The effect of physician-nurse substitution in primary care in chronic diseases: a systematic review

Martínez-González, Nahara Anani; Rosemann, Thomas; Tandjung, Ryan; Djalali, Sima

doi:10.4414/smw.2015.14031

Cited by 40 publications

(55 citation statements)

References 52 publications

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“…But unlike in many other countries where roles and activities are largely determined by nurses’ professional education level and practice competence (Fealy et al, ), all nurses, regardless of what education they have, are qualified to perform all the routine tasks as long as they pass the National Nurse Qualification Examination (NNQE) (Wong & Zhao, ). This policy represents a significant opportunity cost in nursing care in community settings, as nurses with advanced education can provide high‐quality care, even physician‐comparable care, for a range of acute and chronic illnesses in the primary care setting (Martínez‐González, Rosemann, Tandjung, & Djalali, ), but graduates are less willing to work in primary care settings because of the low salary and social status (Zhang et al, ). Indeed, 89.7% of our community nurses reported monthly incomes lower than the average level for nurses of all types in Sichuan province in 2014.…”

Section: Discussionmentioning

confidence: 99%

Roles and activities of community nurses in China: A descriptive study

Xian-dong

Wei

et al. 2018

J Nurs Manag

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Aims To collect information about the current status of community nurses in China and explore the roles and activities that they perform in their daily community setting. Background Community health services are central to efforts to improve public health in China. Clarifying who performs which community nursing services can help assess the contributions of community nursing and guide future practices. However, specific information is limited in China. Methods A descriptive, cross‐sectional survey was conducted from March to November 2014. Information was collected on demographics, work roles, and activities of community nurses. Results Most community nurses in our survey were young with a low educational level. Their daily routine most frequently involved immunization and basic medical services, while their main roles were caregiver, educator, organiser and manager. Conclusion Although community nurses cover nearly all areas of service that the national government requires, some roles and their associated activities are neglected. The quantity and quality of community nurses may be hindering their ability to fulfill all roles and activities envisioned by the national government. Implications for Nursing Management Further training should be provided to increase the ability of community nurses to perform frequent functions as well as activities that are currently neglected.

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Section: Discussionmentioning

confidence: 99%

Roles and activities of community nurses in China: A descriptive study

Xian-dong

Wei

et al. 2018

J Nurs Manag

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“…Nurse-provided care showed equivalent or better quality of care across a large range of clinical outcome measures (Martinez-Gonzalez et al, 2014a, Martinez-Gonzalez et al, 2014b, Martinez-Gonzalez et al, 2015b, Tsiachristas et al, 2015. The trials were primarily conducted among patients with chronic conditions or undifferentiated illnesses in various care settings.…”

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confidence: 99%

“…However, additional sub-group analyses of care models showed a differentiated picture: Lower mortality was found in on-going care and longer-term follow up care (defined as more than 12 months) but not in single visits and shorter follow-up periods (defined as less than 12 months). The reasons for lower mortality in the nurse-led care models have not been sufficiently explored, but hypotheses suggest that this may be related to generally stricter adherence to protocols and guidelines by nurses, more information provided to patients on the disease and selfmanagement, longer time taken for consultations or more return consultations, and increased efforts on secondary prevention, among other factors (Martinez-Gonzalez et al, 2015b, Tsiachristas et al, 2015. Further research is required to analyse the impact of greater nurse involvement on mortality in different care models and their underlying reasons.…”

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confidence: 99%

Nurses in advanced roles in primary care

2017

OECD Health Working Papers

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“…6 There have been studies examining the effect of role substitution, where nurses take on tasks previously carried out by doctors, in particular in primary and community care 1617 However, advanced non-medical practitioners are not intended to function simply as cost-effective substitutes for doctors.…”

Section: Methods and Analysismentioning

confidence: 99%

Impact of advanced autonomous non-medical practitioners in emergency care: protocol for a scoping study

et al. 2017

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IntroductionEmergency care services are looking for new models of care delivery to deal with changing patient demographics and increased pressures. It has been suggested that advanced non-medical practitioners might be valuable for delivering such new models of care. However, it is not clear what the impact of the deployment of advanced non-medical practitioners in emergency care is. This scoping study addresses the following research question: What is known from the literature about the different types of impact of the deployment of advanced (autonomous) non-medical practitioners in emergency care?Methods and analysisA scoping study will be undertaken to examine and map the impact of the deployment of advanced non-medical practitioners in emergency care. The scoping study follows the methodology proposed by Arksey and O'Malley. Searches will be carried out on databases of peer-reviewed literature and other sources to systematically identify and characterise the literature. Papers will be screened using a 2-stage process to identify the most relevant literature. Papers will be screened by title and abstract, followed by full-text review. Data abstraction and synthesis will be performed using a narrative thematic analysis.Ethics and disseminationWe will communicate the findings to Health Education England, NHS Improvement and the Royal College of Emergency Medicine through existing links provided by members of the project team. We anticipate that the findings will also be of interest to other similar organisations internationally. By identifying gaps in the research literature, we anticipate that the study will generate recommendations for informing future high-quality research studies about the impact of advanced non-medical practitioners in emergency care as well as in other settings. The research findings will be submitted for publication to relevant peer-reviewed journals as well as professional magazines. The scoping study uses only previously published material, and does not require ethical review.

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The effect of physician-nurse substitution in primary care in chronic diseases: a systematic review

Cited by 40 publications

References 52 publications

Roles and activities of community nurses in China: A descriptive study

Roles and activities of community nurses in China: A descriptive study

Nurses in advanced roles in primary care

Impact of advanced autonomous non-medical practitioners in emergency care: protocol for a scoping study

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