Empowered nurse providing pediatric care in a supportive community.

Rethinking Child Healthcare: How Nurses Can Lead the Way to a Healthier Future

Avery Sinclair in Health & Wellness June 2025 • 5 min read.

"Explore how task delegation to nurses in preventive child healthcare can improve efficiency, accessibility, and outcomes for children and families."

The healthcare landscape is constantly evolving, requiring innovative solutions to meet the changing needs of families and children. Traditional models of child healthcare, often heavily reliant on doctors, may not always be the most efficient or accessible. In the Netherlands, a growing need for more flexible and tailored child healthcare services has sparked interest in task delegation – entrusting trained nurses with greater responsibilities in preventive care.

Task delegation involves transferring specific tasks from a higher-ranking professional (like a doctor) to a lower-ranking one (like a nurse), with appropriate training and support. This approach has the potential to address several key challenges in child healthcare, including a shortage of doctors, increasing demands for psychosocial support, and the need for more integrated care within community settings. By empowering nurses to take on more responsibility, healthcare systems can optimize resources and improve the overall quality of care.

This article explores the findings of a controlled before-after study conducted in the Netherlands, examining the feasibility and impact of doctor-nurse task delegation in preventive child healthcare. The study investigates the effects of this approach on nurse competence, the percentage of children assigned to nurse-led care, changes in abnormal findings and referrals, and the experiences of both healthcare professionals and parents.

Empowering Nurses: A Closer Look at Task Delegation in Child Healthcare

Empowered nurse providing pediatric care in a supportive community.

The study compared two experiment teams, where nurses were trained to conduct regular check-ups on healthy children aged 2 months to 4 years, with two control teams following the traditional doctor-led model. Abnormal findings identified by nurses were discussed with the attending doctor, ensuring a collaborative approach to care. The study assessed the impact of task delegation from multiple angles:

Nurses in the experiment teams underwent specialized training to equip them with the necessary skills for conducting regular check-ups, including screening for developmental issues, vision and hearing problems, heart conditions, and hip dysplasia. Their competence levels were measured using questionnaires before, during, and after the training period.

Nursing Competencies: Questionnaires assessed changes in both general nursing skills and newly acquired skills in physical examination.
Assignment Rates: The percentage of children assigned to the nurse-led schedule was tracked to determine the feasibility of implementing this model.
Screening Results: Data on screening outcomes for various health indicators (eyes, heart, hips, growth, and development) were extracted from electronic health records to compare the detection rates of abnormal findings and referrals between the experiment and control teams.
Experiences and Perceptions: Focus group interviews were conducted with healthcare professionals (doctors, nurses, and administrative staff) and parents to gather qualitative data on their experiences with task delegation.

The findings of the study revealed several key insights into the feasibility and impact of doctor-nurse task delegation. One of the most significant outcomes was the improvement in medical screening skills among nurses in the experiment regions. This suggests that targeted training can effectively equip nurses with the expertise to perform routine check-ups and identify potential health concerns in young children. Approximately 69% of all children in the experiment group were assigned to the nurse-led schedule, demonstrating the potential for this model to be widely implemented. There were no significant differences in the change of abnormal findings or referrals in the experiment teams compared to the control teams, except for hips, the interviews showed that both doctors and nurses thought positively of the new working method, yet made some recommendations for improvements. Parents felt well-informed and experienced an equal level of proficiency but less continuity in person.

A Promising Path Forward: Embracing Nurse-Led Care in Child Healthcare

This study provides compelling evidence that task delegation from doctors to nurses in preventive child healthcare is a feasible and promising approach. By investing in the training and empowerment of nurses, healthcare systems can improve efficiency, increase access to care, and enhance the overall quality of services for children and families. However, it's crucial to carefully manage the implementation process, ensuring that healthcare professionals are fully engaged and supported. Further research is needed to explore the long-term effectiveness and cost-efficiency of this model, as well as to address any potential challenges or unintended consequences. By embracing innovative approaches like task delegation, we can build a more resilient and responsive child healthcare system that meets the evolving needs of our communities.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0139187, Alternate LINK

Title: Feasibility And Impact Of Doctor-Nurse Task Delegation In Preventive Child Health Care In The Netherlands, A Controlled Before-After Study

Subject: Multidisciplinary

Journal: PLOS ONE

Publisher: Public Library of Science (PLoS)

Authors: S. Janine Benjamins, Maurice L. W. Damen, Henk F. Van Stel

Published: 2015-10-14

Everything You Need To Know

What is task delegation in the context of child healthcare, and why is it being considered?

Task delegation in child healthcare involves transferring specific duties from a higher-ranking healthcare professional, such as a doctor, to a lower-ranking one, such as a nurse. This shift requires appropriate training and support for the nurse. Task delegation is being considered to address challenges such as a shortage of doctors, the increasing need for psychosocial support, and the demand for more integrated care within community settings. By empowering nurses, healthcare systems can optimize resources and potentially improve the quality of care. This approach aims to create more flexible and tailored child healthcare services.

How was the feasibility and impact of doctor-nurse task delegation assessed in the Netherlands?

A controlled before-after study was conducted in the Netherlands to evaluate the feasibility and impact of doctor-nurse task delegation in preventive child healthcare. Two experiment teams of nurses received specialized training to conduct regular check-ups on healthy children aged 2 months to 4 years. Their performance was compared to two control teams that followed the traditional doctor-led model. Researchers assessed nurse competence, the percentage of children assigned to nurse-led care, changes in abnormal findings and referrals, and the experiences of both healthcare professionals and parents using questionnaires, electronic health records, and focus group interviews.

What specific skills were nurses trained in to effectively perform check-ups, and how was their competence measured?

Nurses in the experiment teams received specialized training to perform routine check-ups, including screening for developmental issues, vision and hearing problems, heart conditions, and hip dysplasia. Nurse competence was measured using questionnaires before, during, and after the training period. These questionnaires assessed both general nursing skills and newly acquired skills in physical examination, providing a comprehensive evaluation of the impact of the training on their abilities to perform assigned tasks effectively.

What were the main findings regarding the implementation of task delegation, specifically in terms of assignment rates, screening results, and the perceptions of healthcare professionals and parents?

The study revealed that approximately 69% of all children in the experiment group were assigned to the nurse-led schedule, demonstrating the potential for wide implementation. There were no significant differences in the change of abnormal findings or referrals in the experiment teams compared to the control teams, except for hips. Healthcare professionals, including doctors and nurses, generally viewed the new working method positively, although they made recommendations for improvements. Parents reported feeling well-informed and experienced an equal level of proficiency, but noted less continuity in person.

What are the potential long-term implications of embracing nurse-led care in child healthcare, and what further research is needed?

Embracing nurse-led care through task delegation has the potential to improve efficiency, increase access to care, and enhance the overall quality of services for children and families. However, careful management of the implementation process is crucial, ensuring full engagement and support for healthcare professionals. Further research is needed to explore the long-term effectiveness and cost-efficiency of this model. Additionally, research should address any potential challenges or unintended consequences that may arise from widespread adoption of task delegation in child healthcare settings. Addressing these aspects will help build a more resilient and responsive child healthcare system.