**Title:** Nursing Consultancy in Vascular Access Management: Defining Professional Role, Competencies and Organizational Impact

 

**Background:** While nursing consultancy in vascular access is widely practiced in clinical settings, it remains formally unrecognized and unregulated in Italy, despite clear professional competence and clinical value.

 

**Objective:** To characterize nursing consultancy practices in vascular access across Northern Italian healthcare facilities and develop a competency profile for consultant nurses in this specialization.

 

**Methods:** Multicenter observational study conducted across seven Northern Italian regions (Friuli-Venezia Giulia, Liguria, Lombardy, Piedmont, Trentino-Alto Adige, Valle d'Aosta, Veneto). Two distinct survey panels: ward/service nurses (642 responses) and PICC team specialists. Structured questionnaires examined consultancy availability, activation procedures, and perceived needs.

 

**Results:** Nursing consultancy exists in 58% of ward environments, with vascular access being the most active consultation area. Among PICC team nurses, 93% provide consultation services despite lack of formal role definition. Key consultation areas include device selection, complication management, care protocol guidance, and staff education. Importantly, 98% of ward nurses consider expert vascular access consultation essential, while 42% of PICC team nurses report inadequate training function support.

 

**Conclusions:** Significant gap exists between recognized clinical practice and formal professional recognition of vascular access nursing consultation. Establishing formal consultant nurse role with defined competency standards is essential for optimizing patient safety, enhancing care quality, and providing appropriate professional recognition and compensation.

 

**Keywords:** Nursing consultancy, specialist nursing, vascular access, advanced practice, professional recognition, role development