Rabbit Remedy: the impact of having a pet rabbit on a paediatric inpatient unit

Key contacts

Tami Benzaken, Rebekah Short, Sarah Crew, Joseph Machta, Kerry Robinson, Caroline Fertleman.

Introduction

An increasing evidence base has shown contact with animals to have positive health impacts on children, both physically and emotionally1-2. In particular, there is increasing research into the use of Animal Assisted Therapy as a therapeutic adjunct in a variety of healthcare settings3.

In October 2017 we introduced a very important new member to the general paediatrics team at the Whittington Hospital, Holly the rabbit. To our knowledge we are the only hospital inpatient department in London with a pet on site.

SMART objectives

  1. Encourage interaction between patients and Holly to help improve their experience in hospital (in both in the inpatient and outpatient setting).
  2. Facilitate staff interaction with Holly and her participation in staff meetings, to help improve inter-team working and boost morale.
  3. Review Holly’s impact on both patients, carers and staff through free text questionnaires and independent feedback.

Progress made: What have you learned from doing this?

Holly has been a wonderful addition to our team and our recent survey results are a testament to that. She lives in the play area of Ifor ward and is often visited by both our inpatients, outpatients, their families and staff.

Out of the total of 37 patients and parents who responded to the survey, the entire cohort responded positively regarding their experience with Holly and her impact on their stay. When exploring the feelings she evoked in patients, happiness (n=15) and calm (n=17) were reported in 86% of respondents. One 10-year-old inpatient reported that, ‘meeting the rabbit made me happy, when I go to hospital I’m always sad’.

A parent of one of our patients seen in the out-patient department describes their first experience of meeting Holly, ‘We were soothed and calmed by sitting outside and running our hands through her soft and fluffy fur as she sat contently on our laps. In a time of advanced medicine and complicated technology, I was moved by such a simple yet insightful way of caring for children (and their parents!).’

As part of our project we aimed to survey staff’s attitudes towards the introduction of a pet into a hospital environment, a novel concept for most of our staff. Out of the 19 staff surveyed, 15 cited a positive therapeutic response on patients. Other reported benefits included her calming effect on patients, her being a great distraction, boosting staff morale and improving team working. One member of staff summarises her experience of Holly, ‘Holly is the best thing that has happened to paediatrics in years. She has a positive effect on enhancing working relationships between nursing and medical staff’.

A few issues raised by staff included concern regarding infection control and caring for Holly. The introduction of Holly to Ifor ward has been approved by our infection control and microbiology team. At times looking after Holly has been challenging, especially during busy periods on the ward when there has been a lack of ownership over her care. We have have addressed these issues by discussing her care as part of our daily safety huddle to ensure she has been fed, watered and cleaned on a daily basis.

Finally, a theme that consistently emerged from both patient and staff questionnaire responses, was the effect Holly has had in improving experience for mental health patients admitted to the ward. Twenty percent of patients who responded identified a mental health complaint as their reason for admission (including depression, self harm and intentional drug overdose). They all cited Holly’s positive impact on their stay. One patient wrote that Holly made her stay, ‘more relaxed and happier to be in hospital’. Another staff member recounts one experience she had with Holly and a patient, ‘One time in particular Holly helped a mental health patient suffering from depression, low self esteem and lack of self-worth. She often said to the nursing staff, ‘why would anyone love me?’. Her mood changed remarkably when in the rabbit’s company… it was almost as if her depression left the room once the rabbit was there’.

What’s your take home message?

Introducing Holly to the ward has been shown to have beneficial effects on both patients and staff, as demonstrated by both our qualitative questionnaire as well as independent feedback. She has made patients’ stay more enjoyable, improved staff morale (especially important in a time of increasing stress levels reported amongst NHS staff4), and in particular has positively impacted the stay of patients admitted with mental health complaints.

We feel this project’s benefits could be replicated in other paediatric units to improve the care we provide and impact positively on patient experience of the healthcare system.

Resources?

  1. Vagnoli, L., Caprilli, S., Vernucci, C., Zagni, S., Mugnai, F., & Messeri, A. Can presence of a dog reduce pain and distress in children during venipuncture?. Pain Management Nursing, 16(2), 89-95.
  2. Lima, M., Silva, K., Amaral, I., Magalhães, A., & Sousa, L. 2014. Can you help when it hurts? Dogs as potential pain relief stimuli for children with profound intellectual and multiple disabilities. Pain Medicine, 15(11), 1983- 1986.
  3. Calcaterra et al. 2015. Post-operative benefits of animal-assisted therapy in pediatric surgery: a randomised study. PLoS One. 2015 Jun 3;10(6):e0125813.
  4. Rimmer. 2018. Staff stress levels reflect rising pressure on NHS, says NHS leaders. BMJ2018; 36

 

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