Animals may be present in healthcare facilities for multiple reasons. Although specific laws regarding the use of service animals in public facilities were established in the United States in 1990, the widespread presence of animals in hospitals, including service animals to assist in patient therapy and research, has resulted in the increased presence of animals in acute care hospitals and ambulatory medical settings. The role of animals in the transmission of zoonotic pathogens and cross-transmission of human pathogens in these settings remains poorly studied. Until more definitive information is available, priority should be placed on patient and healthcare provider safety, and the use of standard infection prevention and control measures to prevent animal-to-human transmission in healthcare settings. This paper aims to provide general guidance to the medical community regarding the management of animals in healthcare (AHC). The manuscript has four major goals:
Review and interpret the medical literature regarding risks and evidence for animal-to-human transmission of pathogens in the healthcare setting, along with the potential benefits of animal-assisted activities in healthcare.
Review hospital policies related to AHC, as submitted by members of the SHEA Guidelines Committee.
Summarize a survey that assessed institutional AHC policies.
Offer specific guidance to minimize risks associated with the presence of AHC settings.
Recommendations for the safe oversight and management of AHC should comply with legal requirements and minimize the risk of transmission of pathogens from animals to humans when animals are permitted in the healthcare setting. Although little published literature exists on this topic, we provide guidance on the management of AHC in four categories: animal-assisted activities, service animals, research animals, and personal pet visitation. Institutions considering these programs should have policies that include well-organized communication and education directed at healthcare personnel (HCP), patients, and visitors. Appropriately designed studies are needed to better define the risks and benefits of allowing animals in the healthcare setting for specific purposes.