Infermiere di Famiglia e di Comunità: realtà a confronto

Background: The hospital-centered vision that has characterized Healthcare in recent decades is moving towards an Initiative Medicine, in which the district structures and home-care represent the preferential settings of the Family and Community Nurse (FCN), the practitioner with advanced skills who should represent the connection between hospital and territory, as well as the protagonist in the management of chronic conditions and health promotion. Aim: The purpose of this study is to understand how the FCN is currently included in the Primary Care system and its work, selecting some of the international best practices, and comparing them with pilot projects conducted in Italy. Methods: This is a narrative review. PubMed, Google Scholar and also Google (for Italy) databases were consulted. The research question is: "How is the Family and Community Nurse inserted in the territorial settings of international and national Primary Care in order to improve the response to care needs?". It has been structured according to the PIO (Problem, Intervention, Outcome) methodology. Results: As they met the eligibility criteria, 18 articles were chosen, out of which 10 from PubMed, 7 from Google Scholar and 1 from Google. The international best practices of 5 European countries were evaluated: United Kingdom; Spain; Switzerland, Holland and Norway, and compared with the Italian experiences. The study designs analyzed are: 1 RCT; 3 phenomenological studies, 7 case studies; 2 reviews; 1 working paper; 1 good practice brief; 1 report; 1 case series and 1 observational study. The discussion has been divided into 3 themes: target of care; setting; organizational model and care approach. Conclusions: The role of the FCN is not yet embedded evenly across the Italian National Health System. Although the special feature of this nurse is its versatility, and its Identikit and specific role seem clear, formally emerges the difficulty of local health structures in inserting this figure in a rational and sustainable way. The Spanish, British and Holland models are successful best practices reccomented to be implemented in Italy. Keywords: “Primary health care” (PHC); “Family nurse practitioner”; “Family and Community Health Nurse”; “Primary Care Nurse”; “Care management”.