To ensure the safety of surgical procedures, a local health authority in Turin (Piedmont Region, Italy) adopted an operating room chart as a standard procedure that contextualizes the Ministerial surgical checklist and fills the surgical safety requirements of the regional health authority. Three characteristics make the adopted operating room chart especially useful and innovative: (i) it is completed by surgical nurses; (ii) it is completed during the surgical procedure itself; (iii) the greater number and type of checks required in addition to those specified in the ministerial checklist.