Development of an Animal-Assisted Activity/Therapy Dog Checklist for Long-Term Care Facilities

Animal-assisted activities (AAA) and therapy standards of practice have been published to protect the well-being of animals, animal handlers, and the special populations of patients that benefit from this mode of treatment. Inconsistencies among practice standards with concerns surrounding the topics of dog welfare, human well-being, and zoonotic transmission have been reported. The purpose of this qualitative research study was to review published AAA and therapy standards with older adult populations for best practices, conduct focus group sessions with caregivers from long-term care facilities that allow therapy dog visitation, and synthesize findings into an AAA checklist to be used by long-term care facility decision-makers when interviewing or bringing in therapy dog teams. Comparative analyses utilizing a systematic and sequential approach was used to analyze the data from the focus group sessions. Due to the COVID-19 pandemic, only two focus group sessions at one long-term care facility were conducted resulting in a total of 15 caregivers. Four themes emerged from the data: promotes positive mood, essential resident screenings, caregiver roles, and memory aides. Relevant themes and AAA and therapy standards and guidelines were then combined in the development of the AAA/Therapy Dog Checklist. Administrators may find having a user-friendly AAA/therapy dog checklist a useful tool that can be used when interviewing therapy dog teams to ensure future dog therapy experiences will be positive and safe. The safety and well-being of residents in long-term care facilities and animals are essential to promote positive health outcomes for both populations.

Should we use a patient’s port as the preferred intravenous route rather than inserting an additional venous access?

Early in 2021, the Infusion Nursing Society has released the latest version of the Infusion Therapy Standards of Practice. In the last two decades, these Standards have been representing one of the most important evidence-based documents available in the world of venous access. Nevertheless, we were quite concerned reading a recommendation included in chapter 26 (Vascular Access Device Planning: practice recommendation I, C): “Use a patient’s port, unless contraindicated (e.g. existing complication) as the preferred IV route in preference to insertion of an additional VAD.” Such recommendation is offered not on the basis of evidence, but as experts’ opinion (“Committee Consensus”). This Editorial deals with the opinion of GAVeCeLT (The Italian Study Group for Long Term Central Venous Access) that strongly discourage the use of ports for intravenous treatment different from chemotherapy (or from the therapy that specifically required that long term, infrequent access). The rationale for this choice is based on the consideration that the patient’s port—if used in a non-specialty ward—would be at high risk of complications, some of them potentially leading to the loss of the device, and that such complications might be particularly difficult to manage in this setting. The continuous or frequent use of a port transforms it into an external device, thus cancelling the main advantage of a totally subcutaneous location, while adding a significant disadvantage (need for repeated percutaneous punctures and risk of extravasation/infiltration due to improper insertion or dislocation of the non-coring needle). One exception is the possible use of port for radio-diagnostic purposes (as long as the port is power injectable). This strategy may be associated with advantages for the patient, and imaging quality improvement, but requires the adoption of specific protocols for prevention of infective and mechanical complications.

Chronic endometritis: prevention and treatment options

This article is a review of publications devoted to the treatment of chronic endometritis and methods of its prevention. Methods of empiric therapy, standards of antibacterial therapy, and modern guidelines for treatment under development (colonystimulating factor, immunotherapy, amplipulse therapy) are presented. Key words: infertility, miscarriage, colony-stimulating factor, chronic endometritis, cytokine therapy