The 2026 meeting of the Association of periOperative Registered Nurse (AORN) in New Orleans showcased an innovative approach that combined standardized intraoperative nursing practices, interdisciplinary teamwork, and vigilant data tracking in improving surgical outcomes, particularly in colorectal surgeries. This revolutionary strategy was encapsulated in a poster presentation titled, ’49 – Reducing Surgical Infections: Evidence-Based Care in Colorectal Surgery.’ The insightful poster was the brainchild of Julia Martin, MSN, APRN, AGCNS-BC, CCRN, and Amanda F. Freedman, MSN, RNC-OB, APRN, ACNS-BC, clinical nurse specialists affiliated with WakeMed Health & Hospitals in North Carolina.
In colorectal surgery, surgical site infections (SSIs) have long been a source of concern, leading to poorer patient outcomes, extended lengths of hospital stay, and escalating healthcare costs. In light of an observed increase in deep-tissue SSIs, Martin and her colleagues pioneered a multifaceted response. Their approach hinged on the concept of an inclusive intraoperative care bundle designed to unify practices and mitigate variability.
The authors stressed on the importance of the methodical application of evidence-backed practices throughout the surgical process to address the critical concern of SSIs in colorectal surgeries. The successful realization of this initiative was a testament to the synergy of a cross-disciplinary team that pooled in experts from various disciplines – perioperative nurses, Enhanced Recovery After Surgery coordinator, operating room supervisor, infectious disease nurse, quality and patient safety specialist, pharmacist, and colorectal surgeons.
The team meticulously reviewed the existing literature and current clinical practices, identifying and addressing lacunae in infection prevention across all surgical phases. A spotlight was placed on intraoperative care, where tweaks and improvements could fetch substantial dividends. Consensus was reached on integrating several evidence-based interventions into the usual care procedure.
The proposed care bundle made alterations to physician order sets for antibiotics, stipulated protocols for skin preparation, and adopted tools and approaches such as fascial wound protectors and abdominal irrigation techniques. It also lent prominence to refined closure practices that incorporated gown and glove changes, dedicated closure trays, and antibiotic-coated sutures. The onus of incorporating these changes fell upon the perioperative nurses. They not only enforced updates on antibiotic administration but also conduced education sessions for the surgical team and spearheaded the integration of the bundle into the electronic medical record for seamless documentation and compliance tracking.
The advent of an adherence dashboard to assess whether protocols were being followed added another layer of accountability, offering comparative data across different campuses, operating rooms, and physicians to guide future quality enhancement efforts. This shift towards a data-informed, interdisciplinary stance is increasingly resonating across medical communities battling infections in high-risk surgical patient populations. It underscores the undeniable contribution of perioperative nurses in infection containment, not just at the bedside, but also at systemic intersections requiring change.