Barriers and facilitators to the implementation of doctor‐nurse substitution strategies in primary care

22 April, 2019

This new Cochrane systematic review concludes: 'Patients, doctors and nurses may accept the use of nurses to deliver services that are usually delivered by doctors. But this is likely to depend on the type of services. Nurses taking on extra tasks want respect and collaboration from doctors; as well as proper resources; good referral systems; experienced leaders; clear roles; and adequate incentives, training and supervision. However, these needs are not always met.'

CITATION: Karimi Shahanjarini A, Shakibazadeh E, Rashidian A, Hajimiri K, Glenton C, Noyes J, Lewin S, Laurant M, Colvin CJ. Barriers and facilitators to the implementation of doctor‐nurse substitution strategies in primary care: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2019, Issue 4. Art. No.: CD010412. DOI: 10.1002/14651858.CD010412.pub2.

The review included 66 studies (69 papers), 11 from low- or middle-income countries and 55 from high-income countries.

The full text is restricted-access but there is a comprehensive abstract and plain language summary available here:

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010412.pub2/...

It would be interesting to see a comparative sub-analysis of papers from high-income and low/middle-income countries, but the abstract does not mention whether this was done.

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org