Center of Excellence to Build Nursing Scholarship and Improve Health Care in Italy

Key wordsNursing scholarship, nursing research, nursing center infrastructure, conceptual designAbstractPurpose: This article profiles the establishment and initial phase (2010-2014) of a Center of Excellence (CoE) as an instrument to strengthen nursing scholarship and improve health care in Italy.Approach: This CoE is unique as a non-university-based center. The National Regulatory Board of Registered Nurses, Health Visitors, and Pediatric Nurses (IPASVI) designated substantial administrative and funding support to the CoE for advancing nursing education, clinical practice, research development, and research training. Boyer's Model of Scholarship underpinned the CoE's conceptual framework, and its operational infrastructure was adapted from the U.S. National Institutes of Health P20 program award mechanism. Diverse methods included sponsoring research studies by nurse-led teams, research training courses, nursing education longitudinal studies, evidence-based practice training, and related pilot studies.Findings: Multiple collaborative projects were conducted via the CoE in conjunction with the successful launch of an expansive digital library and communication system accessible to nurses. The introduction of English proficiency courses was also a unique contribution.Conclusions: The CoE concept is a potential instrument to strengthen nursing scholarship in Italy with potential scalability considerations to other global settings.Clinical Relevance: An overlapping focus on research, education, and practice under the umbrella of nursing scholarship within a CoE while engaging all levels of nursing is important to impact healthcare changes.The professionalization of nursing has been depicted in terms of a global picture of the needs, issues, and recommendations for strategic planning and actions to advance nursing at the country or national level by the World Health Organization (WHO, 2010), with the call for action amplified by the U.S. Institute of Medicine (IOM, 2011). Common strands of recent reports stated that healthcare and health professional education are based on evidence and competency (WHO, 2009); the context of health issues in patient safety and quality of care are part of health professional training and care services (WHO, 2009); the continuum of practice is matched to the changing needs of the population (WHO, 2014); and ethics and value underpin practice, education, and research (IOM, 2011; WHO, 2009). A salient premise underscored the "need for a fundamental transformation of the nursing profession" (IOM, 2011), particularly expanding nursing's role beyond the traditional scope of practice (IOM, 2010). The "call for action" relative to the global state of professionalization informed changes in Italian nursing throughout the past decade.The purpose of this article is to describe a new approach in "scaling-up" Italian nursing to the global nursing standards (IOM, 2011; WHO, 2009). This approach was the institution of the first nursing Center of Excellence (CoE) infrastructure in Italy as a vehicle for change in the professional role of nursing through advances in nursing scholarship aimed at improving the health care of the populace. Background on the Italian context of professional nursing is presented, followed by highlights of the CoE organizational framework, outcomes, and lessons learned for nurses to assess its potential scalability in other global settings.Professional Transformation of Nursing in ItalyUnderstanding the healthcare system context within a country or nation is essential to forging change in the professional status of nursing. A priority is efforts to leverage assets and resources that will increase the chances for success in developing new nursing roles and expanding the scope of practice. For example, U.K. midwives worked diligently within the established British National Health Service to expand the scope of midwifery services to better meet the needs of women, children, and families across the past two decades (Kirkham, 1999). …