Substitution of nurses for physicians in the hospital setting for patient, process of care, and economic outcomes

Butler, Michelle; Schultz, Tim; Drennan, Jonathan

doi:10.1002/14651858.cd013616

Cited by 3 publications

(3 citation statements)

References 59 publications

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“…The physicians and the nurses are found as complementary of each other for the production of inpatient services. On the other hand, since the effect of nurses is also important in the production of outpatients, as Butler et al [ 72 ] discussed, the substitution of nurses for doctors in some outpatient clinics like rheumatology clinics may be suggested. The replacement of physicians with nurses could help address physician shortages and lighten physician workload [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

Measuring efficiency of public hospitals under the impact of Covid-19: the case of Türkiye

Sülkü,

Mortaş,

Küçük

2023

Cost Eff Resour Alloc

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The Covid-19 pandemic has had serious medical, administrative and financial effects on the health system and hospitals around the world. In Türkiye, compared to 2019 realizations, in 2020 and 2021 respectively there were 39% and 21% decrease in the number of outpatient services and 29% and 17% decline in total inpatient services of public hospitals. The main subject of this research is how the pandemic period affects the Turkish public hospitals’ efficiency. We have measured the technical efficiency of outpatient and inpatient care services of Turkish public hospitals using Stochastic Frontier Analysis (SFA). The dataset includes 563 hospitals for the years 2015 through 2021. Inputs of number of physicians, nurses and other medical staff, and number of beds and their interactions with each other are introduced to the SFA models of outputs of outpatient visits and inpatient discharges adjusted with case mix index are derived. Firstly, we found that the years associated with Covid-19 have a significant negative impact on the inpatient service efficiency. Training and Research and City Hospitals have low efficiency scores in outpatient services but high efficiency scores in inpatient services. In addition, the regions with high population rates have positive impact in outpatient efficiency and negative impact in inpatient efficiency. During the pandemic, city hospitals, have received large investments, gained a key role by increasing both the patient load and their efficiency. Future reforms can be guided by taking advantage of the efficiency differences of hospitals in different environmental factors.

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Section: Discussionmentioning

confidence: 99%

Measuring efficiency of public hospitals under the impact of Covid-19: the case of Türkiye

Sülkü,

Mortaş,

Küçük

2023

Cost Eff Resour Alloc

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“…Building rapport and trust remotely can be challenging, emphasizing the need for effective communication strategies. nurse practitioners, are facilitating the implementation of nurse-led interventions including nurse-led telehealth, that involve patients and their families/carers in managing their health conditions (Bulter et al, 2020).…”

Section: Challeng E S and Cons Ider Ationsmentioning

confidence: 99%

“…Nurse scope of practice in nurse‐led interventions covers healthcare activities initiated and implemented by nurses, often without direct physician overseeing, to promote patient well‐being and optimize patient outcomes. Emerging nurse‐led models of care, coordinated primarily by registered nurses, advanced practice nurses, and/or nurse practitioners, are facilitating the implementation of nurse‐led interventions including nurse‐led telehealth, that involve patients and their families/carers in managing their health conditions (Bulter et al., 2020).…”

Section: Challenges and Considerationsmentioning

confidence: 99%

The role of nurse‐led telehealth interventions in bridging healthcare gaps and expanding access

Bulto

2024

Nursing Open

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Roles of nurse‐surgeons in global surgical care: A scoping review

Grota,

Betihavas,

Burston

et al. 2023

Journal of Advanced Nursing

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AimTo identify the roles of nurse‐surgeons in the provision of surgical care.DesignScoping review.MethodsThis scoping review adhered to the JBI guideline for scoping reviews and EQUATOR Network's PRISMA‐ScR checklist. Searches were performed from May 2022 to July 2022 using a combination of MeSH headings, keywords and filters via database and hand searching based on the eligibility criteria. Keywords included nurse‐surgeon, nurse endoscopist, nurse hysteroscopist and nurse cystoscopist. Data sources were CINAHL, Cochrane, Google Scholar, PubMed and Scopus. Descriptive analysis was used to report the findings.ResultsNinety‐six included records indicated nurse‐surgeon practice in 26 countries. Forty‐one nurse‐surgeon titles were found, the majority of which were types of nurse practitioner. A total of 5,684,198 surgeries were performed by nurse‐surgeons varying from laparotomies to biopsies. Nine records reported that nurse‐surgeons perform surgeries safely and on par with physicians with zero to minimal complications. Nineteen records reported improved surgical care efficiency by nurse‐surgeons in terms of patient access to surgery, waiting times, surgery times, patient show rates, patient education, physician workload and junior physicians' training. Seven records reported high patient satisfaction. Nurse‐surgeons were cost‐effective according to five records. Thirteen records recommended the standardization of nurse‐surgeon practice.ConclusionNurse‐surgeons performed millions of surgeries worldwide assisting in easing the global surgical burden. This review identified the roles and benefits nurse‐surgeons play in global surgical care. Research gaps on nurse‐surgeon roles were discovered including the ambiguity in nurse‐surgeon titles and the need to regulate nurse‐surgeon practice.ImpactThis research addressed the clinical safety, quality, contribution to timely surgical access and cost efficiency of nurse‐surgeon performed surgeries, as well as the need to standardize nurse‐surgeon practice and use a more consistent nurse‐surgeon title to ensure role identification and monitoring.

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Substitution of nurses for physicians in the hospital setting for patient, process of care, and economic outcomes

Cited by 3 publications

References 59 publications

Measuring efficiency of public hospitals under the impact of Covid-19: the case of Türkiye

Measuring efficiency of public hospitals under the impact of Covid-19: the case of Türkiye

The role of nurse‐led telehealth interventions in bridging healthcare gaps and expanding access

Roles of nurse‐surgeons in global surgical care: A scoping review

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