Loredana Sasso

Aim (s): To develop and preliminarily evaluate a case‐based rubric for assessing undergraduate nursing students' person‐centred clinical reasoning within the Fundamentals of Care Practice Process (FoC‐PP). Design: Methodological study of rubric development and preliminary validity and reliability evidence. Methods: The study was conducted from January to October 2025 and comprised rubric development and preliminary evaluation of selected sources of validity and reliability evidence. Content validity was assessed by an expert panel of five participants using structured ratings. Face validity was explored through cognitive interviews with 12 nursing tutors and clinical placement mentors. Inter‐rater reliability was evaluated through independent scoring of 83 undergraduate nursing students' performances during a structured clinical reasoning exercise based on a standardised case. Each performance received two independent tutor ratings. Reliability was analysed using a one‐way random‐effects model for anonymous paired tutor ratings. Measurement precision was examined using the standard error of measurement and minimal detectable change at the 95% confidence level. Results: Item‐level CVI values ranged from 0.80 to 1.00, with an S‐CVI/UA of 0.87 and S‐CVI/Ave of 0.97. Face validity findings supported clarity and usability, with minor wording refinements. Inter‐rater reliability was high. ICC(1 1) was 0.970, 95% CI: 0.953 to 0.980 for a single rating, and ICC(1,2) was 0.985, 95% CI: 0.976 to 0.990 for the mean of two ratings. SEM and MDC95 were 0.61 and 1.68 points for a single rating, and 0.43 and 1.19 points for the mean of two ratings respectively. Conclusion: The rubric provides a theory‐informed approach to assessing person‐centred clinical reasoning within case‐based FoC‐PP assessment. Findings provide preliminary support for content validity, face validity, scoring consistency and measurement precision. Further research should examine construct validity, internal structure, responsiveness, performance across cases and raters, and applicability across educational and cultural contexts. Implications for the Profession and/or Patient Care: By supporting the formative assessment of person‐centred clinical reasoning within the FoC‐PP, the rubric may strengthen alignment between education, supervision and clinical practice, contributing to the development of person‐centred fundamental care. Impact: What problem did the study address?: Assessment approaches in nursing education often fail to capture integrated, person‐centred clinical reasoning within fundamental care. What were the main findings?: A theory‐informed rubric showed high content validity indices, supportive face validity findings, high scoring consistency across anonymous paired tutor ratings with measurement precision quantified using SEM and MDC95 under controlled assessment conditions. These findings support its cautious formative use in undergraduate nursing education. Where and on whom will the research have an impact?: The findings are relevant for nursing educators, clinical mentors, and educational institutions seeking to support person‐centred care through structured assessment practices. Reporting Method: This study adheres to the Guidelines for Reporting Reliability and Agreement Studies (GRRAS), with methodological considerations for reliability and measurement error informed by COSMIN guidance for performance‐based outcome measurement instruments. Patient or Public Contribution: This study did not include patient or public involvement in its design, conduct, or reporting.

Aim: To translate, culturally adapt and validate the Dignity in Care Scale for Nurses (DISC‐N) into the Italian language. Design: A national multicentre cross‐sectional study. Methods: Translation and cultural adaptation followed recognised guidelines for health measurement instruments. Content validity was assessed through expert review. Structural validity, item performance, reliability, construct validity and measurement invariance were examined in a national sample of registered nurses and nursing students. Results: A total of 1385 registered nurses and 905 nursing students from 14 regions and one Autonomous Province participated in this study. The Italian DISC‐N showed excellent content validity, a coherent six‐domain structure, and strong reliability for the total scale and its domains. Measurement invariance was supported across gender, age and professional role, indicating that comparisons across these groups are appropriate. Construct validity was supported by positive associations with ethical climate. Conclusions: The Italian DISC‐N is a culturally appropriate and psychometrically robust instrument for evaluating dignity‐preserving nursing practice in Italian clinical and educational settings. Implications for the Profession and Patient Care: The scale can support professional development, undergraduate education and quality improvement by helping organisations assess, monitor and strengthen dignity‐preserving care. Impact: This study addressed the absence of an Italian instrument for assessing nurses' perceptions of dignity‐preserving care. The main finding is that the Italian DISC‐N provides a valid and reliable measure for nurses and nursing students. The findings will affect clinical educators, nurse managers, researchers and healthcare organisations seeking to promote person‐centred and dignity‐preserving care. Reporting Method: The study was reported according to the Consensus‐based Standards for the selection of health Measurement Instruments reporting guideline. Patient or Public Contribution: No patient or public contribution.

Aim: To evaluate the effectiveness of educational programs on disaster preparedness and management for emergency nurses and nursing students, focusing on teaching methods that enhance readiness and competence. Background: The increasing frequency and severity of disasters require healthcare systems to be adequately prepared. Nurses, often on the frontline, must receive structured and effective training to respond to critical events with competence and resilience. Methods: A Rapid Evidence Assessment was conducted to explore and synthesize the available literature on educational interventions in disaster preparedness. Studies were identified through structured searches in international databases and were selected and evaluated using the PRISMA 2020 checklist. The quality of included studies was appraised using the CASP tool. Results: Thirty‐six studies met the inclusion criteria. Educational programs incorporating realistic simulations, virtual technologies, and interprofessional exercises were most effective in improving technical skills, confidence, and crisis management. Programs varied in format and intensity but shared common elements such as experiential learning and integration of psychological preparedness. Discussion: Educational interventions must balance theory with practice and adapt to diverse cultural and contextual needs. Simulations and technology‐enhanced learning emerge as critical strategies to reinforce emergency competencies. Conclusion: Educational programs in disaster preparedness positively influence nurses’ readiness, skills, and confidence. Integrating these interventions into nursing education is essential to prepare a responsive and resilient workforce. Implications for Nursing: Ongoing and structured education strengthens nurses’ ability to respond effectively during disasters, promoting professional growth and emotional resilience. Implications for Health Policy: Policies should support the mandatory inclusion of disaster preparedness training in nursing curricula and continuing education. National frameworks must prioritize standardized educational models to ensure healthcare system resilience and nurse preparedness worldwide.

Background/Objectives. Country-level evidence on the economic footprint of home care nursing is still scarce, particularly in systems where tariffs for community-based nursing are lacking. In Italy, recent laws have expanded home care; yet planning and funding remain constrained by the absence of robust micro-costing evidence. Objectives. To estimate the accounting cost of home care nursing visits in Italy using a bottom-up micro-costing approach and to identify the main cost drivers influencing expenditure. Methods. A multicentre, cross-sectional study was conducted. Data were collected in two phases: (1) a national survey of 3949 home care nurses from 70 Local Health Authorities (April–October 2023), describing workload, travel time, and the most frequently performed activities; and (2) a time-and-motion study of 527 consecutive home visits performed by 83 nurses in three Local Health Authorities (March 2024). Direct costs were estimated from the Italian National Health Service perspective and included nursing time, travel time and transportation, back-office activities, and materials. Personnel costs were derived from national collective labour agreements and inflation-adjusted. A base-case scenario estimated accounting costs directly measured in the study. An extended, illustrative scenario explored the economic value of nursing activities by applying existing outpatient tariffs. Deterministic and probabilistic sensitivity analyses (10,000-iteration Monte Carlo simulation) were performed. Results. The mean accounting cost of home care nursing was €27.78 per patient per day. At the provider level, the corresponding daily cost per nurse was €190.00, assuming a mean caseload of 6.84 patients per nurse per shift. In the extended scenario, the imputed economic value of nursing activities increased the estimated daily cost to €120.81 per patient and €826.32 per nurse. Sensitivity analyses identified organizational factors (particularly the number of patients per shift and the number of activities per visit) as the dominant cost drivers, while material and transportation costs had a comparatively limited impact. Conclusions. Home care nursing in Italy appears to be delivered at a relatively low accounting cost, with organizational factors playing a greater role than unit prices in determining expenditure. The absence of a dedicated reimbursement framework for nursing activities may result in a substantial under-recognition of the economic value of home-based nursing care. These findings provide preliminary evidence to support workforce planning, reimbursement policies, and the sustainable development of territorial care services.

This article offers a practice-oriented reflection on conducting Grounded Theory (GT) in midwifery research. Building on a constructivist GT study on Italian midwifery care, it does not restate standard GT procedures; instead, it focuses on the methodological decision points that most strongly shaped analytic quality, coherence, and feasibility. Rather than providing a generic overview, it traces the concrete steps, trade-offs, and adaptations involved in implementing GT in a real world, applied setting. The paper discusses the importance of explicit paradigmatic positioning, the central interpretive role of the researcher, and the need to preserve continuity between data collection and analysis. It also examines practical issues that are often underreported, including the organisation of episodes, early and ongoing memoing, data management, the limits of automation, and the time-intensive nature of analytic consolidation. By making these aspects explicit, the article aims to support researchers in planning and conducting GT studies with greater methodological awareness and rigour, especially in applied healthcare contexts. In doing so, it offers a transferable methodological template for designing and reporting constructivist GT studies in midwifery and related fields.

Aim: To classify Italian home care models based on structural characteristics, process factors and stakeholder perceptions. Design: This is a secondary analysis of the AIDOMUS‐IT multicentre cross‐sectional study, conducted in Italy between July 2022 and December 2023. Methods: Data were collected via online surveys completed by 33 Local Health Authority Nursing Directors, home care nurses and patients. Hierarchical cluster analysis was used to classify different organisational models based on structural and process‐related factors. Nurses' and patients' perceptions of care were described for each identified cluster. Results: The analysis identified three distinct organisational home care models: The ‘multidisciplinary model’, in which nurses reported high dissatisfaction due to organisational complexity and excessive workloads. In the ‘nurse‐centred model’, characterised by publicly employed nurses, strong leadership, and a supportive work environment, patients reported high levels of satisfaction. The ‘performance‐based model’, which operated with a lower nurse‐to‐patient ratio, reduced service hours, and greater reliance on external professionals. Nurses in this model reported high job satisfaction but also a greater intention to leave, while patient satisfaction was lower. Conclusions: This study underscores the importance of leadership, resource management, and a supportive work environment in influencing both job satisfaction and patient outcomes in home care settings. Implications for the Profession and/or Patients Care: Policymakers could use these findings to refine care models and improve service delivery. Impact: Limited research has examined the organisational structures of home care services, which are important for professionals' organisational well‐being, patient safety, and quality of care. This study identified three distinct organisational home care models that could be used to refine care approaches and improve service delivery. Reporting Method: This study respects the EQUATOR guideline for observational studies (STROBE). Patient or Public Contribution: This study did not include patient or public involvement in its design, conduct, or reporting.