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Pioneering guidance launched on use of dogs in healthcare settings

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The Royal College of Nursing has launched the first ever nationwide protocol for working with animals in healthcare, in a bid to encourage more hospitals to explore the benefits of animal therapy.

The protocol, which was unveiled at the RCN congress in Belfast yesterday, is designed to provide best practice guidance on introducing dogs to health and care settings and includes advice on licking, paws on beds and allergy management.

“We hope that it will encourage all health services to consider how animals can help their patients”

Amanda Cheesley

The project was prompted by an RCN survey last year, which found the vast majority of nurses thought animals could be hugely beneficial to patients.

In all, 90% of nurses surveyed felt animals could improve the health of patients with depression, while 60% felt the presence of animals could speed up recovery. Yet most also reported animals were banned from their workplace.

The college noted that research suggested interaction with animals such as dogs, cats, dolphins, birds, cows, rabbits, ferrets and guinea pigs may be an effective treatment for mental and behavioural disorders such as depression, schizophrenia and alcohol or drug addiction.

Studies also indicated animal-assisted therapy could be an effective complementary therapy for people with dementia, it said.

The RCN’s protocol highlights that there has been an increase in the number of working therapy dogs, alongside a rise in the number and type of assistance dogs, which help people with physical disabilities and mental health conditions.

“Given that we know dogs can make a significant difference to the lives of people with a range of disabilities and conditions, this is a positive move,” said the guidance, which only refers to dogs.

“However, there are rightly a number of concerns being raised about bringing a dog into a clinical environment and these need to be addressed,” it stated.

While each organisation is responsible for developing its own policy, the hope is that the protocol will promote a more consistent approach.

“There are rightly a number of concerns being raised about bringing a dog into a clinical environment”

RCN protocol

Policies, which need to consider the welfare of both people and animals, must take into account the fact some people are severely allergic to animals, are scared of them or have a full-blown phobia, the protocol stated.

Staff must also consider cultural or religious beliefs before a dog is allowed to visit an area, said the document.

Nurses can expect registered assistance dogs to be highly trained, so they will sit or lie quietly next to their owner and not “wander freely about the premises”, said the protocol.

They will not display behaviour such as “growling, snarling, lunging or biting” and are trained to go to the toilet on command, so are “unlikely to foul in a public place”, it said.

Working dogs should wear an ID tag or jacket that identifies them as an assistance or therapy dog and should not be left alone with anyone other than their handler or owner, it added.

“It is important to recognise that many healthcare settings are unfamiliar environments for most dogs”

RCN protocol

When it comes to infection control, the protocol recommends dogs should only visit patients with surgical wounds if those wounds are covered.

“The dog should not be allowed to lick anyone,” the protocol stated. “They should not be allowed to sit fully on the bed and, in particular, not near a person’s face.

“If the dog is putting their feet on a bed, then a protective pad (e.g. incontinence pad) should be put under their paws and discarded after each individual visit to avoid contamination from one patient to the next,” it said.

As well as covering the use of trained therapy or assistance dogs, the guidance looks at how to handle requests from patients to have contact with their own pets or those belonging to family or friends.

Under the protocol, bringing in family pets is only recommended in “exceptional circumstances”, such as if someone is in hospice care and nearing the end of life.

“From time-to-time people may make a request to bring a pet dog to visit a person in a healthcare setting,” said the document.

It said: “While we understand that people may value having time with their pet dog, it is important to recognise that many healthcare settings are unfamiliar environments for most dogs and can be very unsettling for a dog that has not been temperamentally screened and trained to deal with a very wide range of environments.

“Similarly, it is difficult for hospital staff to have to deal with the requirement to assess a dog’s health and vaccination history,” it said.

The protocol also highlighted the need to ensure animals were not over-worked.

“It is recommended that each active session with the dog is no longer than one hour and that dogs should work for no more than three active hours a day,” the document stated.

The development of the protocol was led by Amanda Cheesley, the RCN’s professional lead for long-term conditions and end-of-life care.

She said that, despite the benefits, many healthcare organisations were deterred from allowing animals into settings due to health and safety fears.

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Amanda Cheesley

“Anyone who’s worked in this area can see the amazing impact animals have on the health of adults and children alike,” she said.

“However, there are so many myths around the dangers of having animals in health care settings that most organisations are too concerned to try it out,” she noted.

She said she hoped that the protocol would address these fears and give staff more confidence.

“This protocol will help to dispel these fears by supporting hospitals to include animals in the care they deliver in a safe and professional way,” said Ms Cheesley.

“We hope that it will encourage all health services to consider how animals can help their patients and help us to remove the taboo from what is a really remarkable area of care,” she added.

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