Nurses as substitutes for doctors in primary care

Citation: Laurant M, van der Biezen M, Wijers N, et al. Nurses as substitutes for doctors in primary care. Cochrane Database of Systematic Reviews 2018; (7): CD001271

What is this? The COVID-19 pandemic is placing a great strain on health systems and healthcare workers. One way to ease this may be to move the care of some patient groups from more specialised to less specialised health workers, for instance by moving certain tasks from doctors to nurses.

In this Cochrane systematic review, the authors searched for randomised trials evaluating the effects of nurses substituting for doctors. They did their most recent search in March 2017, and identified 17 trials from high-income countries and one trial from a middle-income country. A summary of this review is available here. There is also a linked Cochrane Review of qualitative evidence for factors influencing the implementation of nurses substituting for doctors. A summary of the implementation considerations identified is available here.

What works: Delivery of primary healthcare services by nurses instead of doctors probably leads to similar or better patient health and higher patient satisfaction.

Nurses probably have longer consulta­tions with patients.

Using nurses instead of doctors makes little or no difference in the numbers of prescrip­tions and tests ordered.

What doesn’t work: Nothing noted.

What’s uncertain: The effects of using nurses instead of doctors on the amount of information offered to patients, the extent to which guidelines are followed and the costs of health care are uncertain.

 

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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