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  Background & Aim: The central venous pressure measurement is a common and important care provided by nurses in intensive units. The measurement should be according to the pre-defined standards. The purpose of this study was to evaluate the effect of using a checklist in measuring central venous pressure by nurses .

  Methods & Materials: This was a nonequivalent group design on 70 nurses working in ICUs. T he quality of measurement of central venous pressure by recruited nurses were measured via direct observation in the control (n=35) and experiment (n=35) groups. The intervention group nurses were recommended to use a performance checklist in each measurement of central venous pressure for one month. At the end of the intervention, the performances of both groups were evaluated through observation. Collected data were analyzed using the Chi-squared test, paired and independent test in the SPSS-17 . 

  Results: At b aseline, the mean scores in both groups were not statistically significant (P=0.7) The mean performance score of the control group at the beginning and one month later were 7.64±2.33 and 7.65±2.28, respectively (P=0.6). In the experiment group, the mean performance score was 7.85±2.29 before the intervention and 9.28±3.16 after the intervention (P=0.001). T he difference between the scores before and after the intervention were significant (P=0.001) in the intervention group .

  Conclusion: Using checklist by critical care nurses could enhance their performances in measurement of central venous pressure. This method can be used as an accessible, inexpensive, and simple method to improve quality of nursing practices .

  

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Background & Aim: The success of the surgical safety checklist in reducing surgical mortality and morbidity largely depends on the degree of compliance with the checklist and correct implementation of its components by the staff. The aim of this review is to determine the challenges of effective implementation of the surgical safety checklist and to provide solutions for its more effective implementation.
Methods & Materials: In the present systematic review, all the relevant qualitative papers published from 2010 to October 2018, were examined. A  literature search was done in databases SID, Iran Medex, Iran doc, Magiran, Science Direct, Medline/PubMed, Web of Science, Scopus, ProQuest, Google Scholar, Cochran Library with keywords patient safety, surgical procedures, operative, checklist, World Health Organization, implementation science, qualitative research and their equivalent terms in Persian. Inclusion criteria were articles written in English or Persian, qualitative studies and relevant to the objectives of the study. Exclusion criteria were review articles, posters, presentations, letters to editor and quantitative studies.
Results: The findings of the review of 14 qualitative studies showed that the most important challenges in effective implementation of the surgical safety checklist were unpredictable priorities, lack of collaboration and coordination of the surgical team members, mismatch between the checklist and hospital setting, lack of patient’s cooperation and lack of a planned approach towards implementing the checklist. The strategies to improve the implementation of the surgical safety checklist included checklist localization, improving the collaboration and coordination of all the team members, training and practicing, patient participation, and active organizational leadership.
Conclusion: The introduction of the surgical safety checklist to the health care setting is a permanent challenge and requires ongoing evaluations and its integration into the workflow in the hospital, active and effective leadership, explanation of why and how to use it by managers and receiving support from the organization. Continuous education, performance evaluation and the participation of all the surgical team members in the implementation of the checklist are key factors for effective implementation of the surgical safety checklist.