Julie MeyerManager of Infection Prevention Megan CooperPatient Relation Specialist Objectives Describe z oonotic definitions Identify the difference between service and companion animals AnimalsPets ID: 759233
Download Presentation The PPT/PDF document "Infection Prevention & Risk Manageme..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Infection Prevention & Risk Management in a Healthcare Setting
Julie Meyer-Manager of Infection Prevention
Megan Cooper-Patient Relation Specialist
Slide2Objectives:
Describe zoonotic definitionsIdentify the difference between service and companion animals
Slide3Animals-Pets
Over centuries, animals have been domesticated by people
who brought
these animals
into the home environment to share food and shelter.
These
animals are what we think of as
‘pets’.
Nearly 1/3 of households in the United States have dogs and cats.
Many people live with less traditional pets, including reptiles, rodents, exotic birds and chickens.
These unusual pets pose different risks to human health and may require additional precautions.
Information about how to handle non-traditional pets can be found on CDC website.
Slide4Can Animals Cause Infection in the Hospital?
Zoonoses
refer to diseases that pass between people and animals.
Recently, researchers have determined that >70% of emerging infectious diseases in people actually come from animals.
Examples of new emerging infectious diseases:
viral hemorrhagic fevers, like Ebola
respiratory diseases, like SARS
What these serious diseases have in common is that they all start as
zoonoses
in the animal kingdom.
Slide5What are the zoonoses that can be transmitted to people by contact with cats and dogs?
Zoonoses
that pass directly from dogs and cats to people:
Infect through
animal bites or scratches
bacteria like
Bartonella
that cause cat scratch fever
viruses that cause rabies
diseases like ringworm that are caused
by
fungi
Infect through Vector-transmitted
fleas
, ticks, flies,
mosquitoes
diseases
for which cats and dogs
may
act as reservoirs for the
pathogen
Diseases
transmitted from animal feces when parasite eggs are inadvertently eaten by humans, such
as
Roundworms, toxoplasmosis,
coccidia
,
salmonella
Slide6Reverse Zoonoses
Reverse
zoonoses
are diseases that do not normally occur in dogs and cats but can be passed from infected people to their pets
e.g. tuberculosis, MRSA, flu
Slide7Infectious disease
Cats
Dogs
Fish
Birds
Rabbits
Reptiles§
Primates
Rodents§
Campylobacteriosis
+
+
n/a
n/a
n/a
+
+
+
Capnocytophaga canimorsus infection
+
+
n/a
n/a
n/a
n/a
n/a
n/a
Cat scratch disease (Bartonella henselae)
+
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Leptospirosis
+
n/a
n/a
n/a
n/a
n/a
+
+
Mycobacteriosis
n/a
n/a
+
+
n/a
n/a
n/a
n/a
Pasteurellosis
+
+
n/a
n/a
+
n/a
n/a
n/a
Plague
+
n/a
n/a
+
n/a
n/a
+
+
Psittacosis
n/a
n/a
n/a
+
n/a
n/a
n/a
n/a
Q fever (Coxiella burnetti)
+
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Rat bite fever (Spirrillum minus, Streptobacillus monliformis)
n/a
n/a
n/a
n/a
n/a
n/a
n/a
+
Salmonellosis
+
+
n/a
+
+
+
+
+
Tularemia
+
n/a
n/a
n/a
+
n/a
n/a
+
Yersiniosis
n/a
n/a
n/a
n/a
+
+
+
+
Slide8What is the public health role in dealing with zoonotic infections pets?
Local, state, and national public health officials seek to prevent
human disease, and that includes zoonotic diseases.
Ex: a child hospitalized because of
Brucella
canis
, a bacteria seen in dogs.
When the
child’s laboratory
result was communicated to public health officials:
I
nterviewed the family and determined that a puppy had recently been purchased from a pet store.
Slide9Is there any kind of surveillance system that monitors zoonotic diseases and infections in pets?
There is no organized surveillance system that counts the number or types of zoonotic diseases occurring in pets.
Sick animals are often treated by independent veterinary clinics.
Information regarding the diagnosis of a fairly minor
zoonoses
is unlikely to be reported to any kind of surveillance system.
When veterinarians see an increase in the number of animals that come into a clinic with a zoonotic disease, it’s likely that the information will be communicated through informal networks.
Slide10Zoonotic Disease Studies:
There
have been very few studies on whether animals in hospitals can transmit diseases.
In 2006
a study
of 100 dogs in hospitals in Ontario
found
that about 80 percent of those animals
carried
potentially harmful bacteria, including
Clostridium difficile
and
Salmonella
.
Slide11Pets in the Hospital
Are pets allowed?
Should
all pets be allowed into a patient's room?
Should
only pets with proven immunization records by allowed entry?
Should
size be a factor?
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.
Slide12Terms and Definitions
Service Animal Companion or Assistance Animal Animal-Assisted TherapyAnimal-Assisted Activities
Slide13Therapy Dog vs. Service Dog
Therapy Dog Vs. Service Dog
Slide14Service Animals
A service animal
is
not considered a pet
is
an animal trained to provide
assistance to a person because of a disability.
Title
III of the “Americans with Disabilities Act” (ADA)
of 1990
mandates that persons with disabilities accompanied by service animals be
allowed:
Slide15Service Animals
There are 2 questions staff can and should ask when an animal enters the healthcare setting- Is this animal required because of a disability?What work or task has this animal been trained to perform?
Slide16Service Animals
Excluding a service animal from
a “restricted area”.
General
infection-control measures
Hand
H
ygiene
Personal Protective Equipment
gloves
,
gowns
and
masks
Slide17Service Animals
Exclusion of such an animal must be based on the actual behavior of the particular animal, not on speculation about how the animal might behave
Slide18Animal Assisted Therapy-AAT
The concept The benefits of contact with animals Goal-directed intervention
Slide19Animal Assisted Therapy-AAT
Guidelines for establishing AAT programs are available for facilities considering this option.
Animals participating in either AAA or AAT sessions
good
health
up-to-date immunizations
and prophylactic medications (e.g., heartworm prevention
)
Slide20Personal 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.
Policy at Sanford Health
Slide21Emotional Support Animal
Emotional Support Animal is a pet that helps alleviate symptoms of a mental or emotional disability through companionship and affection. Unlike most types of assistance animals, such as service dogs, ESAs are not required to have any kind of specialized training or experience.
Slide22Emotional Support Animal
To legally make your pet an emotional support
animal
A
licensed therapist must write you an ESA letter recommending an emotional support animal for your condition
.
Slide23Identifying emotional support dogs for the public
Emotional
support dogs are often identified by wearing an emotional support dog vest or
tag
Some
businesses, such as airlines, prefer to see an identification card or vest that indicates that the dog is an emotional support dog.
Slide24Emotional Support Animals in the Hospital
Patient’s Pet
Visitor’s Pet
Slide25Observations
ADA service
animals behavior-jumping
, not obeying, using the entrance rugs as a restroom
F
emale had
a
kitten hidden in
her
coat, running
around in a patient room
Female patient
that is
reoccurring
, patient carries the dog in her arms.
The dog wears
a tutu and a ADA service vest that the When we asked what task does the animal provide, she replied it keeps me calm, she is my therapy dog.
Male patient requested to have a dog present during a procedure
Family brought a dog in a bag into a restricted area.
Slide26Allergies?
The American Academy of Allergy, Asthma, and Immunology estimates that dog or cat allergies occur in approximately 15% of the population.Minimizing contact with animal saliva, dander, and/or urine helps to mitigate allergic responses. Some facilities may not allow animal visitation for patients withunderlying asthmaknown allergies to cat or dog hairrespiratory allergies of unknown etiologyimmunosuppressive disorders
Slide27Risks to Patient & Visitors
Animal
Bites
Common
pathogens associated with animal
bites
Capnocytophaga
canimorsus
Pasteurella
spp
Staphylococcus
spp
Streptococcus
spp.
Rodents, exotic species, wild/domestic animals (i.e., wolf-dog hybrids), and wild animals whose behavior is unpredictable should be excluded from AAA or AAT programs.
Slide28Infection Control
The most important
infection control
measure to prevent potential disease
transmission
Strict
enforcement of hand-hygiene measures
Avoid
direct contact with animal urine or
feces
Appropriate clean-up
of
waste products
Slide29Policy, who enforces it?
Slide30Summary
Pet therapy and volunteer program guidance
Develop a written policy for animal-assisted activities and designate a liaison for such activities.
Allow only dogs to serve in animal-assisted activities.
Make sure all animal handlers have all required immunizations.
Require everyone who handles the animal to perform hand hygiene before and after contact.
Do not allow animals to come in contact with invasive devices.
Slide31Summary
Service animals
Make sure hospital policy is compliant with the Federal Americans for Disability Act, and include a statement that only dogs and miniature horses are recognized as service animals under federal law.
Notify the infection control team if an inpatient has a service animal and discuss institutional policies with the patient.
Slide32Summary
Personal pet visitation
Generally, do not allow pets to enter the facility.
Consider exceptions if the team determines a visit could benefit the patient and happen with limited risk. Even then, restrict visitation to only dogs.
Slide33