Practice nurse-led care just as good as that of doctors, report shows

Research gleaned from 18 international case studies show that the care and expertise shown by nurses is equal to that of doctors in primary care

A recently-updated report – entitled Nurses as substitutes for doctors in primary care – shows that the care provided by practice nurses is just as effective and high in quality as the care provided by doctors – if not better.

Researchers in the Netherlands put together the research from 18 case studies across various first-world countries.

Higher-than-ever doctor workloads and increasingly challenging medical needs mean that alternative models of primary care delivery are sorely needed. Many patients visiting a primary care centre do not necessarily require the expertise of a doctor; thus, the report explores the concept of using nurses as a means to improve primary care access and efficiency.

The aim of the research was to gauge how well nurses work as a substitute for doctors in primary care, based on patient outcomes, processes or care and utilisation.

The report found that nurse-led care could lead to better patient satisfaction, as well as lower mortality rates – the data analysed showed that six in 1,000 patients died under doctors’ care, while between four and six died under nurse-led care.

Other clinical issues, such as blood pressure, cholesterol levels and rheumatoid arthritis, were also found to be just as positively dealt with by nurses as doctors.

The authors of the report stated in the paper:

“This review shows that trained nurses, such as nurse practitioners, practice nurses, and registered nurses, probably provide care that is equal to or of better quality than that provided by primary care doctors, and probably achieve equal or better health outcomes for patients.

“Although the included studies show effects of an independent practice role for nurses, it is likely that the quality of patient care overall is determined by overall functioning of the primary care team, including nurses, doctors, and other healthcare providers.

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“Policy makers should be aware that implementing nurse substitution in primary care teams may have an influence on the functioning and quality of care delivered by the entire care team.”

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