Restriction is used proactively to protect other hospitalized animals from exposure to infectious diseases by temporarily isolating a patient until its infection status has been clarified. Cage Restriction is initiated to contain a potential pathogen that has not yet been identified. The objective is to limit contact with the pathogen, by limiting the number of individuals in contact with the patient, limiting patient movement in the clinic, and carefully restricting the use of equipment and supplies to an individual cage.
Restriction Unit Basics and Communication
- Access to the Restriction area requires orientation by an HWC supervisor, or EAMS clinician, house officer, or staff.
- Traffic in the Restriction area shall be restricted to that necessary for optimal care.
- Restriction status requires mandatory communication from the attending clinician to EAMS Technical staff, Attendant staff, and an HWC supervisor.
- The senior clinician is responsible for informing all personnel, which may have contact with an animal, about the nature of the infectious disease(s) to be encountered.
- Patients diagnosed with or suspect of having a zoonotic disease require further special management, including contact logs and mandatory communications.
- When the presence of a pathogen has been identified or is strongly suspected by a clinician, cage restriction is not a substitute for movement of the animal to isolation.
Restriction Area Setup and Management
- The patient shall remain in it’s original cage and restriction setup around it.
- A space on the floor will be marked off by red tape in front of the animals’ cage to provide a visible barrier and mini-isolation. Traffic to the ward will also be limited.
- Non restricted patients shall be moved to another ward and monitored closely for similar clinical signs.
- To the extent possible, diagnostic and therapeutic procedures shall be performed in the restricted area or ward where the patient is housed. When procedures outside the ward are necessary, these procedures shall be cleared and scheduled with the responsible staff members to minimize contact with other patients, and to ensure complete and immediate decontamination following the procedure.
- Hands should be thoroughly washed immediately after handling the animal and after glove removal.
- Patients on restriction should be treated after all non-restricted patients; including surgical procedures and diagnostics.
- Items brought into the restricted area for care of the patient shall be disposed of following use, or shall be thoroughly disinfected and / or autoclaved prior to returning to general use. If more than one patient is housed in this area each patient will have their own supplies and any equipment needed to be used on both patients will be disinfected and / or autoclaved between uses.
- Waste leaving the restricted area shall be placed in a biohazard bag, it will be double bagged, labeled, and transported directly for incineration.
- Dirty linen is placed in a red biodegradable bag and transported to the dirty laundry bin for removal.
- If the patient's cage requires frequent cleaning, additional cages should be assigned for exclusive use by the patient.
- When the patient is discharged or moved to another area of the hospital, the supervisor of that clinical area shall be notified so that the cage and cart (if used) can be properly cleaned and disinfected.
- Animal technicians are to use an appropriate disinfectant and cleaning equipment that is assigned to this patient when cleaning the cage. To reduce contamination, the cleaning equipment must not be used to clean other areas.
- Patients may be moved to another housing area within the hospital with approval from the clinical area supervisor and use of appropriate contamination protocols.
- Shoe covers, gloves, blue gown, hair covers if hair hangs below the collar, face shield and mask (when applicable).
Visitors (Non-CVM persons)
- Are permitted visitation at the discretion of the attending clinician.
- Visitor must be oriented by the attending clinician or house officer, including proper ppe use, safety precautions, health risks, risk to other animals, etc.
- Visitor must be accompanied by a service member at all times, no exceptions
- Visitor is not permitted to re-enter the main hospital after visiting the restriction area. They must exit through the closest exterior door. Attending clinician or house officer shall instruct the visitor on how to properly decontaminate themselves to avoid transmission to animals or people.