Nursing Diagnosis Accuracy in Nursing Education: Clinical Decision Support System Compared With Paper-Based Documentation-A Before and After Study.

Computer-based technologies have been widely used in nursing education, although the best educational modality to improve documentation and nursing diagnostic accuracy using electronic health records is still under investigation. It is important to address this gap and seek an effective way to address increased accuracy around nursing diagnoses identification. Nursing diagnoses are judgments that represent a synthesis of data collected by the nurse and used to guide interventions and to achieve desirable patients' outcomes. This current investigation is aimed at comparing the nursing diagnostic accuracy, satisfaction, and usability of a computerized system versus a traditional paper-based approach. A total of 66 nursing students solved three validated clinical scenarios using the NANDA-International terminologies traditional paper-based approach and then the computer-based Clinical Decision Support System. Study findings indicated a significantly higher nursing diagnostic accuracy ( P < .001) in solving cancer and stroke clinical scenarios, whereas there was no significant difference in acute myocardial infarction scenario. The use of the electronic system increased the number of correct diagnostic indicators ( P < .05); however, the level of students' satisfaction was similar. The usability scores highlighted the need to make the electronic documentation systems more user-friendly.

Impact of standardized nursing terminologies on patient and organizational outcomes: A systematic review and meta-analysis.

AIMS: To explore the impact of 12 American Nurses Association recognized standardized nursing terminologies (SNTs) on patient and organizational outcomes. BACKGROUND: Previous studies reported an effect of SNTs on outcomes, but no previous frameworks nor meta-analyses were found. DESIGN: Systematic review and meta-analyses. REVIEW METHODS: PubMed, Scopus, CINAHL, and OpenGrey databases were last consulted in July 2021. All abstracts and full texts were screened independently by two researchers. The review included primary quantitative studies that reported an association between recognized SNTs and outcomes. Two reviewers independently assessed the risk of bias and certainty of evidence for each meta-analyzed outcome using the "Grading of Recommendations, Assessment, Development and Evaluation" (GRADE) approach. RESULTS: Fifty-three reports were included. NANDA-NIC-NOC and Omaha System were the most frequently reported SNTs used in the studies. Risk of bias in randomized controlled trials and not-randomized controlled trials ranged from high to unclear, this risk was low in cross-sectional studies. The number of nursing diagnoses NANDA-I moderately correlated with the intensive care unit length of stay (r = 0.38; 95% CI = 0.31-0.44). Using the Omaha System nurse-led transitional care program showed a large increase in both knowledge (d = 1.21; 95% CI = 0.97-1.44) and self-efficacy (d = 1.23; 95% CI = 0.97-1.48), while a reduction on the readmission rate (OR = 0.46; 95% CI = 0.09-0.83). Nursing diagnoses were found to be useful predictors for organizational (length of stay) and patients' outcomes (mortality, quality of life). The GRADE indicated that the certainty of evidence was rated from very low to low. CONCLUSIONS: Studies using SNTs demonstrated significant improvement and prediction power in several patients' and organizational outcomes. Further high-quality research is required to increase the certainty of evidence of these relationships. CLINICAL RELEVANCE: SNTs should be considered by healthcare policymakers to improve nursing care and as essential reporting data about patient's nursing complexity to guide reimbursement criteria.

Distance education during COVID 19: an Italian survey on the university teachers' perspectives and their emotional conditions.

BACKGROUND: Following the COVID-19 pandemic, distance education (DE) replaced traditional "face-to-face" teaching and has become the main method of teaching. The aim of this study was to 1) evaluate the impact of DE by teachers in our department during the second semester of the 2019-20 academic year following the March-May 2020 Italian national lockdown and 2) evaluate the relationship between DE and the emotional well-being of teachers during the period of home confinement. METHODS: Ninety-seven university teachers (51.5% women; most represented age group 60-69 years range, 40.2%) responded to an anonymous online cross-sectional survey between July 15 - September 30, 2020, on the advantages and disadvantages of DE, developed by one online teacher focus group. The emotional conditions were assessed by a short version of the Beck Depression Inventory-II (BDI-II). The internal consistency reliability survey and the 10-item BDI-II were measured by Cronbach's alpha. A correlation analysis (r-Pearson) was conducted between the overall evaluation of the experience of DE and the variables included in the study. RESULTS: Teachers reported difficulties in technical aspects, and in psychological factors, as the discomfort of "speaking in the void" (64.7%). The absence of "face-to-face" eye contact with the students was complained by 81% of teachers. Significant impairments in sleep patterns and loss of energy were reported, with female teachers having greater difficulty concentrating than their male colleagues. A quarter of teachers showed depressive symptoms of varying severity. The most satisfied teachers were those most stimulated by DE (r = 0.752, p < 0.000), who showed a lower impact of depressive symptoms (r = - 0.289, p = 0.005). The teaching load in hours influenced the perception of disadvantages (r = 0.214, p = 0.035) and contributed to a lower appreciation of the challenges of DE. The more significant the manifestation of depressive symptoms during the lockdown was, the greater the subjective recovery of a good emotional condition once the domestic confinement was over (r = 0.344, p = 0.001), despite maintaining DE. CONCLUSIONS: Our study highlights the impact of technical, didactic, and psychological difficulties of DE, reported by our teachers. The appreciation of their new learning promoted by DE seemed related to better emotional well-being of university teachers accepting this "challenge" in their important role in the high-education system, influencing good learning and promoting students' professional success.

Graduate Student Outcomes Following Critical Care Simulation: An Italian Pilot Study.

ABSTRACT: High-fidelity simulation provides nursing students with the opportunity to learn and achieve competence in a safe context. The aim of the study was to assess learning outcomes following multiple exposures to high-fidelity simulation sessions. The sample consisted of 18 graduate students enrolled in a critical care nursing course. A four-hour high-fidelity simulation experience was conducted, with a four-hour retraining one month after. Group performance, self-efficacy, self-confidence, and satisfaction improved after multiple exposures to high-fidelity simulation. High-fidelity simulation is a valid adjunct to nursing education in the short term and may improve learning when offered at multiple time points.

The lived experiences of intensive care nursing students exposed to a new model of high-fidelity simulation training: a phenomenological study.

BACKGROUND: In postgraduate intensive care nursing courses, high-fidelity simulation is useful to prepare students to guarantee safe and quality care of critically ill patients. Surprisingly, this issue has not attracted sufficient attention in the literature, and it is not clear whether the linear application of the traditional high-fidelity simulation method based on prebriefing, the simulation session and debriefing, can serve as empirical reference in postgraduate students' education. The aim of this study was to investigate the lived experiences of postgraduate students receiving multiple exposures to an innovative high-fidelity simulation design based on Kolb's Experiential Learning Theory. METHODS: A phenomenological study was conducted at an Italian University involving a purposive sample of 15 nursing students attending the postgraduate intensive care course. Audio-recorded face-to-face in-depth interviews were held by a researcher in a dedicated room complemented with non-verbal communication outlined in the field notes. Thematic analysis was used to analyse the transcribed data. RESULTS: Three themes and ten categories were derived from the data analysis. The themes included pragmatic learning experience, the emotional path, and confidence. CONCLUSIONS: Multiple exposure to high-fidelity simulation was lived as a pragmatic learning experience enhancing the students' ability to apply theory into practice. This novel approach also contributed to the transition from negative to positive feelings and improved students' confidence about technical and non-technical skills when caring for a critically ill patient.

Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study.

AIM: The aim of this study was to investigate any possible relationship between sleep disorders, burnout and job performance in a shift-work population of nurses. BACKGROUND: Sleep disorders and burnout can affect the job performance of nurses in terms of efficiency, productivity, task execution speed and supervision, which can be compromised when work shifts are organized on a 24-hour schedule and when the shift itself is irregular. DESIGN: A cross-sectional observational study was conducted from August 2014 - January 2015 on a sample of 315 shift-work nurses across 39 wards in seven central Italian hospitals. METHODS: The Pittsburgh Sleep Quality Index was used to detect the presence of sleep disorders, the Copenhagen Burnout Inventory was used to detect the presence of any possible type of burnout and the Job Performance Scale was used to measure job performance. Data analysis was mainly based on a multivariate logistic regression to identify variables significantly associated with investigated outcomes. RESULTS: On shift-work nurses' sleep quality and burnout correlated positively. The female gender and personal burnout were significantly associated with impaired sleep quality, while working in the psychiatric setting, working a long cycle shift pattern and experiencing daytime dysfunction were significantly associated with burnout. A significant negative association between patient-related burnout and job performance was observed. CONCLUSION: Specific characteristics of shift-work nurses can directly affect sleep quality and burnout and indirectly job performance. This evidence offers healthcare administrators opportunities to intervene with measures to promote nurse's health, well-being and safety.

Ethical difficulties in healthcare: A comparison between physicians and nurses.

BACKGROUND:: Advances in biomedical sciences, technologies and care practices have resulted in an increase in ethical problems and a resulting growth of difficulties encountered by health workers in their professional activity. OBJECTIVE:: The main objective of this study was to analyse knowledge in the ethical field and experience with and the propensity for using ethics consultations by nurses and physicians. METHODS:: Between March and June 2014, a cross-sectional observational study was conducted on a sample of 351 nurses and 128 physicians in four central Italian hospitals. For data collection, a semi-structured questionnaire was used, consisting of 21 items divided into four sections exploring (1) demographic and occupational characteristics, (2) knowledge in the ethics field, (3) experience with ethical issues and (4) the propensity to use ethics consultation. ETHICAL CONSIDERATIONS:: Research ethics approval was obtained from the Italian Nurses Professional Board. RESULTS:: The results show that both nurses and physicians are faced with ethically sensitive situations. Nurses were found to have better judgement concerning their own knowledge than physicians, but more physicians were found to have a deeper level of specific training in ethics issues. The propensity to ask for ethics consultations to address ethical issues was found to be significantly associated with the degree to which ethical issues have deepened (and the level of experience acquired in this field). CONCLUSION:: The presence of a consulting service that can lead to shared choices may represent, together with basic and continuing education, a valid support for professional growth in the ethical field for both physicians and nurses.

Complex adaptive systems and their relevance for nursing: An evolutionary concept analysis.

This study aimed to analyse the concept of "complex adaptive systems." The construct is still nebulous in the literature, and a further explanation of the idea is needed to have a shared knowledge of it. A concept analysis was conducted utilizing Rodgers evolutionary method. The inclusive years of bibliographic search started from 2005 to 2015. The search was conducted at PubMed©, CINAHL© (EBSCO host©), Scopus©, Web of Science©, and Academic Search Premier©. Retrieved papers were critically analysed to explore the attributes, antecedents, and consequences of the concept. Moreover, surrogates, related terms, and a pattern recognition scheme were identified. The concept analysis showed that complex systems are adaptive and have the ability to process information. They can adapt to the environment and consequently evolve. Nursing is a complex adaptive system, and the nursing profession in practice exhibits complex adaptive system characteristics. Complexity science through complex adaptive systems provides new ways of seeing and understanding the mechanisms that underpin the nursing profession.

The role of shock index as a predictor of multiple-trauma patients' pathways.

OBJECTIVES: This research was conducted with the aim of investigating the accuracy of the shock index (SI) in distinguishing which multiple-trauma patients should be admitted to an intensive care unit (ICU) after treatment in an emergency room (ER). BACKGROUND: The SI is an easily obtained indicator, as it corresponds to an arithmetic ratio between the two parameters that are always measured during the first-aid treatment of multiple-trauma patients: heart rate (HR) and systolic blood pressure (SBP). There are many studies examining the SI in the multiple-trauma patients as a possible predictor of the destination unit. The SI is evaluated both at the trauma scene (pre-hospital SI-pH) and in the emergency room (SI-ER). DESIGN AND METHODS: An observational study with a retrospective approach was conducted on 158 adult patients with multiple trauma. RESULTS: The mean SI-pH and SI-ER values were higher in ICU patients than in-patients discharged or admitted to a normal ward, but the difference between these two patient groups was significant only for the SI-ER. Analysis of the receiver operating characteristic (ROC) curves confirmed that only the SI-ER is significant as a reliable indicator for ICU admission with a best cut-off of 1·05. However, a threshold value of 0·75 was still able to establish the correct type of destination for multiple-trauma patients, with a sensitivity of 57·3% and a specificity of 62·5%. CONCLUSIONS: This research showed that the SI-pH and SI-ER values are correlated, but only the SI-ER has shown statistical significance in terms of distinguishing the type of destination of multiple-trauma patient (ICU, ordinary ward or discharge) after initial treatment in the ER. RELEVANCE TO CLINICAL PRACTICE: The results of this study suggest the possibility of using SI in multiple-trauma patients as a triage indicator to assess the patients' care complexity and to guide the choice of proper clinical paths.

Clinical competence in nursing: A concept analysis.

INTRODUCTION: In nursing, clinical competence is a central issue for patient care and a clear understanding of the concept is critical for nursing education and nursing discipline. AIM: To perform an analysis of the concept of 'clinical competence' in nursing to better understand its meaning. METHOD: The Walker and Avant's concept analysis model was used. A systematic literature review on international databases (PubMed, CINAHL, Scopus, Cochrane, Ovid, Open Grey) from 1993 to 2015 was conducted. In the retrieved articles, the utilization of the concept of "clinical competence in nursing" was examined. RESULTS: According to Walker and Avant's method all the 8 steps were described on the basis of the findings of the literature review. Attributes, antecedents, consequences and empirical referents of the clinical competence in nursing have been identified and discussed and model, borderline, opposite cases were constructed. The relevance of the concept both for education and nursing professionalism have been also debated. CONCLUSION: This concept analysis has defined 'clinical competence in nursing' as 'a mix of skills, knowledge, attitudes and abilities that each nurse must possess to perform acceptably those duties directly related to patient care, in a specific clinical context and in given circumstances in order to promote, maintain and restore the health of patients'.

Psychometric properties of the Jefferson Scale of Empathy-Health Professional Student's version: An Italian validation study with nursing students.

This methodological study was conducted to test the psychometric properties of the Jefferson Scale of Empathy-Health Professional Student's version (JSE-HPS), in a convenience sample of 797 Italian nursing students and to describe their empathic engagement. Data were subjected to exploratory and confirmatory factor analysis, test-retest, correlation analysis, t-test, and analysis of variance method. Principal component factor extraction with Oblimin rotation on the first half of the sample was conducted. The analysis suggested a three-factor solution for 14 items: "compassionate care/emotional engagement," "perspective-taking," and "standing in the patient's shoes." Confirmatory factor analysis on the second half of the sample showed good fit indexes for the 14-item solution, indicated by the exploratory factor analysis, and the 20 item solution of the scale, with the exception of one item. Test-retest correlation was 0.50 (P < 0.001) for the overall scale. Results from group comparisons and correlations are also provided and discussed. The Italian version of the JSE-HPS is a psychometrically sound tool. The translated 20-item solution is also suitable to carry out cross-cultural comparisons.

[Relationship between nurse staffing and nursing outcomes: a narrative review of literature]. / Relazioni tra nurse staffing e nursing outcomes: revisione narrativa della letteratura.

INTRODUCTION: The measurement of nursing sensitive outcomes represents a fundamental element in "Health Management" in order to assess the suitability and quality of care given, particoulaly in hospitals for the acutely ill. OBJECTIVES: To highlight how some variables connected with nurse-staffing can determine the quality of processes and the care outcomes. METHODS: A narrative review of international literature has been carried out on investigating possible correlation between nurse-staffing characteristics and care outcomes regarding patients, taking into account primary and secondary sources, written either in English or Italian, without time limits. RESULTS: The bibliographical research strategies used, have brought about the restitution of no. 4244 articles were retrived, of these 56 were analyzed. Articles were categorized into 3 specific areas: 1) Which aspects determine the efficacy and quality of nursing care; 2) The direct effects of nursing care on care outcomes; 3) The indirect effects of nursing care on care outcomes. CONCLUSIONS: Results confirm the existence of a noticeable relationship between the main components of nurse-staffing and the direct and indirect outcomes on patients health. Longitudinal studies shound be carried out highlighting the results obtained up till now even more and assist in accurately measuring the importance of possible predictive variables on care outcomes correlated to nursing care.

[ICNP- International Classification of Nursing Practice: origin, structure and development]. / ICNP - Classificazione Internazionale per la pratica infermieristica: origini, strutturazione e sviluppo.

ICNP is a standardized nursing terminology included within acknowledged terminologies by WHO, it is a relevant aspect of ICN programs and strategies. This paper aims to describe structure and characteristics of ICNP terminology as well as to highlight how this tool can be useful both in practice and in terms of nursing professional development. This version looks like a pyramid with seven axes describing different areas of nursing and related interventions, enriched by two special axes related to pre-coordinated Diagnosis / Outcomes (DC) and Operations (IC) which facilitate daily use in practice. In order to clarify how this tool can be actually be used in daily nursing practice some examples are provided, clarifying how adopting the current version of ICNP terminology (2015 release) Diagnosis/Outcomes and Interventions can be built. The ICNP Italian Centre is committed to introduce it to Italian nurses as a tool for sharing and disseminating terminology in our Country, having as main final aim to achieve even in Italy, professional visibility objectives promoted in different ways by the International Council of Nurses.

[The nursing image in Italy: an analysis of the historic archive of national newspaper]. / Percezione degli ambienti di tirocinio e soddisfazione degli studenti infermieri nel primo tirocinio clinico: studio osservazionale.

PURPOSE: The main aim is to describe the nursing profession image as it appears in one of the main national newspaper. METHOD: A retrospective study has been conducted through the analysis of 2017 articles published between 1906 and 2005 on the national newspaper "La Stampa". RESULTS: 11 thematic clusters emerged from the analysis. The articles published with a higher frequency were those concerning "news and chronicle", with a relevant increase after the second half of the '80s, followed by "working conditions" with a maximum spread during the '90s. Instead the articles that rarely appeared on the newspaper were those concerning, "aesthetic" and "contests". More than half of the articles concerning "staff shortage" reported consequent disruptions. Almost all the articles concerning "malpractice" highlighted the inadequate care delivered from nurses and they have been published with constant trend starting from the a '50s. The articles concerning "staff shortage", "innovation", and "education", showed their maximum spread starting from the '90s. CONCLUSIONS: The analysis of the articles published in the newspaper "La Stampa" allowed to read the nursing profession story as troubled, made of professional achievements obtained from struggles, claims and countless educational and organizational changes though many of the analyzed articles did not contributed to show, and consequently to appreciate, the nursing profession for its real content and contributions to the population's health.

Telehealth care and remote monitoring strategies in heart failure patients: A systematic review and meta-analysis.

BACKGROUND: Heart failure (HF) is a cardiac clinical syndrome that involves complex pathological aetiologies. It represents a growing public health issue and affects a significant number of people worldwide. OBJECTIVES: To synthesize evidence related to the impact of telemonitoring strategies on mortality and hospital readmissions of heart failure patients. METHODS: A systematic literature review was conducted using PubMed, Scopus, CINAHL, IEEE Xplore Digital Library, Engineering Source, and INSPEC. To be included, studies had to be in English or Italian and involve heart failure patients of any NYHA class, receiving care through any telecare, remote monitoring, telemonitoring, or telehealth programmes. Articles had to contain data on both mortality and number of patients who underwent rehospitalizations during follow-ups. To explore the effectiveness of telemonitoring strategies in reducing both one-year all-cause mortality and one-year rehospitalizations, studies were synthesized through meta-analyses, while those excluded from meta-analyses were summarized narratively. RESULTS: Sixty-one studies were included in the review. Narrative synthesis of data suggests a trend towards a reduction in deaths among monitored patients, but the number of rehospitalized patients was higher in this group. Meta-analysis of studies reporting one-year all-cause mortality outlined the protective power of care models based on telemonitoring in reducing one-year all-cause mortality. Meta-analysis of studies reporting the number of rehospitalized patients in one-year outlined that telemonitoring is effective in reducing the number of rehospitalized patients when compared with usual care strategies. CONCLUSION: Evidence from this review confirms the benefits of telemonitoring in reducing mortality and rehospitalizations of HF patients. Further research is needed to reduce the heterogeneity of the studies.

Applying the Participatory Slow Design Approach to a mHealth Application for Family Caregivers in Pediatric Ear, Nose, and Throat Surgery.

Pediatric ear, nose, and throat (ENT) surgery is very common, and its outcomes may improve with family education. In this regard, mobile health (mHealth) applications (apps), which are on the rise due to digital transformation, can be beneficial in healthcare. This study outlines the user-centered design and development of a mHealth app (version 5.15.0) to support family caregivers during the perioperative process of pediatric ENT surgery. Conducted over two years in an Italian maternal and child health hospital (January 2020-May 2022), the study employed a participatory design method based on the Information System Research (ISR) framework and guided by the principles of Slow Medicine. Utilizing the Relevance, Rigor, and Design cycles of the ISR framework, the mHealth app's content, functionalities, and technical features were defined and developed. A committee of fifteen experts guided the process with input from 25 family caregivers and 24 healthcare providers enrolled in the study. The mHealth app content was structured around five crucial educational moments characterizing the ENT perioperative period, providing evidence-based information on surgical procedures, strategies for preparing children for hospitalization and surgery, pain management, and post-discharge care. The mHealth app featured a function that sends customized notifications to guide caregivers at specific perioperative stages. The development of mHealth apps by implementing a rigorous, participatory, and Slow design process can foster accessible and family-centered information and care in the field of maternal and child health and beyond.

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources.

Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.

[Progressive Patient Care Model and its application into hospital organization: a narrative review]. / Progressive Patient Care e organizzazione ospedaliera per intensità di cure: revisione narrativa della letteratura.

Aim of this article is to review the literature about the Progressive Patient Care Model, in particular its conceptual and practical characteristics, its implementation and effects on the current health care organization. Was conducted by an integrative-narrative literature review. The Progressive Patient Care is a model which aims at group patients according to their complexity in order to place patients in the most appropriate care setting. The original model consists on five care levels: intensive care, intermediate care, self-care, long term care, home care.In Italy the above mentioned model can be considered as a contextualization of Progressive Patient Care in the light of similarities both in terms of model purposes and care levels classification. The organization for intensive care levels is an opportunity for Italian healthcare facilities to reach continuity of care. This model emphazises care processes looking to patients' needs rather than a division according to criteria of specialties.

Measuring nursing care workload in non-intensive cardiac surgery: an observational study.

BACKGROUND: An understanding of the time nurses spend assessing and meeting patients' needs is key to improve nursing outcomes and support organizational well-being. AIMS AND OBJECTIVES: The study was designed to determine whether the use of an assessment scale with some clinical parameters indicative of hemodynamic, neurological, respiratory and mobility functions could be able to estimate nursing care workload in non-intensive cardiac surgery patients. METHODS: A correlational descriptive study was designed. Two types of inpatients were included in the study: those waiting for cardiac surgery and those who had already undergone cardiac surgery. Using specific indicators, patient's clinical status was classified in 10 levels of complexity and nursing care interventions were divided into three categories: clinical activities, educational activities and organizational activities. For each of this categories the correlation coefficient between the nursing time and the level of patient's complexity was measured. RESULTS: Per hour of hospitalization, nurses spent an average of 11 minutes and 49 seconds providing care to each patient. A good correlation coefficient between the amount of the nursing time spent for clinical activities and the level of patient's complexity was found. Educational activities were minimal compared with the clinical and organizational activities, but they were mostly conducted during the preoperative phase. CONCLUSIONS: The assessment scale tested in this study, including some information about the patient's clinical status, allowed to estimate clinical nursing workload in non-intensive cardiac surgery patients.

The Implementation of the WHO's Surgical Safety Checklist by Italian Operating Teams: A Descriptive Study.

AIM: The study aimed at reporting the extent to which nurses in operating teams comply with the WHO's surgical safety checklist at the national level. METHOD: A total of 621 nurses who attended the conferences held by the Association of Italian Nurses in Operating Teams (AICO) in 2019 were selected as the sample group for this descriptive study. They filled a paper-based questionnaire of items, which were according to WHO's recommendations for surgical safety. Descriptive analyses were used to illustrate participants' characteristics and responses to the questionnaire. The chi-square test was used to outline the relation between participants' socio-cultural features and the information on the extent to which participants implemented the surgical safety checklist. RESULTS: According to the data collected, a majority of the participants (95.2%) claimed to comply with the checklist in perioperative procedures. Moreover, most participants (63.2%) revealed that they revise the checklist according to specific circumstances affecting their workflow and/or operational team. Additionally, almost a third of participants (31.9%) stated that they undertake an oral completion of the steps in the checklist to ensure its effective implementation. CONCLUSION: In this study, it emerged that the implementation of measures ensuring safety standards is largely inconsistent with the guidelines provided by WHO. Notably, major discrepancies occur when it comes to team members' coordination, the revision of the checklist according to specific circumstances, the oral completion of the checklist's steps during the workflow, and the active contribution of all team members in the implementation of the surgical safety checklist.