Objective Bambino Gesù Childrens’ Hospital has developed a “programme for the continuous improvement of quality of care”, aimed at achieving Joint Commission International Accreditation. This programme is based on five principles; two can be summarised as follows: (1) quality care is safe, effective, patient-centered, timely and even; (2) to act towards an organisational awareness. The objective of this experience is to promote shared and common safety awareness. The goal is to adopt safe measures based on facts, supported by nursing/anaesthesiological procedures, aimed at improving the safety level of the paediatric patient.

Materials and Methods In 2005–6, in cooperation with the healthcare department, the nursing service promoted a specific training programme for the nursing staff in the surgery compartment. In cooperation with scrub nurses, it has developed a nursing documentation by setting the following procedures: behavioural rules; gauzes, needles, blades and surgical tools check; patient preparation; proper patient identification; management of averted adverse events.

Results 70% of the surgery compartment staff has been involved. Nursing documentation is regularly filled in and all the procedures are applied. In 2007, an increase of 450% (from 2 to 11) of averted adverse events procedures has been reported.

Conclusion Due to paediatric patient vulnerability, risk management in the surgery compartment is a fundamental organisational priority. This experience has turned out to be positive so far, showing a cultural change that emerges from the increased number of reports, but it has to be strengthened by criticalities in monitoring and discussion.