AORN26: Teach-Back Method in PACU Discharge Education Reduces Surgical Site Infections

Surgical site infections (SSIs) are often associated with intraoperative factors, but what happens after a patient leaves the operating room can be just as critical. At the 2026 (Association of periOperative Registered Nurses) AORN Global Surgical Conference & Expo (AORN26), a team from Kaiser Permanente Fremont Medical Center presented an initiative that reframes SSI prevention through a simple but powerful tool: patient understanding.

Led by Sienna Tango, MSN, RN, BS Psychology, alongside Timothy Yu, BSN, RN; Harmeet Brar, MSN, MHA, RN; Rebecca Christman, BS, RN; and Trang Pham, MSN, RN, NI-BC, CPAN, NPD-BC, the poster presentation was titled, “SSI Prevention Using the Teach-Back Method During Discharge Teaching” focused on implementing the teach-back method during discharge education in the post-anesthesia care unit (PACU).

Identifying the Gap Beyond the OR

The initiative began after the facility observed “a significant increased number of SSI in the first 3 quarters of year 2024.” This prompted a deeper evaluation of perioperative processes, led by the Unit Professional Governance Council and supported by the Quality and Safety Department.

Through surveillance, the team identified a critical issue: “There was a gap in the delivery of discharge education in the (PACU), which could have affected the SSI occurrences.”

Importantly, many infections were occurring weeks after surgery, suggesting that patient and caregiver understanding of wound care may have been insufficient.

“Many of these infections occurred weeks after surgery… there might have been a lack of understanding of surgical wound care from [a] patient’s [and] caregiver’s standpoint,” the team noted.

For infection prevention professionals, this finding reinforces a key reality. Infection risk does not end at discharge, and patient education is a vital extension of perioperative care.

Read Infection Control Today for more AORN26 coverage.

Designing a Structured, Patient-Centered Approach

To address the gap, the team implemented the teach-back method, an evidence-based communication strategy that asks patients to repeat information in their own words to confirm understanding.

Preparation included observing existing discharge workflows, identifying opportunities to embed teach-back, and enhancing educational scripting. A video-based training tool was developed for staff, along with an audit tool to measure accuracy and consistency.

The intervention introduced “a standardized teaching script and three guided open-ended questions” as part of the PACU discharge process. This ensured that education was both consistent and interactive.

Rather than simply delivering instructions, nurses actively validated comprehension, allowing them to identify misunderstandings in real time and reinforce key points.

Strong Adherence and Measurable Outcomes

The results of the initiative were striking.

A total of 50 patients received the intervention, with “49 out of 50 (98%)” successfully meeting all measures of the teach-back process. The single patient who struggled to recall key information received additional support, including reinforced written materials.

More importantly, the initiative coincided with a meaningful reduction in infections. “0 superficial General Surgery SSIs [were] noted in Nov 2024… and every month thereafter until May 2025,” the team reported.

While multiple factors can influence SSI rates, the findings suggest that improving patient comprehension during discharge played a significant role.

Improving Confidence and Engagement

Beyond clinical outcomes, the intervention had a clear impact on patient experience. “Patients and caregivers expressed feeling more confident and well-equipped to care for their surgical sites after discharge,” the team noted.

Nurses also observed increased engagement during education sessions, indicating that the teach-back method helped transform discharge from a passive process into an active dialogue.

For perioperative teams, this shift is critical. Engaged patients are more likely to follow instructions, recognize early signs of infection, and seek timely care.

Implications for Infection Prevention

The success of this initiative highlights the importance of integrating communication strategies into infection prevention efforts.

The team outlined several key next steps, including standardizing the teach-back method across surgical service lines, enhancing patient education materials, and expanding staff training. They also emphasized the need to improve access to information, for example, by using QR codes to link patients to wound care resources.

Additionally, ongoing monitoring will help ensure that improvements in discharge education translate into sustained adherence at home.

As demonstrated at AORN26, improving communication is not just a patient satisfaction initiative. It is a measurable, evidence-based strategy for reducing infections and improving outcomes.