Donna Armellino

• Northwell Health

Objective: With many preventable causes of surgical site infections (SSIs) identified, the effect of operating room (OR) size on SSI rates has not been assessed. This study investigated the effect of OR size on incidence of SSIs for orthopaedic procedures. Background: SSIs remain a common complication within the perioperative realm. Responsible...

Background Overutilization of antibiotics remains an issue in the inpatient setting. What is more, many protocols geared toward curbing improper antibiotic use rely heavily on resource- and personnel-intensive interventions. Thus, the potential for using the EMR to facilitate antibiotic stewardship remains largely unexplored. Methods We implemente...

Background: This non-randomized comparative observational study evaluated the performance of a standard manual-chemical disinfection process with an automated process employing focused multivector ultraviolet (FMUV) light technology during operating room (OR) terminal cleaning. Methods: An Association of periOperative Registered Nurses terminal...

Importance To help prevent surgical site infections (SSIs), recommendations by a national organization led to implementation of a mandatory operating room policy in a large multicenter health care organization of required use of disposable perioperative jackets. Objective To assess whether the use of perioperative disposable jackets is associated...

Background Preventing the transmission of multidrug-resistant organisms requires strict adherence to isolation precautions. Candida auris (CA), an emerging multidrug-resistant fungal pathogen, can cause widespread and persistent contamination of environmental surfaces within healthcare facilities and lead to outbreaks. While direct observation (DO)...

A focused multivector ultraviolet (FMUV) light system was used in a parallel process with manual chemical disinfection during operating room (OR) turnovers to assess the impact on cleaning time. The average time to disinfect an OR using only chemical wipes and mops was 19.0 minutes (n = 68); for the FMUV process, the average time was 18.8 minutes (...

There are many sources of contamination in the perioperative environment. Patient experience can be negatively affected by the presence of environmental contamination, especially if it is the cause of a surgical site infection. Perioperative and environmental services staff members and leaders are tasked with ensuring a clean and safe environment f...

Background: The aim of this study was to evaluate the performance of a focused multivector ultraviolet (FMUV) system employing shadowless delivery with a 90-second disinfection cycle for patient care equipment inside and outside the operating room (OR) suite without manual-chemical disinfection. Methods: A 5-point multisided sampling protocol was u...

Surgical site infections are unintended consequences of surgery that can cause harm to patients and place financial burdens on health care organizations. Extrinsic factors in the OR—including health care providers’ behavior and practices that modify air movement, the physical environment, equipment, or surgical instruments—can increase microbial co...

Background: The utilization of live biological agents as vectors for gene delivery systems is becoming more prevalent in clinical research. Often, these agents are handled in patient care environments, such as hospitals and ambulatory sites. While expanding the use of these agents from nonclinical to clinical research, Northwell Health first establ...

A pilot initiative to assess the use of remote video auditing in monitoring compliance with manual-cleaning protocols for endoscopic retrograde cholangiopancreatography (ERCP) endoscopes was performed. Compliance with manual-cleaning steps following the initiation of feedback was measured. A video feed of the ERCP reprocessing room was provided to...

Achieving high vaccination rates of health care personnel (HCP) is critical in preventing influenza transmission from HCP to patients and from patients to HCP; however, acceptance rates remain low. In 2013, New York State adopted the flu mask regulation, requiring unvaccinated HCP to wear a mask when in areas where patients are present. The purpose...

Background Exposure to blood and bodily fluids represents a significant occupational risk for nurses. The most effective means of preventing bloodborne pathogen transmission is through adherence to Standard Precautions (SP). Despite published guidelines on infection control and negative health consequences of noncompliance, significant issues remai...

Importance Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by the surgical team remains elusive. Objective We evaluated the impact of remote video auditing with real-time provider feedback on checklist compliance during sign-in, time-out a...

Achieving high vaccination rates of health care personnel (HCP) is critical in preventing influenza transmission from HCP to patients and from patients to HCP; however, acceptance rates remain low. In 2013, New York State adopted the flu mask regulation, requiring unvaccinated HCP to wear a mask when in areas where patients are present. The purpose...

Chlorhexidine gluconate (CHG) decreases hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) that can cause colonization and infection. A standard approach is the bathing of all patients with CHG to prevent MRSA transmission. To decrease CHG utilization, this study assessed selective daily administration of CHG bathing to intensive...

Using remote video auditing (RVA) and real-time feedback, we replicated health care workers hand hygiene in a second intensive care unit. During the first 4 weeks using RVA without feedback, the compliance rate was 30.42%. The rate during the 64-week postfeedback period (initial 16 and 48 weeks maintenance) with RVA and feedback exceeded 80% on ave...

TO THE EDITOR: Clinical infections with livestock-associated Staphylococcus aureus sequence type (ST) 398 have been reported in Europe, Canada, and the People's Republic of China (1), as well as the Caribbean (2,3), and Colombia (4). Most reports describe infection with methicillin-resistant S. aureus; relatively few describe infection with methici...

Hand hygiene is a key measure in preventing infections. We evaluated healthcare worker (HCW) hand hygiene with the use of remote video auditing with and without feedback. The study was conducted in an 17-bed intensive care unit from June 2008 through June 2010. We placed cameras with views of every sink and hand sanitizer dispenser to record hand h...

Surgical site infection (SSI) is recognized as a focus area by the Centers for Medicare and Medicaid Services, the Joint Commission, the Institute for Healthcare Improvement, and the Institute of Medicine. An estimated 47% to 84% of SSIs present after discharge from the hospital or ambulatory care facility and, as a result, go undetected by standar...

Background: On April 24, 2009, students from a New York City (NYC) school presented with influenza-like illness (ILI) to a hospital emergency department (ED) of Schneider Children's Hospital at Long Island Jewish Medical Center (LIJMC). These were the initial cases of novel influenza A (H1N1) infection in NYC. Despite public health risk messaging L...

The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; th...

The North Shore-Long Island Jewish Health System Laboratories serve 15 hospitals and affiliated regional physician practices in the New York City metropolitan area, with virus testing performed at a central reference laboratory. The influenza A pandemic (H1N1) 2009 outbreak began in this area on April 24, 2009, and within weeks respiratory virus te...

Objective: The aims of this study were to determine the MRSA colonization status of patients admitted to 9 separate intensive care units (ICUs) in 5 different hospitals in the same geographic area. We also determined a variety of fingerprints on all of the isolates. Design: This prospective study was conducted at 5 hospitals and included 9 ICU’s (...

J.S. Cervia, B. Farber, D. Armellino, J. Klocke, R.-L. Bayer, M. McAlister, I. Stanchfield, F.P. Canonica, G.A. Ortolano. Point-of-use water filtration reduces healthcare-associated infections in bone marrow transplant recipients. Transpl Infect Dis 2010: 12: 238–241. All rights reserved Abstract: Outbreaks of infection with gram-negative bacteria...

Objective: To increase clinician involvement in improving and standardizing clinical practices, and implementing best practices, through the design and implementation of quality management web-based technology. Methods: The Institute for Healthcare Improvement (IHI) 100,000 Lives Campaign to prevent central line infections was prioritized as a qu...

We report a nosocomial epidemic of Hepatitis A involving two pediatric patients and four Pediatric Intensive Care Unit (PICU) nurses and the potential role of Hepatitis A vaccine (HAVac) in limiting the outbreak. The index case (i.c.) was a three year old male from the Dominican Republic admitted for repair of an AV canal in April 1996. Post-operat...

Objective: To determine the incidence of infection in human immunodeficiency virus (HIV)-infected patients during periods of neutropenia and non-neutropenia. To compare the infection rates in patients with HIV disease to those in a group hospitalized with neutropenia and hematologic malignancy. Design: Prospective observational study conducted b...

Leu 13 is a 16 kDa human lymphocyte surface Ag and monoclonal anti-Leu 13 induces T cell aggregation and alters T cell proliferation. In previous studies using anti-Leu 13, Leu 13 Ag has been detected on endothelial cells (EC) of arteries, capillaries, and veins in human tissue sections. In contrast, in this study using the same antibody, Leu 13 Ag...

Human plasma heparin cofactor II (HCII) inhibits thrombin by rapidly forming a stable, equimolar complex in the presence of heparin or dermatan sulfate. Cultured human hepatoma-derived cells (PLC/PRF-5) secreted (approximately equal to 200 ng/ml in 3 days) a protein of MW - 72 kD that was immunoisolated and immunoblotted with anti-HCII, co-migrated...