Optimizing Infusion Center Efficiency in Multiple Sclerosis: A Nursing Multicenter Survey on Organizational Impact of Ublituximab.

Background: The increasing use of infusion therapies for multiple sclerosis (MS) has improved disease management but has also increased organizational complexity and nursing workload within infusion centers. Evidence on the organizational implications of infusion care and the perspectives of MS nurses remains limited. This study aimed to characterize the organization of Italian MS infusion centers, explore nursing workload and operational challenges, and assess nurses' perceptions regarding the potential organizational implications of shorter infusion protocols. Methods: A sequential two-phase study was conducted. First, a multicenter cross-sectional survey was administered to nurses working in Italian MS infusion centers (July-September 2025). Subsequently, a national expert board was convened (March 2026) to discuss and contextualize the survey findings. Descriptive statistics, multivariable linear regression, and non-parametric analyses were performed. Results: Sixty-eight MS nurses participated (response rate: 87.2%). Infusion centers were characterized by high patient volumes, limited staffing, frequent multitasking, and substantial administrative burden. Post-infusion monitoring represented the most time-consuming phase of care. Resource availability was independently associated with the number of daily infusions (β = 0.46, p < 0.001), whereas time devoted to nursing assistance and operational workload were not. Expert panel discussions highlighted chair occupancy, workflow organization, and the distinction between technical and relational nursing time as key organizational issues. Nurses perceived shorter infusion protocols as a potential opportunity to improve scheduling flexibility and patient flow, while emphasizing that any organizational benefits would depend on broader workflow redesign. Conclusions: Organizational capacity in MS infusion centers appears to be driven primarily by structural resources rather than nursing task duration. Nurses identified several opportunities to improve infusion pathways and suggested that shorter infusion protocols may support organizational optimization. However, these potential advantages should be regarded as hypotheses based on nurses' perceptions and require confirmation in prospective comparative studies.