TABLE 1.

Procedures for Robotic Pet Therapy in the Intensive Care Unit

Category	Details
Selection	Patients are determined based on factors that reflect interest in, positive response to, or expectations of therapeutic benefits; factors include: Pain, agitation, delirium, immobility, sleep disruption, or other disorder that might respond to pet therapy; history of having a pet; current symptoms/observations (eg, aggressive behaviors); positive response to visiting therapy pets and/or stuffed animals Benefits and risks are discussed with interdisciplinary team and the patient or caregiver/decision maker If the intensive care unit team and patient/decision maker approve, patient is offered a choice of companion animals
Assessment	Nurse determines when interaction with the robotic pet should be encouraged Nurse observes the patient for therapeutic benefits According to the patient’s care plan, interaction with the companion animal could be encouraged before providing care or in other situations to prevent responsive behaviors
Implementation	Nurse retrieves companion animal; activates/turns on companion animal; models how to interact with it (eg, pet the animal’s back); encourage patient interaction with companion animal; and provides brief verbal cues and/or demonstrations (eg, “What a beautiful cat! May I pet him? (demonstrate petting it). Listen to him purr! Will you pet him?”)
Monitoring response	Nurse observes the patient for desirable responses, such as brighter affect or being more alert or engaged, calmer; changes in responsive behaviors; or any undesirable responses (eg, increased anxiety, tearfulness, or agitation in response to the pet). If an undesirable responses occurs, nurse discontinue use, documents response, and consults with intensive care unit team
Documentation	Nurse documents use of robotic pet and patient response
Storage and cleaning	Companion pet is stored in patient's room Nurse practices hand hygiene before touching the pet, such as washing their hands, using hand sanitizer; or wearing gloves if indicated If indicated, the patient will be encouraged to practice hand hygiene before interacting with pet Nurse will wipe down the fur of the pet using cleaning procedures at least weekly as needed and if the pet appears soiled or comes into contact with a soiled surface Cleaning procedures: wipe down fur of pet with hydrogen peroxide wipes; let fur dry as much as possible; brush the fur; clean the brush; and replace batteries as needed
Safety	Potential safety concerns are discussed during the selection phase; including patient behaviors that raises safety concerns Initial interactions are observed for safe interactions If the intensive care unit team has concerns about the pet being available throughout the day, the pet will be stored out of sight and out of reach when not in use