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International Nursing Opportunities

Through the largest international public/private partnership ever undertaken by a U.S. academic medical center, specialized clinical services—such as liver transplantation—are available to the citizens of Sicily and southern Italy. The Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT) (the Mediterranean Institute for Transplantation and Advanced Specialized Therapies) is a joint venture of UPMC, the Italian government and Civico and Cervella hospitals of Palermo.

The way care is delivered at ISMETT, by a multinational team trained in the United States and with nurses in expanded roles, is as unique as the clinical services to the region. New technologies, such as a paperless medical record system and a telepathology link between UPMC and ISMETT, also set ISMETT apart from other Italian or European centers.

In addition to liver transplantation and other treatments for liver diseases, ISMETT continues to expand the kidney transplant service at Civico Hospital and eventually will offer transplants of other organs and provide advanced cardiology, oncology, and orthopaedics care. The newly renovated clinical space at Civico Hospital temporarily houses the program until construction of the 72-bed facility is completed.

The Cervello Hospital oversees gastroenterology and pre- and post-transplant care. The Civico Hospital, which will lead the kidney transplant service, houses the temporary facility with 16 beds, four ICU beds, and two operating rooms. Kidney transplants are currently being performed at Civico Hospital, and liver transplantation and the treatment of liver diseases will be among the new services provided by ISMETT. Eventually, it will be the first center in southern Italy capable of transplanting all organs.

ISMETT is the first of UPMC's international initiatives to involve actual health care delivery. ISMETT reflects UPMC's philosophy and commitment to work in partnership with the local medical community and within the cultural context of the host country. Having performed more than 10,000 transplants, UPMC is considered the world's leading organ transplant center. It is equally well regarded for its oncology, cardiology, and orthopaedic departments, each of which has distinguished itself with research and clinical advances.

As part of its agreement with the Italian government under a health reform law, UPMC is managing the facility as it would an American medical center, incorporating the most advanced technologies. It is also overseeing the clinical training and educational aspects of the program. Already, 37 Italian nurses and 12 physicians have trained in Pittsburgh; a number of medical consultants from UPMC visit ISMETT regularly.

The Support of UPMC Staff
Key to the ongoing education and training is the support provided by various UPMC clinical staff. Nursing staff from many specialty areas (liver transplant ICU, liver and kidney transplant units, cardiothoracic ICU and units, Post Anesthesia Care Unit (PACU), hemodialysis, OR nurses and technicians, nurse anesthesia) and staff representing respiratory therapy, physical therapy, and pharmacy all offer their expertise and contribute to the development of expert nurses at ISMETT.

Nursing will continue to evolve at ISMETT. The goal of nurses assuming the role of autonomous, critical-thinking, decision-making caregivers who are patient advocates and patient educators is being realized as ISMETT nurses care for patients and interact with physicians.