuals who are visually impaired and/or blind.
• A hearing animal trained to alert a person with significant hearing loss or who is deaf when a sound occurs.
• Special skill animal trained to assist a person who has a mobility or health disability.
• A seizure response animal trained to assist a person with a seizure disorder.
• A companion animal or emotional support animal that assists a person with a psychological disability.

Service animals are permitted in areas commonly accessed by the public. A patient accompanied by a service animal is not required to disclose the nature of their disability.

For the purpose of safety and infection control requirements service animals will not be permitted in the following areas of the hospital:
• Food preparation areas
• Medication storage/preparation areas
• Procedure areas (operating room, labour/delivery, pre/post-op recovery areas)
• In a room where there is an immunosuppressed patient

Requests for exceptions will be considered as required by the manager of the department.

Requirements
1. The service animal must be supervised and the handler/designate must retain full control, and be responsible for the care and behaviour of the animal at all times.

2. All owners of a service animal must maintain the appropriate certification and documentation to support the role of the service animal.

3. Where the service animal is excluded from a prohibited area, an alternate, safe location will be offered where it can wait, if the person is able to be separated from the animal while obtaining the service. Assistance will be offered to the person with a disability while he or she is separated from the service animal.

QHC staff should be aware of the following while caring for a patient who is accompanied by a service animal:
• Allow the service animal to accompany the patient at all times and everywhere on the property except where animals are specifically prohibited.
• Do not pet or touch a service animal. Petting a service animal when the animal is working distracts the animal from the task at hand.
• Do not feed a service animal. The service animal may have specific dietary requirements.
• Do not deliberately startle a service animal. Do not separate or attempt to separate a patient from her or his service animal. Avoid making noises at the animal (barking, whistling etc.).
• Converse with the owner/handler, not the animal. Avoid eye contact with the animal. In the event of contact with the animal, practice hand hygiene.
• Remember, not all disabilities are visible. The nature of the person’s disability is a private matter, and you are not entitled to inquire for details.
• A service animal may wear specialized identifiable harness and vest. All service animals/users have identification cards.

B: Pet Visitation

QHC recognizes the value and therapeutic benefit of pet visitation and animal therapy. Objectives of these visits include:
• To alleviate loneliness and stress for patients by providing opportunities to maintain meaningful relationships with their pets;
• To provide stimulus for the withdrawn or anxious patient through contact with their pet on a reasonably regular basis and;
• To alleviate a patient’s concern for a pet’s well-being by providing contact through visiting arrangements.
Staff or volunteers are not permitted to bring their pet(s) onto hospital premises outside of the above mentioned circumstances.

Pets are not allowed in the following areas of the hospital:
• Food preparation and public food services area
• Medication storage/preparation areas
• Procedure areas (operating room, labour/delivery, pre/post-op recovery areas)
• In a room where there is an immunosuppressed patient
• Rooms in which patients are actively undergoing invasive procedures
Requests for exceptions will be considered as required by the manager of the department.

Requirements
1. In order for an animal to enter the hospital the animal must meet the following criteria. The animal shall:
• Be healthy and free of parasites
• Have proof of up-to-date rabies vaccination
• Not have been fed within 2 hours of the visit
• Be transported in a carrier or on a leash
• Have an accompanying adult handler at all times, and
• Not interact with other patients
If there is any concern, a certificate from a Veterinarian will be requested.

2. The request for pet visitation to a patient care unit must be pre-arranged with the Interprofessional care team by contacting the Patient Care Lead (PCL), or delegate, in advance of the visit in order to determine appropriateness, time, place and length of visit. One animal is permitted per visit.

3. The person bringing the animal to the unit is responsible for the animal’s actions at all times.

4. Visiting animals shall be limited to domestic companion animals that are household pets and shall be kept on a short leash or in a cage at all times. No reptiles, birds or rodents are permitted to visit (Lefebvre et al, 2008). Pets shall be taken directly to the patient they are visiting and will exit immediately after.

5. If the patient is in a private room, the visitor and pet may go directly into the room, except in the circumstances listed in the policy statement above.

6. If the patient is in a multiple bed unit, the pet will be allowed to accompany the visitor unless a medical reason contraindicates that visit; for example, the illness type of the patient or of the other patients in the room (i.e., allergies, infection or fear of pets). If the visit is still desired by the patient, then the patient should be brought to a private area and the visitor and pet may visit there.

7. If there are concerns about allergies of care providers, or other patients who will occupy the visitation area, the manager/delegate is to contact the housekeeping department to discuss cleaning procedures or an alternate area for the visitation (i.e., an area that is easily wiped down).

8. All persons who touch/handle the animal shall practice hand hygiene before and following contact with the animal.

9. If an elimination accident should occur, the individual who has escorted the pet will be given gloves, paper towels, and a plastic bag to clean up the urine/feces. Housekeeping will then be contacted to mop up the floor.

10. No food for the pet should be brought into the hospital.

11. Infection control protocols shall apply in all circumstances, where applicable.

Recording and Reporting:
• Arrangements for the visit shall be recorded on the Care Plan (Admin Data Screen)
• Results of the visit are to be recorded in the patient’s health record, under a focus note
• Adverse incidents related to the patient or visitor should be reported on the QHC Event Report System
• Adverse incidents involving staff should be reported on the QHC Cares Event Report as per OH&S Policy 8.1, Workplace Illness, Injury & Hazard Reporting

C: Therapy Dogs

Therapy dog programs bring comfort, joy and companionship and patients reap the benefits of unconditional love associated with Therapy Dogs’ visits. It has been demonstrated that the petting, affection, and regular visitation of a dog can be beneficial to hospitalized patients (St. John’s Ambulance Therapy Dogs Services Program, 2007, Delta Society, 2009). Therapy dogs are not allowed in the following areas of the hospital:
• Food preparation and public food services area
• Medication storage/preparation areas
• Isolation rooms
• Procedure areas (operating room, labour/delivery, pre/post-op recovery areas)
• In a room where there is an immunosuppressed patient
Requests for exceptions will be considered as required by the manager of the department.

Requirements
1. Provision of Therapy Dogs programs must be consistent with those same standards and guidelines as set out for Pet Visitation, per this policy, Section B: Pet Visitation.

2. All Therapy Dogs must have been tested for temperament and therapeutic qualities, and must be annually certified by their veterinarians as being up-to-date on all required vaccinations and in good general health. It is a requirement of the program that all dogs must be clean and thoroughly groomed within 24 hours of each visit.

3. The owner of a Therapy Dog must provide certification documents to prove that the dog has gone through one of two programs: St. John Ambulance or the Canadian Canine Association.

APPENDICES AND REFERENCES
References:
Centers for Disease Control and Prevention (2013). Retrieved from: http://www.cdc.gov/hiv/pubs/brochure/oi_pets.htm
Food and Drug Administration (FDA) http://www.fda.gov/fdac/features/2004/104_pets.html
Government of Ontario (2007). Accessibility for Ontarians with disabilities. Retrieved December 16, 2013 from: http://www.elaws.gov.on.ca/html/source/regs/english/2011/elaws_src_regs_r11191_e.htm
Lefebvre, S., Golab, G., Christensen, E., Castrodale, L., Aureden, K., Bialachowski, A., Gumley et al (2008). Guidelines for animal-assisted interventions in health care facilities. American Journal of Infection Control. Retrieved February 27, 2014 at http://www.ncbi.nlm.nih.gov/pubmed/18313508
Pet Partners (formerly Delta Society) (2014). Retrieved from: http://www.petpartners.org/page.aspx?pid=183
Quinte Health Care (2014). Policy: Accessible Customer Service.
St. John Ambulance (2014). Therapy Dog Services. Retrieved from:
http://www.sja.ca/English/Community-Services/Pages/Therapy%20Dog%20Services/default.aspx