Commentary on Thompson DR and Watson R (2010) Guest editorial: h-indexes and the performance of professors of nursing in the UK. Journal of Clinical Nursing 19, 2957-2958.

In Italy, there is controversy in nursing about impact factors. The recent introduction of nursing education in universities (June 2000), specifically in the Faculties of Medicine, requires that scientific output is measured based on the impact factor and h-index, to rate academics’ performance. The current necessity in Italy to reduce the number of academic staff has excessively raised academics’ performance rating targets. In fact, the Italian Ministry of Education, University and Research has recently declared that Italian academics have to achieve an h-index of at least 25, if they want to obtain governmental funding and enrol new researchers. In nursing, this situation runs the risk of giving rise to two critical and related phenomena: • First 1 , in Italy, nursing research, as well as the first PhD programmes of nursing, started only in 2006; very few Italian indexed scientific nursing journals are available to publish. Novice-nursing researchers are obliged to find space in an already overcrowded international sector. Furthermore, owing to the nature of nursing, the impact factors of nursing journals tend to be lower than medical journals. Above all, the combination of all these factors could generate an unhealthy frenzy to publish at all costs, known as ‘impact fever’ (Bloch & Walter 2001, Anseel et al. 2004, Ironside 2007, Nolan et al. 2008). • Second, the consequence of this ‘impact fever’ could lead to ‘impact factor addiction that can generate an impact factor cessation’ (Jackson et al. 2009). The result of this could be that nursing professionals, pressured by the need to compete with overwhelmingly high-rating models (impact factors and h-indices) for nursing, could concentrate on publishing, at the expense of the true development of nursing. Thompson and Watson (2010) report that in the UK, which boasts a long tradition of nursing publications, only eight of the top-ranking nursing scholars have an h-index >10 (meaning that 10 papers of their papers have been cited at least 10 times). It is therefore clear that the decision to set an exceedingly high h-index for Italian nursing academics has no rational foundation; moreover, owing to the intrinsic nature of nursing, the h-index cannot be the sole measurement to rate nurses’ academic excellence. As suggested by Hack et al. (2010), nurse academics who are in difficulty should on the contrary be supported, so that they may have sufficient time and resources to dedicate to their research activities and be in the condition to achieve an acceptable h-index in line with international standards.