Reacción a "Substituting physicians for nurses in hospital interventions does not affect patient safety, says review"

The study is based on a robust methodology, as it is a Cochrane systematic review with meta-analysis of clinical trials, developed under international standards such as EPOC/MECIR, with risk of bias assessment and evidence grading using GRADE. Overall, the results indicate that replacing doctors with nurses in hospitals produces small or non-existent differences in mortality and patient safety, and may provide benefits in some areas, such as the management of chronic diseases, physical and psychological function, and certain dermatological problems.

A significant limitation is the high heterogeneity among the studies included, both in terms of patient types and interventions, as well as healthcare systems, training levels, and degrees of professional autonomy. Furthermore, the study focuses exclusively on the hospital setting, so its conclusions cannot be directly extrapolated to primary care. All of this means that the certainty of the evidence is moderate or low in some outcomes and that the results should be interpreted with caution.

In the Spanish context, the study provides conclusions of the highest level of evidence on an ongoing process of professional reorganisation, driven by ageing, chronicity and the high complexity of care. However, the comparison must be made with caution, as in Spain many of the activities analysed, such as patient education, clinical assessment and some forms of prescribing, are part of standard nursing practice. Even so, the results reinforce the need to modernise and make professional boundaries more flexible, as the growing demand for care cannot be met by a model focused exclusively on doctors, and nurses have demonstrated that they have the necessary skills to take on new roles while ensuring quality and safety.