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Case study: the development of specialist nurse roles in Malta

07 December 2023
Volume 32 · Issue 22


Specialist nurses play a significant role in healthcare. This study investigated and evaluated the primary and extended roles and the development of specialist nurses in Malta. Methods: A qualitative case study design and purposive sampling techniques were used to gain a deep understanding of the complex issues surrounding specialist nurses from multiple data sets. A survey of the total specialist nurse population in 2013 (n=27), in-depth interviews with a group of specialist nurses (n=9) and four focus groups with key professionals and policy stakeholders (total n=28) were carried out. Data were collected between 2013 and 2015 and analysed using thematic analysis. Findings: Three themes emerged: the roles and attributes of specialist nurses in Malta; the development of specialist nurses; and the influences on the advancement of specialist nursing practice in Malta. Although these data are nearly a decade old, no further research has been carried out. Conclusions: A legally accepted set of definitions as well as preparation and evaluation of the specialist nurse role from a national policy perspective is needed. Attitudes and systems that limit specialist nurses need to be challenged.

As the demand for high-quality healthcare soars, the need for specialist nurses is also increasing. Well-trained, skilled nurses are assets for any healthcare organisation. Those with advanced skills can make complex decisions and provide world-class, good-value healthcare. Although nursing is a well-established profession, the term ‘specialist nurse’ is still not clearly defined (Pulcini et al, 2010; Jokiniemi and Miettinen, 2020; Decock et al, 2022), and the role of a specialist nurse varies between countries. However, according to Debout (2021) and Decock (2022), there are minimal data on nurses' specific roles in Europe.

Following objection by a medical association in Malta, the term ‘specialist nurse’ was replaced by ‘practice nurse’ to include all specialist and practice development nurses.

Debout (2021) noted that political, local and country-based policies and cultural beliefs heavily influence nursing. Specialist nurses in Malta work in dedicated areas including surgery, diabetes, cardiovascular diseases, primary healthcare, infection control, tissue viability, diabetes and continence care.

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