G28 Effective safety netting: an important contribution to avoiding preventable deaths

Abstract

Safety netting has conventionally been used during consultations when clinicians are uncertain about the trajectory of an illness to provide patients with guidance about when and where to re-consult (Roland et al 2013). Recent high profile events involving failure to recognise and appropriately safety net children with sepsis highlights this is a significant issue in healthcare. Aim The aim of the paper is to raise awareness of the importance of quality safety netting information for parents of young children drawing on findings from the ASK SNIFF research programme. Methods 1. Systematic integrative review of interventions designed to support families with an acutely sick child. 2. Qualitative study with 27 parents and 16 first contact health professionals using a grounded theory approach. Results A review of over 7000 articles identified only 22 which examined an intervention educating and advising parents on when to seek medical care. Analysis of these papers showed that interventions which provide information on assessment and management and are endorsed by health care professionals (HCPs) have shown greatest effect. Irrelevant information appears to reduce parent’s trust in the intervention. These findings validated the emerging themes from the qualitative work. Parents of sick children, in the latter, want information pre, during and post consultation with a HCP to inform their own safety netting decisions. Information is not routinely offered during consultations, is inconsistent in content and delivery method and often reported to be verbal only. The extent of safety netting was reported by HCPs to be influenced by parental status, an assumption of individual parent’s knowledge and practical factors such as working printers. Both groups want safety netting tools to improve consistency and quality of information available for parents with a sick child. Conclusion Safety netting information is essential for parents to know when to consult with a sick child. Absent or incomplete safety netting leaves parents to search elsewhere and with responsibility for assessing the reliability of information. Incomplete, inconsistent information may mislead and at best lead to increased consultations and at worst to delay and avoidable morbidity and mortality.