Nurses can safely deliver many services traditionally performed by doctors, with little to no difference in deaths, safety events, or how patients felt about their health, according to a new review, appearing in the Cochrane Database of Systematic Reviews. In some cases, nurse-led care even outperformed doctor-led care.

Health care services are facing pressure due to an aging population, complex health needs, long waiting lists, and doctor shortages. Receiving care from nurses, rather than doctors, has been proposed as one way to improve access to hospital services for patients who may otherwise face long waits.

A group of researchers from Ireland, United Kingdom, and Australia evaluated nurse-doctor substitution in inpatient units and outpatient clinics, analyzing 82 randomized studies involving over 28,000 patients across 20 countries.

Studies included advanced nurse practitioners, clinical nurse specialists and registered nurses substituting for junior or senior doctors across specialties such as cardiology, diabetes, cancer, obstetrics/gynecology, and rheumatology.

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