Leading the Way to Zero
Julie Spallino, CAN, CRCST, AGTS
Kindred Hospital Las Vegas – Flamingo
Las Vegas, NV
Julie Spallino, special procedures technician at Kindred Hospital Las Vegas - Flamingo in Las Vegas, Nevada, has had a major impact on her facility’s infection prevention and control practices as they relate to endoscopy, invasive procedures, and sterilization.
Spallino took responsibility for infection prevention activities for Kindred’s endoscopy and sterilization programs in 2001. She single-handedly set up the endoscopy program, including the protocols and procedural complication tracking. Since that time, there has not been a single infection tracked back to any of her procedures.
Spallino changed pre-cleaning of the scopes to include a hands-free flushing pump that automatically cleans the channels for 90 seconds, replacing manual flushing methods. Spallino also implemented the use of a miniature chemistry kit that checks the cleanliness of flexible endoscopes to ensure no blood remains in the channels.
She said to her knowledge, Kindred is the only hospital in the Las Vegas Valley using this type of system. “It’s another quality check that the scope is ready for processing.”
The endoscopy program she set up also includes bedside pre-procedure checks of the physician’s order, patient history, consent, and progress notes as to reasons for the procedure.
Procedures under her guidance are no longer performed at the bedside. Instead, patients are taken to a procedure room with better environmental controls. “When they come to the procedures room, they come on a clean gurney, and sites are prepped with Chlorhexidine before we begin.”
A member of APIC for nine years, and certified by IAHCSMM, Spallino has impressed upon staff and physicians the importance of good hand hygiene. “When we put in a central vascular access device – we use the total bundle associated with central line-associated bloodstream infection prevention, including the full body drape. When the patients come in for the procedure, I prep the area, and I give them a clean gown and top sheet so everything is clean.”
The results of the changes to Kindred’s protocols in this area have been remarkable. “We’ve had zero infections,” she said.
Spallino, who was named Kindred’s Employee of the Year for 2009, and served as 2009 president of the Nevada chapter of SGNA (Society of Gastroenterology Nurses and Associates), was consulted by the Centers for Disease Control and Prevention during its 2008 investigation of a hepatitis outbreak at a Nevada endoscopy center.