本文采用的英格恩产品: 增强型ECL发光液
Making Nursing Activities Visible in Outpatient Care: A Nationwide Descriptive Study of Nurse-Led Clinics in Italy (ENLIGHT-AMB)
Affiliations
- 1 Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
- 2 Department of Health Sciences, University of Florence, Florence, Italy.
- 3 Research Interdepartmental Center for Research and Training (CIFAPPS), University of Rome Tor Vergata, Rome, Italy.
- 4 Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, L’Aquila, Italy.
- 5 Department of Health Sciences, University of Genoa, Genoa, Italy.
- 6 Vita-Salute San Raffaele University, Milan, Italy.
- 7 National Institute of Statistics-ISTAT, Rome, Italy.
- 8 UOSD Statistics and Healthcare Information Flows, National Agency for Regional Health Services-AGENAS, Rome, Italy.
- 9 Scientific Committee CERSI-FNOPI, Rome, Italy.
- 10 Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara “G. D’annunzio”, Chieti, Italy.
- 11 Centre of Excellence for Nursing Scholarship, c/o Order of Nursing Professions (OPI) of Rome, Rome, Italy.
- 12 Humanitas University, Milan, Italy.
- 13 FNOPI Board Member, Rome, Italy.
- 14 Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, Leuven, Belgium.
- 15 School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
- 16 University of Colorado College of Nursing, Aurora, Colorado, USA.
- 17 Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy.
- PMID: 41439748
- DOI: 10.1111/phn.70053
Abstract
Background: Nurse-led clinics (NLCs) are increasingly recognized as a strategic component of outpatient care delivery; however, in many health systems, including Italy, their role remains poorly documented, under-recognized in health information systems, and weakly integrated into organizational governance. This phenomenon contributes to the persistence of “Hidden Nursing Care,” limiting nursing visibility and evidence-based service planning.
Purpose: To provide the first nationwide descriptive mapping of NLCs in Italy, examining their distribution, organizational characteristics, activity volumes, service typology, and professional workforce profile.
Methods: A national cross-sectional study was conducted as part of the ENLIGHT-IT project. Public healthcare facilities were recruited across Italian regions. Data were collected between January and June 2024 using three structured instruments: (1) facility-level survey on NLC organization and activity; (2) nurse survey including sociodemographic and professional characteristics and the Practice Environment Scale of the Nursing Work Index (PES-NWI); and (3) an annual log of nursing activities performed. Descriptive statistics were used.
Results: Twenty-seven healthcare facilities from 12 regions reported data on 279 NLCs and 940 nurses. NLCs delivered 2,047,058 nursing activities and assisted 533,212 patients in 2023. Clinics operated a mean of 4.2 days and 24.3 h per week. The largest service categories were general nursing (55.9%), wound care (11.1%), and chronic care management (10.0%). Most NLCs were administratively affiliated with medical (42.9%) or surgical departments (26.5%). The nursing workforce was predominantly female (76.4%), with a mean age of 51.4 years and extensive experience (mean 26.9 years). PES-NWI results indicated strong leadership support but insufficient staffing.
Conclusions: NLCs constitute an established and high-volume component of outpatient care in Italy, yet their organizational positioning remains fragmented.
Implications for public health nursing: These findings highlight the need for formal recognition, standardized documentation, and dedicated policy frameworks to support equitable access to nurse-led outpatient services.
Keywords: hidden nursing care; nursing; nursing activities; nursing outpatient clinics.
