Second point of discussion: the decision maker is very very often just the owner of the company.
That means that you need to know how to reach her/him. And this is not a easy job unless you know and handle quite well the local culture.
You can find some hints about the Italian culture, for foreigners, in this interesting website.
But you should not need to study the whole Italian style, just find out someone to rely on.
There are some part if Italy where you should be introduced to the owner by someone whom (s)he knows and trusts, so that you can earn your credibility through this third party.
And you need to understand the human attitude of the owner before talking business.
Italians are quite formal and do not like straight talks. We have invented the art of diplomacy a long time ago during the Middle Age and please do remember that Machiavelli, whom is known to be the father of the subtle talent of manipulation, was an Italian guy.
The only straight way you should consider is the one bringing you in front of the owner, do not waste time with nice and intelligent people, who can be very smart and professional, but who cannot really take decision until the owner has approved them.
So sit down a figure out your best strategy to reach the people you really want to target.