The Evolution of Professional Nursing Culture in Italy: Metaphors and Paradoxes

Integrating Key Nursing Measures into a Comprehensive Healthcare Performance Management System: A Tuscan Experience

This paper addresses the evaluation of nursing quality and safety beyond nursing tasks in specific healthcare settings and sets it in a context that conveys the sense of complexity and multifaceted nature of the contribution that nursing makes to the whole system. The paper describes research conducted in Tuscany during 2019 involving regional managers and heads of nursing departments. This research has led to the development of an integrated evaluation framework through focus groups and consensus process with the latter, which includes Performance Organizational climate data, Patient-Reported Experience Measures (PREMs), and Patient-Reported Outcome Measures (PROMs). This integrated framework aims at both making sense of extant measures as key performance indicators shared among different professionals while recognizing the important role of nursing care by adding specific measures and can be seen as a tool that boosts the sense of “teamness” in healthcare.

Professional values and nursing self-efficacy in the Italian context. Correlational descriptive study

INTRODUCTION

Nurses' professional values (NPVs) and self-efficacy (SE) are two fundamental elements in nursing care that influence its professional identity, competences, resulting in changing the behaviour of professionals and their response to the patient's health needs. The various studies produced so far have not investigated a possible relationship between these two areas. Therefore, the objective of the following study is to identify and deepen the relationship between NPV and SE, in order to improve the knowledge of these issues.

MATERIALS AND METHODS

An observational, correlational and multicentric study has been carried out through a questionnaire based survey. The sampling was conventional. The data collection took place through Nursing Professional Values Scale, version 3 (NPVS-3), which investigates professional values; and Nursing Professional Self-Efficacy Scale (NPSES), which investigates self-efficacy and a socio-demographic questionnaire.

RESULTS

The total sample was 532 nurses and 65.6% was female, with a median age of 42 years and a median of 15 working years. Positive statistically significant correlations between the various domains of the NPVS-3 and NPSES scales were found. These relationships also emerged in the analyses between geographical areas. Overall, the relationships between self-efficacy and values were similar in all the analyses.

DISCUSSION

As the professional values of nurses increase in their response to the patient's health needs, self-efficacy perceived by them increases and vice versa, significantly effecting the clinic and care outcomes of the patients and improving nursing outcomes. The stratification of the sample by geographical area regarding the relationship between age, years of work and professional values indicated that these variables strongly influence the NPV and SE of nurses. Therefore, in some contexts, more support in maintaining a stable value structure may be needed; moreover, it is necessary to incentivise nurses with more effective interventions, as an example and a basis of motivation for future generations.

Missed nursing education: Findings from a qualitative study

AIM

To understand what nursing education activities are missed in the daily life of nursing programmes, by also identifying antecedents and consequences of missed educational activities.

DESIGN

A descriptive qualitative study according to the COnsolidated criteria for REporting Qualitative research guidelines.

METHODS

A purposeful sample of 32 participants with different roles (nurse educators, clinical nurses, students, and administrative personnel) and working in different settings (university, administrative, healthcare service levels) were involved in three focus groups and nine face-to-face interviews from 2019-2020. Both focus groups and face-to-face interviews were audio-recorded and transcribed verbatim. The data that emerged were thematically categorized by induction.

FINDINGS

Missed Nursing Education reflects those educational activities needed in the process of nursing education that are missed or delayed. Direct educational activities missed include clinical rotations, classroom teaching and students' overall learning experience. Indirect missed educational activities concern continuing professional development of nursing faculty members, nursing discipline development and the organizational processes of the nursing programme. As antecedents, missed nursing education is triggered by factors at the organizational, nursing faculty, and student levels. Consequences have been reported for students, nursing faculty, clinical nurses, and patients.

CONCLUSIONS

Missed Nursing Education can be considered a multifaceted, multicausal phenomenon, with multitargeted consequences.

IMPACT

To date, missed nursing care has only been investigated in clinical practice. However, care also permeates the relationship between nurse educators and students. Thus, at the point of 'educational care' delivery, aspects can also be omitted. Educational activities at risk of being missed or delayed affect the quality of nursing education and, in the short- and in the long- terms, also the quality of patient care. Some Missed Nursing Education antecedents can be modified by appropriate strategies that should be addressed by policy, health care and academic institutions.

The process of developing the professional identity of the Nurse Case Care Manager: A Grounded Theory Study

Background and purpose.

The Nurse Case Care Manager (NCCM) is still an emerging figure in the Italian healthcare context. The knowledge of the dynamics inherent in the process of identity development shows how they can be decisive for the affirmation and recognition of this new role. The aim of the study was therefore to analyse the psychosocial processes of developing the identity of the NCCM for a better understanding of the variables that influence its development.

Methods.

A qualitative study with Grounded Theory method was conducted. From December 2018 to January 2019, 20 semi-structured interviews were given to the NCCM of the Emilia Romagna Region and the Lombardy Region. The analysis of the material has led to a structuring of the theoretical model on the processes of development of professional identity.

Results.

Two main conditions have been identified: that of the “LOST CASE CARE MANAGER” and that of the “CASE CARE MANAGER DIRECTOR”. This process requires time, perseverance, courage and personal skills. Two transversal background concepts have been identified, namely “available space” and “relationship with the family”.

Conclusion.

The process of developing the NCCM’s professional identity encounters several obstacles. Among these, in particular a lack of recognition by operators highlighting the need for greater organizational clarity in the context in which the professional operates, in order to facilitate the inclusion of the NCCM clarifying skills and effectiveness profile. (www.actabiomedica.it)

Evaluation of Effectiveness of Digital Technologies During Anatomy Learning in Nursing School

The disciplines of biosciences included in the curricula of a nursing degree represent a daunting but crucial type of knowledge that a well-prepared nurse should acquire. Given the importance and the objective difficulties of these courses, nursing students experience anxiety, especially for the anatomy course. This anxiety and the related rate of exam failures lead professors to analyze their teaching approach, by diversifying the lecturing methods. The aim of our study was to test the use of a virtual dissection table (DT) during the anatomy lectures of a nursing course, evaluating the anxiety level before the exam and evaluating the exam score. The feedback of the evaluated student population was positive overall. The integration of the DT in anatomy lectures improved the learning performance and mostly enhanced the self-confidence of the first year nursing students.

International Nursing: GSD International Nursing Academy: An Italian Case of Practical Disruption Highlighting the Worth of Nursing Within Health Care Organizations

It is strategic to describe and disseminate available examples of how nurses find the modus operandi to being fully integrated in their organizations, including the nurse role in determining improvements in clinical practice, management, education, and/or research. This article describes the recent experiences of Gruppo San Donato International Nursing Academy. The disruptive case shared here underlines the worth of nursing within health care organizations. The Gruppo San Donato International Nursing Academy aims to be a striking model to innovate health care delivery through the optimal utilization of the nursing workforce, uniting the areas of nursing management, nursing education, and research into a unique organizational platform.

Policy proposals for a new welfare: the development of the family and community nurse in Italy as the key to promote social capital and social innovation

AIM

To discuss the development of the family and community health nurse (FCHN) in Italy by focusing on three levels: organisational, political and theoretical.

BACKGROUND

The role of the FCHN in Italy is not yet embedded evenly across the Italian National Health System (INHS) and does not have formal recognition, either contractually or organisationally. Although complementary post-basic training has been available for over a decade, the FCHN's role in Italy currently exists only in pilot form. In some regions, the FCHN has operated for longer, thanks to which a clearer understanding of the functions and responsibilities required by the FCHN has emerged. Proposals for professional and social policies have emerged, as the FCHN's role may be an answer to health problems and a contributor to the construction of social capital, capable of influencing both individual and collective well-being.

METHODS

A mixed method investigation via a parallel concurrent design to identify the organisational models for the FCHN was conducted across Italy. In this paper, two profiles are discussed - family and community health nursing and FCHN - but each with its different connotations. The former refers to the practice of nursing and the latter to the nursing practitioners working with family and the community.

CONCLUSION

We describe the expected future outcomes for FCHNs as elements of social innovation for the development of a new welfare system.

Indian nurses in Italy: a qualitative study of their professional and social integration

AIMS AND OBJECTIVES

To investigate the lived subjective experiences of immigrant Indian nurses in Italy and specifically their professional and social integration.

BACKGROUND

To study the worldwide, nursing flux is a health priority in the globalised world. The growth in migration trends among nurses, not only from Philippines or India, has proliferated in recent years. The research on nurses' mobility for Southern European countries is underexplored, and in Italy, the out-migration flows of Indian nurses were never analysed.

DESIGN

Qualitative methodological approach.

METHODS

Semi-structured interviews (n = 20) were completed with Indian clinical nurses working in Italy for more than one year mainly in private organisations. A purposive sampling technique was used for recruitment. The data were then content-analysed using an inductive method.

RESULTS

The findings were categorised into four themes: (1) aspects of professional integration and working experience, (2) intra- and interprofessional relationships and perceptions of the IPASVI Regulatory Nursing Board, (3) initial nursing education and continuous professional development and (4) perceptions of social integration.

CONCLUSION

The results show that for Indian nurses in Italy emigration is important to gain opportunities to expand economic and social privileges as well as escape from historical assumptions of stigma associated with nursing work, especially for women. However, these conclusions have to be seen in wider socio-cultural complexities that are at the basis of transnational fluxes (Prescott & Nichter ).

RELEVANCE TO CLINICAL PRACTICE

The research offers an insight into the complicated reasons for Indian nurses out-migration to Italy. Without comprehending the interwoven textures of the political and social relations that are continually constructed and re-constructed among different nations, it is difficult to understand nurses out-migration and consequently have a better and safer collaborative teamwork in the host countries.