Building Trust, Inclusion, and Resilience in the Operating Room: A Conversation With Colleen Becker, PhD, MSN, RN, CCRN-K

Infection prevention in perioperative settings depends on far more than policies and checklists. According to Colleen Becker, PhD, MSN, RN, CCRN-K, senior director of perioperative education for AORN, strong infection prevention practices are rooted in trust, communication, and psychological safety within the operating room team.

“Infection prevention is at the top of all perioperative team members’ minds at all times,” Becker said. “None more important than that perioperative registered nurse who assumes responsibility for the care of that patient while he or she is in their care.”

Becker emphasized that trust must begin with leadership. When leaders demonstrate competence, transparency, and openness, staff feel safer raising concerns about infection risks or workflow challenges. “It’s important to have connections with team members so they feel comfortable bringing forward issues, concerns, and ideas for improvement without fear of being judged or experiencing retribution,” she explained. “That’s how your area gets even stronger.”

This sense of psychological safety, Becker noted, supports both infection prevention adherence and staff resilience. When concerns are addressed collectively, the burden does not fall on a single individual. “That’s why it’s a team. There’s nothing we do independently or by ourselves,” she said.

Becker also highlighted the unique role of perioperative nurses as patient advocates. While all nurses share a commitment to patient care, perioperative nurses often care for patients when they are most vulnerable and unable to speak for themselves. “The perioperative nurse is that patient’s advocate during the perioperative period,” Becker said. “We are there to be their voice when they can’t be.”

Empowering staff to speak up about infection risks requires consistent, open communication rather than sporadic interventions. Becker stressed the importance of sharing data, setting goals collaboratively, and keeping the focus on patient safety. “If you keep it focused on the patient and the outcomes we’ve developed as a team, supported by the data and facts, bringing things forward isn’t as scary,” she said.

Inclusion also plays a critical role in safe perioperative care. Becker described how diverse teams improve infection prevention by bringing lived experience and cultural knowledge that may not be found in textbooks. “If our team resembles the community and patients we serve, they bring insight that helps us see the patient as a whole,” she said. “That inclusivity makes patients feel safer and team members feel valued.”

Burnout remains a persistent challenge, particularly when staffing shortages and stress contribute to shortcuts in infection prevention. Becker encouraged leaders to create safe spaces for conversation and to assess staff well-being proactively. “When issues are out in the open, they are less scary,” she said. “Now they have a place, and the leader can help connect staff with resources so their focus can return to the patient.”

Looking ahead, Becker underscored the importance of continuous, accessible education to sustain both competence and confidence. She described AORN’s education programs as evidence based, inclusive, and adaptable to different learning styles. “Once staff have that knowledge, they have the confidence that their competence is based on evidence,” she said. “Infection prevention is woven through everything we do with education.”

Ultimately, Becker framed perioperative infection prevention as a people-first endeavor. “At the end of the day, there are patients having surgery on the most important day of their lives,” she said. “Our role is to support the staff who provide that care, so it is safe, compassionate, and excellent every time.”