Implementation of a Perioperative Normothermia Bundle to Improve Temperature Maintenance in Adult Colorectal and Hysterectomy Surgical Patients: A Quality Improvement Project

Authors

• Jessica L. Salisbury, University of Texas Health Science Center at HoustonFollow

Author Biographical Info

Jessica Salisbury, BSN, RN, CNOR, an operating room nurse  and a Doctor of Nursing Practice–Family Nurse Practitioner student at UTHealth Houston Cizik School of Nursing. Professional interests include perioperative nursing, evidence based practice, patient safety, and quality improvement. This DNP project focuses on implementing a standardized warming bundle to improve perioperative normothermia among adult patients undergoing colorectal and hysterectomy procedures.

Date of Doctor of Nursing Practice Project Completion

Summer 7-26-2026

Faculty Advisor

Rebecca Tsusaki, DNP

Abstract

Purpose

This quality improvement project evaluated the effectiveness of an evidence based perioperative normothermia bundle in improving maintenance of normothermia among adult colorectal and hysterectomy surgical patients at a community hospital. The project aimed to reduce perioperative hypothermia through standardized warming interventions while improving compliance with evidence based practice.

Background

Preventable perioperative hypothermia increases postoperative complications, prompting implementation of an evidence based warming bundle to maintain intraoperative temperatures 36 Celsius or greater.

Methodology

Using the Iowa Model, an interdisciplinary team implemented an evidence based perioperative normothermia bundle incorporating multimodal warming, temperature monitoring, and staff education. Compliance and temperature outcomes were evaluated before and after implementation using descriptive statistics. Limitations included a single site design and limited specialty patient population.

Results

Perioperative normothermia improved from 3.7% to 70% following implementation. Patients maintained normothermia throughout surgery and recovery. Sustained bundle compliance increased through ongoing education and leadership engagement, with no surgical site infections identified during implementation.

Implications

Standardizing evidence based warming interventions improved maintenance of perioperative normothermia and demonstrated the effectiveness of interdisciplinary collaboration. The bundle was successfully integrated into routine practice despite the limitation of a single site implementation. Future efforts should sustain compliance, expand to additional surgical populations, and evaluate long term clinical outcomes.

Keywords

perioperative normothermia, quality improvement, surgical warming, perioperative nursing, patient safety

Recommended Citation

Jessica L. Salisbury, "Implementation of a Perioperative Normothermia Bundle to Improve Temperature Maintenance in Adult Colorectal and Hysterectomy Surgical Patients: A Quality Improvement Project" (2026). Doctor of Nursing Practice Final Project Abstract. 201.
https://digitalcommons.library.tmc.edu/dnp_abstract/201