Introduction. The implementation of the high-intensity care model (High Care), as per DGR Puglia 1710/2023, required a profound evolution of the nurse specialist role in medical area care processes, with advanced expertise in managing high-complexity patients. Materials and Methods. This 8-month observational study (Feb 4–Sep 30, 2025) was conducted in the Internal Medicine ward of “L. Bonomo” Hospital – Andria – ASL BT. The sample included 149 patients. Four multiparametric devices were used for an average of 91 h 33 m. Module utilization rates were: SpO₂ 100%, ECG 94%, NIBP 91%, position 47%, and temperature 19%. Nursing staff applied clinical governance strategies and quality improvement through calibration of monitoring tools and early warning systems, alongside specific on-field training. Results. The population showed high frailty, frequent motor impairment, dyskinesias, arrhythmias, anemia, and respiratory support. Pre–post high care comparisons revealed improvements in early warning systems: Padua Score 4.9→2.2, qSOFA 3.3→1.1, NEWS2 4.8→2.4. Reduced mortality was documented in levels 2A–2, increased SDO complexity index, improved length-of-stay performance, and perceived quality >80% by patients and staff. Conclusions. High Care implementation in Internal Medicine improved care safety and outcomes, highlighting the strategic role of nurses in advanced surveillance and proactive clinical instability management
Filannino et al. (Fri,) studied this question.