Episode Transcript
[00:00:00] Foreign.
[00:00:34] Hello everyone, My name is Fiona Timmons. I am a professor of Nursing, a Dean and head of school at the School of Nursing, Midwifery and Health Systems, University College Dublin in Ireland. Today I'd like to share some thoughts with you on the advancement of the nursing profession, with a particular emphasis on this advancement. In Italy we have had huge advancements in the nursing profession over the last hundred years or so and in particular the last two or three decades in many countries.
[00:01:07] Globally we have an all graduate workforce, many nurses operate within a framework of advanced degrees and there's increasing and advancing numbers of advanced and specialist nurses in practice.
[00:01:21] Overall, the impact and effect of this is greater autonomy among the nursing profession and advancement of the science of nursing.
[00:01:29] Ultimately, the profile of the profession of nursing has been raised and advanced internationally. It is worth saying that countries both in Europe and remainder of the world have advanced in various different stages in relation to to this development.
[00:01:48] There are of course ongoing challenges such as workforce issues, a concern with the day to day operations and how workforce issues impact on this and this can take away resources from advancing both the specialists and advanced practice, but also the scholarly aspect of professional development within the whole idea of raising the profile of nursing. And as nursing advances through advanced degrees, in particular PhD dissemination of research and practice innovations become very, very important.
[00:02:21] This global publication is important for nursing because it publicizes and raises the profile of important nursing research and activity, it shares important activity and findings with the relevant community and it permits an open dialogue and debate about activities.
[00:02:42] It further enables the research to have impact which can be measured by citation or alt metrics and it serves to raise the profile of the organization and the profession itself.
[00:02:53] And of course it is an important factor in the university rankings and promotion systems which is important for nurses who are scholars in the university system.
[00:03:04] So in terms of understanding a little about how Italy is is featuring in the publication and dissemination route in published nursing journals we can use databases such as Scopus and Clarivate as important resources for determining the impact and extent of research activity of individuals and groups. So having a look at Scopus in February 2025, we can see specifically how much publications that are arising from Italy in the field of nursing generally. And we can also look in specific journals such as the Journal of Advanced Nursing. So we can see that actually to date more than 34,000 publications have been published in the field of nursing since 1956. This represents a huge increase in the last five years. In 2019 the number of nursing publications published from Italy was in around 20,000 so in the last five years we've had an exponential rise in the number of research publications coming out of Italy. We have a number of top authors, Professor Alvisa Palvis, for example, Professor Andemir Bagnesco, Professor Lauren Dana Sasso. So we are beginning to see, mostly in the last five to 10 years, a proliferation and exploration of the nursing research area output in Italy. If we look in the Journal of Advanced Nursing in the last, in the history of the journal, There has been 150 publications arising from Italy. The total number of publications published in the journal Advanced Nursing during this time is about 15,000.
[00:04:51] But what is really interesting is the majority, more than 120of these papers have occurred in the last five years.
[00:04:59] And again in relation to the Journal of Advanced Nursing. Professor Anna Maria Biagnasco, Professor Laura Dana Sasso, Professor Gianluca Catania, Milko Zanini, Professor Alvisa Palis. All of these people are featuring in the top 10.
[00:05:17] So what can we say about these nurses and scholars? Well, what we can say is that the representation of nursing scholarship in the universities in Italy is quite small by comparison to other European or international countries.
[00:05:34] However, we have a very dedicated, energetic, enthusiastic and committed group of nurse scholars that are committed to advancing the science of nursing and the practice of nursing in Italy and have been actively doing so over the last 10 to 15 years. And in particular in the last decade there were various repercussions from this, including developing a Centre of excellence across the country, developing a new Centre of ethics, joining Sigma Theta Tau, hosting international conferences. A range of research activities supporting nursing practice has been advanced by a very small number of Italian nursing scholars and nurses with very limited resources. So what we see, for example, in the Journal of Advanced Nursing, is high level international collaborations working together on important projects, research problems and issues for practice, such as missed care, workforce planning, transgendered people's experience of hospitalisation, patient safety, cultural aspects of care, the organization of work in Italian hospitals, nurses satisfaction, well being, patient safety.
[00:06:52] And this is a very positive good news story.
[00:06:57] Overall, there has been a steady increase year on year in publications categorized as nursing from Italy since the 1990s.
[00:07:06] And as mentioned, there's been an exponential rise over the last five years with the number of publications during that time, more than half of what was published in the preceding decades. The majority of this dissemination is research, original research, and this is a very positive finding given the importance of research and scholarly output in relation to the professional development of nursing as an academic discipline and showcasing this on the global stage. In terms of the strategy for the future development of the profession of nursing in Italy, Professor Laura Sasso and her colleagues outlined to us that Italian nursing is moving forward towards changing and advancing roles, specialist nursing roles in practice. There are some postgraduate specialist qualifications in existence. These programs have been expanded and developed as we speak.
[00:08:01] However, there is limited autonomy within these roles and limited consistent role delineation or governance. There are, however, pockets of strong leadership positioned to lead on the changes going forward for the future. And yet there are challenges to this professional development in terms of staffing shortages, an aging workforce and changing illness trajectories. The use of evidence based practice by nurses is a particular challenge due to language and fiscal barriers. But there is, as we can see, clear evidence of increased nursing scholarship and growth in the strength of the profession in Italy in the last decade.
[00:08:40] Professor Rocco, Professor Barbara Manchiavelli, Professor Sasso and others are real trailblazers and leaders, along with Professor Annemarie Bagnesco, Professor Palvis and others. Professor Rocco has said things like when I'm faced with a problem, I try to solve it. Professor Sasso Institutional supports are needed so a profession can grow. Professor Mangiacavalli Training is needed for leaders. Professor Sasso says Europe needs Italian contribution in problem solving even in the context of limited resources. These scholars and nurses believe that setting up networks and getting a dialogue going about excellence is important. And this is exactly what they have done with the Centre of Excellence. Even when working conditions are not ideal, to move forward in a positive way, to continue to explore, expand and develop the profession, it is important to leave our assets and resources in order to grow and help with expanding the nurse's role. In order to develop that full professionalism and autonomy that we see in other countries internationally, we need to continue an increased emphasis on scholarship and these nurses and scholars believe in this very strongly and know that communication is key to this.
[00:09:56] So it is clear that in Italy there is a small group of committed nurses who created a strategic vision for nursing research and professional development in Italy. At a national level, there has been increased research and publication where clear gaps existed and they surpassed barriers by seeking national and international collaboration and blazing a trail where a trail had not been before.
[00:10:25] Professor Lauren Ana Sasso and others created a clear vision for change in nursing in Italy and realized that vision through hard work, determination and governance.
[00:10:38] Nurses in Italy are a committed workforce.
[00:10:41] However, there are challenges to maintain this ongoing development and quality standards. In the context of ongoing challenges, we need continued strong leadership, both by these nursing leaders and scholars, but also at A governmental and national level. To successfully steer and negotiate this ongoing transformation, we need a clear vision for the enactment of evidence based practice, determining research priorities for the nursing professional profession in Italy, enhancing workforce and using transformational relationship based management style to advance on these matters.
[00:11:20] It has been highlighted that maximising internationally available resources is very prudent when targeting research at critical areas where gaps exist and have international application. And Professor Sasso and others have clearly identified how this can be done. Networking, collaborating with international colleagues on large scale projects that help to advance nursing research and our understanding of healthcare at a global level, but also can have influence in Italy. This is very important to not only reach out, but pool our resources.
[00:11:54] The continuation of small scale research studies is less likely to have the impact and less manageable and feasible where resources are short. So we do need, as Professor Paldiz has outlined, continued actions to address healthcare problems through workforce management, the advancement of specialist advanced practitioners and also through the advancement and continued advancement of research in healthcare. So the next steps then. There are ongoing challenges globally in relation to health trends and technological challenges for the future. The consistently changing nature of healthcare requires a skilled workforce who are critical thinkers and provide evidence based care.
[00:12:38] Nurses are required to understand and use research and fundamentally, nursing scholars ought to be leading and driving research and evidence based practice in the field. And they are certainly doing this and beginning to do this. Moreover, we need to continue to advance and develop the specialism of nursing, the autonomy of nursing and advance those skills that are required to address the challenges of increasingly aging populations and increasingly complex comorbidities of these groups. So this small group of Italian nurses created a strategic vision for nursing research and professional development in Italy. And we need to harness this ongoing activity to support capacity building for nursing with targeted efforts to increase the advanced practice nurse, specialist nursing and increase PhD graduates and publications. This will likely have a positive influence on the impact of the profession globally.
[00:13:37] National and international incentives to support and advance ongoing professional developments are needed in relation to advanced practice and specialist nurse practice. There are important indications and implications for national and local nursing leadership and management.
[00:13:55] There needs to be a regulatory framework, There needs to be comprehensive planning. The gaps that are needed to be filled by advanced practitioners needs to be clearly identified in in the provision of healthcare. We need strong interdisciplinary collaboration and integration, a clarity of goals, strong mentorship to lead out on this at a national level and a robust candidacy program for those nurses moving into advanced and specialist practice.
[00:14:28] We need very clear, detailed, comprehensive planning and importantly, once the plan is underway, a clear evaluation of that.
[00:14:37] So going forward and building on the shoulders of giants. Those visionaries that have begin and begun to advance the profession of nursing and support the advancement of nursing in Italy, they created a clear vision and we need now to continue that vision by creating a clear vision for the future of advanced clinical opportunities for advanced nurse practitioners in Italy. We need to determine needs and resources nationally and we need to collaborate and plan by setting standards and requirements, planning for legislative requirements, and harnessing, enabling and advancing the strong leadership that exists with courage going forward for the future.
[00:15:21] Thank you very much for your attention. I wish you well and goodbye.
[00:15:29] Continuane.
