The study was approved by the St. Cloud Hospital Institutional
Review Board prior to implementation. Parental permission was
obtained through an informed consent process with adherence to
the Health Insurance Portability and Accountability Act (HIPAA).
Written child assent was also obtained in children seven years of
age and older before study enrollment. Prior to study implementation, the dog therapist underwent rigorous screening and
training. The dog was fully vaccinated, bathed regularly, screened
for enteric pathogens, and treated for internal and external parasites on a monthly basis.47 The dog and owner met hospital policy
for participating in animal-assisted therapy, including documentation of the dog’s current vaccinations, controllability, and
temperament.