A new study has found that Spanish nurses trained specifically to resolve acute health problems of low complexity provide care of comparable quality to that of general practitioners. Published early online in the Journal of Advanced Nursing, the findings suggest that nurses may be able to take on some of the care generally provided by physicians.
Mireia Fàbregas, MD, of the Institut Català de la Salut, in Barcelona, Spain, and her colleagues randomized 1461 adult patients who requested same day appointments to see either nurses trained to respond to problems with low complexity or to see general practitioners. The study was conducted in 38 general practices in Catalonia, Spain, and 142 general practitioners and 155 nurses participated. The investigators measured how well patients' symptoms resolved and how satisfied patients were two weeks after the visit.
The investigators found that nurses successfully solved 86.3% of the cases. The health problem that nurses solved with greatest ease was burns, followed by injuries and acute diarrhea. Nurses were less successful at resolving low back pain, acute mild upper respiratory symptoms, and urinary discomfort. "This lower resolution could be explained by the fact that these problems require more complex physical examinations that are not usual in a nurse's daily work," said Dr. Fàbregas. Patients who saw nurses were equally satisfied with their visit as those who saw doctors. When patients were asked about their preferences regarding which professional they would like to visit if a similar health problem arose again, more than 40% of patients in each group expressed indifference.
"This study could help to reduce resistance to change in both physicians and nurses, as well as in the general population, generating confidence in the care provided by nurses," said Dr. Fàbregas. She and her co-authors noted that having nurses solve acute diseases of low complexity could help improve overall health care efficiency.
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"A randomised controlled trial of nurses versus doctors in the resolution of acute disease of low complexity in primary care." Begoña Iglesias, MD, Francisca Ramos, MD, Beatriz Serrano, MD, Mireia Fabregas, MD, Carmen Sanchez, BSc, RN, Maria Jose Garcia MD, Helia Marta Cebrian, BSc, RN, Rosa Aragones, MD, Josep Casajuana, MD, Neus Esgueva, BSc, RN. Journal of Advanced Nursing; Published Online: March 21, 2013 (DOI: 10.1111/jan.12120).