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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.

Although the science of patient safety has been developed and implemented widely, there remains a large gap in the understanding of the chain of events that lead to safety incidents, as well as their cost to patients, healthcare staff and the organisation as a whole. The aim of the study was to evaluate nurses' knowledge and awareness of the local incident reporting system at Malta's acute general hospital. A quantitative, descriptive cross-sectional design was used and data were collected from nurses through an online survey. A total of 323 questionnaires were received with a response rate of 23%. Various shortages within the local setting were identified, including lack of feedback and awareness of the system. Therefore, it is suggested that incident reporting should be given a higher profile on the organisation's agenda and incorporate employed members of staff rather than volunteers.