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The integration of patient-reported outcomes and experiences through PROMs and PREMs tools represents a significant evolution in the quality of care and clinical practice. This article reviews the state of the art and the application experiences of these tools, focusing on their impact on the management of cardiovascular diseases. The use of PROMs and PREMs allows for a more comprehensive assessment of patient well-being by integrating with traditional clinical indicators. An increasing number of studies suggests that the systematic collection of these data can help physicians in better identifying individual patient's needs, improving doctor-patient communication, and personalizing therapies. In aggregate form, these data can be used to improve the quality of services. This article explores the main international experiences, starting from the activities carried out in this field by the European Society of Cardiology, the challenges in implementing such tools, and the prospects for a more widespread adoption in daily clinical practice. It emphasizes the activities carried out in Italy by the Fondazione Toscana Gabriele Monasterio and the Management and Healthcare Laboratory of the Scuola Superiore Sant'Anna of Pisa, highlighting the importance of validated tools, appropriate technologies, and a cultural change to promote patient-centered care.

Background: To date delirium prevalence in the adult acute Italian hospital cardiac population is unknown. In a multicenter study, we assessed the prevalence of delirium over a single day among a population of patients admitted to acute cardiac hospital wards in Italy., Methods: This is a point prevalence study (called "Cardio Delirium Day") which involved 55 Italian cardiologic centers (23 North, 18 Central, 12 South, 2 Sardinia) that collected data on 152 patients older than 65 years hospitalized on March 15, 2023. Delirium was assessed on the same day in all patients using the Confusion Assessment Method for the Intensive Care Unit algorithm, a validated and briefly administered tool which does not require specialized training. We also collected data about clinical variables, functional and nutritional status, dementia, comorbidity, medications, and physical restraints., Results: The mean sample age was 79.0 ± 10 years (33% female). Delirium was diagnosed in 25 patients (16.4%); 17.1% were hospitalized in the intensive cardiac care unit and 13.8% in the cardiology ward (p=NS). Hyperactive was the commonest subtype (48%), followed by mixed (36%) and hypoactive type (8%). In a multivariate logistic regression, male sex (odds ratio [OR] 3.81, 95% confidence interval [CI] 1.18-12.26; p=0.025), chronic obstructive pulmonary disease (OR 0.24, 95% CI 0.063-0.66; p=0.008), sensorial deficit (OR 3.75, 95% CI 1.18-11.95; p=0.025), sleep deprivation (OR 5.81, 95% CI 1.47-22.9; p=0.012) and the presence of ≥3 precipitating factors (OR 7.63, 95% CI 2.32-25.2; p=0.001) were independent predictors of delirium., Conclusions: Delirium occurred in 16.4% of patients in a cardiology setting. The "Cardio Delirium Day" project might become a useful method to assess delirium over time and sensitize the interest and the culture of Italian cardiology in this important aspect of hospital care.

Over the latest years, a worrying progressive reduction of medical specialists has been observed in Italy and in other European and non-European countries. This trend is assuming alarming proportions, especially considering the continuous population aging and the concomitant increase in the prevalence of chronic cardiovascular disease. The underlying reasons are complex and multifactorial. The purpose of this document, derived from the collegial discussion held during the 2023 ANMCO States General is to highlight the current critical issues regarding the lack of healthcare personnel in the cardiology field, examining the current and future Italian situation and proposing some potential strategies to counteract this alarming phenomenon.

Patient safety is the moral and ethical responsibility of healthcare professionals, representing a constantly evolving field in industrialized countries whose key factors are sustainability, training and prevention. Clinical risk management is primarily concerned with systems issues, but people are of paramount importance to effective teamwork and leadership. Hospitals have recently been urged to adopt the methods of high-fidelity organizations to identify and change ineffective practice patterns: recognizing that little things that go wrong are early warning signs of trouble, near miss and errors become information about the health of systems and learn from them. Italian Cardiology will have to assume clinical risk as a common practice, through a rigorous examination of the causes of adverse events, staff training, sharing of validated adverse event analysis tools, identification of corrective actions and definition of shared procedures, the systematic control of the adoption of the planned interventions, the evaluation of the results of the measures implemented by applying stringency and scientific method in this area. The text tries to explain, in a pragmatic way, the main problems that hinder the diffusion of the culture of safety in Italian hospitals and in cardiology by proposing solutions.

Introduction: Although nursing today is an intellectual profession to all intents and purposes, thesocial and professional image gap has not yet been bridged. Also, in the rest of the world, the social image of the nurse suffers from some stereotypes, not only perpetuated by a wrong knowledge on the part of the population but also fostered by the mass media (commentary, cinema, television series)., Objective: To investigate the perception of students at the University of Piemonte Orientale about the nursing profession., Methods: A survey was conducted using an online questionnaire sent during the period of the health emergency linked to COVID-19 (from 18 August to 15 September 2020)., Results: 662 questionnaires were analysed. It was investigated how students describe nurses and whether that description would have been the same even before the COVID-19 health emergency. Furthermore, it was assessed which gender they consider most suited for the profession and whether the mass media has influenced their view of nurses. The students described the nurse with adjectives such as "expert / capable", "courteous / polite" and "welcoming / listening oriented" and stated that they would use the same terms even before the health emergency. The majority of the sample then believed that there is no more suitable gender to fill the role of nurse and that TV series or news reports have positively influenced their perception. However, only a small percentage of the sample would have considered the idea of becoming a nurse., Discussion: A positive view of nurses emerged to overcome gender stereotype and a greater confidence in their technical-professional abilities. The data also highlight that the positive view of the nursing profession is not a consequence of the "publicity" provided by the media during COVID-19 emergency, which represented nurses as "heroes" of the National Health System.

Introduction: Heart failure has an enormous impact in terms of mortality, morbidity, and costs for healthcare organizations. Indications for implanted heart devices, such as pacemakers or implantable cardioverter defibrillators (ICDs) are constantly increasing. With the arrival of the telemedicine, nurses play an important role in the remote management of chronic heart diseases. The purpose of this study was to describe the experiences of nurses who remotely monitor patients with an implanted heart device in Italy., Methods: A qualitative study with a phenomenological approach was conducted. The sample consisted of 7 nurses dedicated to remote monitoring (RM), from three cardiology clinics in Northern Italy. We conducted semi-structured interviews to understand the experience and training nurses received to conduct RM., Results: From the analysis of the interviews, six themes were identified: 'Specialized knowledge and skills', 'Learn through practice', 'Organization of work', 'Decision making', 'Trust', and 'Need for information'. The majority of our sample developed their competencies directly on the field, in absence of a certified recognized pathway, on RM in patients with heart failure implanted with cardiac devices. Therefore, nurses performing RM activities do not receive the same type of education and training., Conclusion: Currently, in Italy, there is no standardised training for nurses who perform RM activities for heart failure patients with implanted heart device, and yet it is instrumental to have appropriate knowledge and training to effectively perform this type of activity and care.

Introduction: Nursing theories are essential for orienting nursing practice. To date, three models for nursing practice have been developed in Italy. In addition, significant epistemological reflections have been published, sparking a rich professional debate regarding the theoretical foundations of nursing in Italy. However, conceptual models from other countries are often still used, despite many difficulties associated with applying them in practice. In order to investigate and redress this 'theoretical gap' and related implications for intervention, three scoping reviews of the Italian nursing literature were conducted to examine three categories of nursing knowledge: (a) nursing practice in Italy; (b) the basic nursing concepts of person, health, environment and nursing; and (c) regulatory/normative statements regarding what nursing practice should be in Italy., Aim: The purpose of this investigation was to identify how nursing is conceptualized in the Italian literature through an integrative narrative analysis of three scoping reviews., Methods: The Scoping Review according to the recommendations published by Arksey and O'Malley and subsequently implemented by Levac et al. has been selected as the optimal methodology for mapping nursing knowledge. At the end of the reviews carried out to answer the three research questions, the researchers integrated the results by conducting a coding of the results., Results: The narrative synthesis highlighted a systemic conception of persons in their social context, 'incorporated' within relational systems. Persons are imagined as active agents with self-determination toward promoting their own health. Health, derived from levels of equilibrium between multiple systemic components and based on the person's holistic view, is a fundamental right and a collective social interest. Maintaining or promoting a person's health requires careful consideration of all these constitutive and integral elements. The nursing process is implemented through technical acts as well as relational and caring skills. Professional autonomy, influenced by clinical and organizational contexts, is expressed in collaboration with other professionals who contribute to the healthcare process. The results of this integrative narrative analysis suggest the need for a holistic vision of persons, with an active role in their health management, indissociable from the system of relationships in which this is contextualized, within which nurses are embedded., Conclusion: In light of the results of our investigation, the promotion of a conceptualization of nursing based on the centrality of the person-social relational system and on the active role of persons that nurses work with, this could guide approaches used in nursing education and administration. This could help enhance care provided by nurses and persons' participation in decisions regarding their own health.

This document aims to be an integral part of the SICI-GISE position document on standards and guidelines for cardiovascular diagnostic intervention laboratories published in October 2015. It was created with the aim of defining quality and quantitative standards by providing practical support for the structuring of a training course to reach high levels of assistance for nursing and technical personnel working within the catheterization laboratories. The competences detected are the expression of a highly specialized organizational and operational reality that combines technicality with a well-defined clinical assistance need as an expression of a real patient care. The Nurses & Technicians Area of SICI-GISE aimed at issuing a flexible and dynamic document based on technical and operational progress which, in addition to defining qualitative and quantitative standards, describes the underlying knowledge of the professionals of the sector operating in our laboratories. This is the first experience that, through a survey carried out in 2015, has been able to decline qualitative and quantitative data so as to provide resources and skills for measuring and improving assistance outcomes.

Introduction: In Italy, the nursing doctoral programs were established in 2006, and after ten years we though it would be important to understand how nursing research in Italy has developed thanks to its four doctoral schools of nursing. Our research question was: How have the Italian doctoral schools of nursing contributed to the development of nursing research in the last ten years?, Methods: A national descriptive observational was conducted to collect all the publications made by the four nursing doctoral schools in Florence, Genoa, L'Aquila, and Rome between 2006 and 2015. For the enrolment of the participants, an online survey was sent to the e-mail address of each student provided by the reference University. The publications collected through the CVs of the current and former doctoral students were then checked against Web Science. The publication trends were analysed considering the type of journal, the Impact Factor (IF), and the topics., Results: A total of 478 papers published between 2006-2015 were retrieved, of which 226 (47.59%) were published in Italian journals and 250 (52,41%) on international journals. The great majority of the papers (59,21%) were published in 30 journals, of which 15 had an Impact Factor (range 0.236 - 3.755). The main topics were clinical care, research methods, education, management, ethics, and policies., Conclusions: Between 2006 and 2015, Italy has produced nursing knowledge and scientific data that can be used to improve the quality of care and facilitate discussions with health policy decision-makers in order to better address the incumbent heath challenges of the near future.

Purpose: To identify orientations in Italian nursing research regarding nursing practice, highlighting strengths, needs for improvement, as well as suggestions and recommendations for promoting the future development of nursing knowledge., Method: An extensive review of the literature was conducted (scoping review) by consulting the following databases: PubMed, CINAHL, PsycINFO, Biosis and Scopus, for the time interval between January 2006 and July 2016., Results: Out of a total of 5635 publications, 35 were identified as relevant to the research question. These highlighted the changes implemented by nurses in Italy through their professional actions according to the best available evidence, especially since 2011/2012. Many publications relate to the implementation of new technical procedures or educational systems for patients, but there is a lack of studies that examine the effectiveness of nursing care and its effects on patients. Many studies do not belong within a program of research or larger projects, and virtually none involve participation in international research teams. With regard to the clinical environments in which the studies were conducted, the majority involved hospitals and the focus was mainly on patients in an acute phase of an illness. Few studies have investigated persons with chronic illnesses, the elderly or have been conducted in long-term care settings such as nursing homes. Another finding identified in this review is the prevalence of quantitative studies, with descriptive study designs, the use of questionnaires that were often created ad hoc, and the recruitment of samples from 'convenience' populations. These findings highlight the need to further review orientations in the Italian nursing research literature, focusing attention on emerging clinical priorities. This should be done through a process that balances the needs of nurses and with those the patients., Conclusions: Italian nursing researchers tend to focus their investigations on technical and educational topics. Theoretical or philosophical frameworks are almost completely missing in the literature, highlighting the need for more work in this area. In most cases, Italian researchers do not seem to follow research tracks based on research priorities, highlighting the need to review practice settings to identify areas that need to be developed, explored or consolidated. For Italian nurses, research is an area that is still under development and consolidation, but with strong potential for the future.