Here is the most commonly asked member question in recent weeks. Don’t forget to check out our member-only web resource for more useful Q+As!

 

Q: What do I need to consider when a patient attends the podiatry clinic with an assistance animal and how do I know if the animal is an assistance animal rather than a pet?

Answer:

The legal definition of an assistance animal according to the Disability Discrimination At 1992 is:

A dog or other animal that is:

  • Is accredited under a State or Territory law to assist a person with a disability to alleviate
    the effects of disability; or
  • Is accredited by an animal training organisation prescribed in the regulations; or
  • Is trained to assist a person with a disability to alleviate the effect of the disability and meets standards of hygiene and behaviour that are appropriate for an animal in a public place.

The therapeutic benefits of animals in healthcare are now broadly recognised. Assistance (service) animals are used by people with disabilities including but not being limited to vision impairment, hearing impairment, episodic medical crises such as epilepsy and diabetes and psychiatric disorders such as post-traumatic stress disorders or panic attacks.

There is an important distinction between an assistance animal that has been trained to assist a person with a disability, versus an animal used by a person without a diagnosed disability for comfort or emotional support. However, care must be taken when exploring the need for an assistance animal with a patient to avoid risks of discrimination.

The issue of allowing assistance animals to enter restricted access areas in health service organisations such as the treatment room is challenging. Consequently, it is essential to identify any patients that may require an assistance animal for support prior to the patient’s appointment so that planning can occur and the needs of all parties are met.

It is not unlawful to request that the assistance animal remains under the control of the person with the disability or the control of another person on their behalf. This is particularly relevant if a person will be unable to have direct control of the animal during treatment. However, please note that one of the subsections of the Disability Discrimination Act 1992 states that the animal may be under the control of the person, even if it is not under the person’s direct physical control.

However, the law does provide that discrimination may be considered reasonable if it is necessary to protect public health and therefore the Australasian College for Infection Prevention and Control (2016) Animal Visits in Healthcare Position Statement and the NSW Health GL2012_007 Animal Visits in Public and Private Health Services in NSW allows health service organisations to restrict assistance animals from having access to certain areas within the health service organisation to minimise the risks for transmission of zoonotic diseases.

 

 

Areas in a podiatry practice where it is not appropriate for an animal to enter include:

  • Treatment room
  • Reprocessing areas
  • Sterile storage areas
  • Kitchen and food preparation areas.

Patients that have assistance animals must be identified prior to their first appointment to enable effective planning for their treatment to occur.

The issues that must be discussed with the patient prior to their appointment include but may not be limited to:

  • Discussing the areas of the facility where the assistance animal may or may not enter so that the risks of transmission of infectious agents can be reduced
  • The requirement to take into account the needs of other patients and staff, particularly where a phobia or an allergy to an animal may be an issue
  • The need for the animal to be washed the day before the appointment
  • Identifying who will care for the animal whilst the patient undergoes their treatment
  • Discussing where the animal will be cared for whilst the patient undergoes their treatment
  • Ensuring appropriate toileting arrangements can be provided for the animal; and
  • Responsibilities for the provision of food and water for the animal.

Consideration must be given to other patients that may be scheduled for an appointment on the same day as the patient, as some people may have allergies, phobias or cultural objections to certain animals. Therefore, the practice manager must ensure that other patients are informed that an assistance animal will be present on the day of their appointment.

Patients should be asked if they have any concerns about the presence of an assistance animal. Where a concern is raised that cannot be reasonably mitigated, for example, an allergy to the animal, consideration should be given to offering to reschedule the appointment for the patient that has raised the concern.

Staff must also be informed that an assistance animal will be attending the practice for the same reasons. Any staff that have an issue such as allergy or phobia may need to be rostered to work elsewhere during the time the animal is in the facility.

All staff and patients must be informed that the assistance animal is not a pet and should not be approached or petted.

Unless contraindicated, the patient should be placed as the last appointment for the day. This limits the number of other patients that may need to be contacted to ensure that they have no allergies, phobias or cultural objections to the assistance animal.

Placing the patient last on the appointment list also ensures that any fur, hair or other material left by the assistance animal will be removed prior to the next working day.

The patient and the carer and any staff that have an interaction with the assistance animal must undertake hand hygiene immediately prior to and after touching the animal or its cage, harness and/or associated paraphernalia.

 

 

Assistance animals must always be leashed or confined to a cage during their presence at the practice. Any instances where the assistance animal shows signs of:

  • Aggression;
  • Uncontrolled behaviour, for example approaching other patients, staff or visitors;
  • Illness; or
  • Inability to control body excretions.

Then the patient and/or their carer responsible for the assistance animal will be requested to leave.

Should an injury occur to staff, patients, visitors or the assistance animal, routine incident management and reporting documentation should occur.

Consideration should be given to arranging the patient, assistance animal and the relative/carer that will be responsible for caring for the assistance animal during the patient’s treatment to be taken directly to the treatment room; instead of waiting in the general waiting room with other patients and carers.

Once the patient is escorted to the treatment room, if practicable the carer and the assistance animal should leave the practice and return when advised the treatment has been completed and the patient is ready to leave.

Generally, it should not be necessary for the assistance animal to enter the treatment room, however under exceptional circumstances, for example, if the patient has post-traumatic stress disorder or suffers panic attacks; allowing the assistance animal into the treatment room may be considered for the patient’s immediate benefit.

The rooms, areas, surfaces, fixtures and/or fittings that have been used during the treatment of the patient and their assistance animal, need to be cleaned after use.

Environmental Services contractors or staff need to be informed that an animal has been in the practice and to ensure that any trace of hair, fur or other material is removed during cleaning.

You can download the APodA’s new Assistance Animal Policy from the updated Infection Control Policy set (full set out soon) which includes a template/form to use for each patient who attends the clinic with their assistance animal.

Have a burning question? Email us at info@podiatry.org.au

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