Journal article on safety netting
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Questions and Answers

What is the estimated percentage of consultations in primary care that may lead to harm?

  • 0.5%
  • 3%
  • 2% (correct)
  • 1%

    • Who formally introduced the concept of safety netting nearly 30 years ago?

  • Cancer Research UK (CRUK)
  • Roger Neighbour (correct)
  • Macmillan Cancer Support
  • National Institute for Health and Care Excellence (NICE)

    • Which organization issued safety-netting guidelines for early diagnosis of cancer and in consultations with children?

  • Macmillan Cancer Support
  • Royal College of Paediatrics and Child Health (correct)
  • Cancer Research UK (CRUK)
  • National Institute for Health and Care Excellence (NICE)

    • What are the three questions that Roger Neighbour defined as part of the safety netting process?

    <p>What do I expect to happen, how will I know if I am wrong, what would I do then</p> Signup and view all the answers

    What was the total number of articles retrieved in the review?

    <p>9949 articles</p> Signup and view all the answers

    Where were the studies included in the review conducted?

    <p>UK, Australia, Belgium, the Netherlands, Sri Lanka, and the US</p> Signup and view all the answers

    What types of settings were primarily discussed in the included articles?

    <p>Primary care, emergency departments, or out-of-hours settings</p> Signup and view all the answers

    What was the most common classification of the included citations?

    <p>Expert opinion</p> Signup and view all the answers

    How many citations offered a definition of safety netting?

    <p>30 citations</p> Signup and view all the answers

    What was highlighted as an essential part of safety netting in the definitions provided?

    <p>Review and act on results of investigations</p> Signup and view all the answers

    When was safety netting recommended to be used?

    <p>In cases of diagnostic uncertainty and when managing children, older patients, those with multimorbidity, or mental health problems</p> Signup and view all the answers

    In what cases was the use of safety netting emphasized?

    <p>When patients may have risk factors for specific diseases or complications</p> Signup and view all the answers

    What methods were utilized in developing the model of safety netting in the review?

    <p>Narrative synthesis, tabulation, grouping, idea webbing, and conceptual mapping</p> Signup and view all the answers

    How many citations provided advice on when safety netting should be used?

    <p>24 citations</p> Signup and view all the answers

    What was highlighted as a reason for recommending safety netting?

    <p>The differential diagnosis includes serious illness or illness that may progress rapidly</p> Signup and view all the answers

    What was the proposed definition of safety netting based on?

    <p>Evidence from the review</p> Signup and view all the answers

    What is the primary focus of safety netting according to the review?

    <p>Managing uncertainty in consultations</p> Signup and view all the answers

    What is listed as one technique in a group of cognitive factors that may help practitioners manage uncertainty?

    <p>Safety netting</p> Signup and view all the answers

    What is an important consideration regarding the significance of safety netting?

    <p>Its significance for patients and carers</p> Signup and view all the answers

    What is needed to understand what patients understand and want from safety-netting advice?

    <p>More research</p> Signup and view all the answers

    What was the focus of the review in terms of age groups and settings?

    <p>Safety netting in all age groups and settings</p> Signup and view all the answers

    What is a limitation of the study mentioned in the text?

    <p>Difficulty in compiling a comprehensive search strategy</p> Signup and view all the answers

    What type of citations comprised over half of the included citations?

    <p>'Expert opinion'</p> Signup and view all the answers

    What has little research sought to define and assess before this review?

    <p>Safety netting</p> Signup and view all the answers

    What has safety netting moved away from to a variety of actions in different settings undertaken by different members of the healthcare team?

    <p>Simple advice at the end of a consultation</p> Signup and view all the answers

    What is the most compelling finding of this review according to the text?

    <p>Lack of empirical research on safety netting and its components</p> Signup and view all the answers

    What is needed to evaluate the effectiveness of safety netting, according to the text?

    <p>Further research</p> Signup and view all the answers

    What aspect of safety netting is included dealing with according to the text?

    <p>Dealing with uncertainty in management</p> Signup and view all the answers

    What is the most recommended component of safety-netting advice?

    <p>Communicating uncertainty</p> Signup and view all the answers

    What is a distinct element of planned follow-up in safety netting?

    <p>Review in a similar setting</p> Signup and view all the answers

    What does safety netting around investigations include?

    <p>Explaining the purpose of tests and ensuring patients can follow up on their results</p> Signup and view all the answers

    What are the organizational components of safety netting?

    <p>Documenting advice in patient's notes and ensuring abnormal results are dealt with</p> Signup and view all the answers

    What is recommended for careful documentation in safety-netting?

    <p>Written safety-netting instructions and careful documentation in the medical notes</p> Signup and view all the answers

    When has safety netting been described as an essential component of the consultation?

    <p>Since 1987</p> Signup and view all the answers

    What does safety netting include managing?

    <p>Uncertainty</p> Signup and view all the answers

    What is the most recognizable part of safety netting?

    <p>Managing uncertainty</p> Signup and view all the answers

    What is a distinct element of planned follow-up in safety netting?

    <p>Review in a similar setting</p> Signup and view all the answers

    What is recommended for careful documentation in safety-netting?

    <p>Written safety-netting instructions and careful documentation in the medical notes</p> Signup and view all the answers

    What are the organizational components of safety netting?

    <p>Documenting advice in patient's notes and ensuring abnormal results are dealt with</p> Signup and view all the answers

    What does safety netting around investigations include?

    <p>Explaining the purpose of tests and ensuring patients can follow up on their results</p> Signup and view all the answers

    What was the focus of the literature review?

    <p>Collating evidence on safety netting for all patients</p> Signup and view all the answers

    What is safety netting primarily recommended for in national guidelines?

    <p>For communicating uncertainty within a consultation</p> Signup and view all the answers

    What does safety netting advice include?

    <p>Specific information on seeking help</p> Signup and view all the answers

    What is emphasized as an essential part of safety netting in the definitions provided?

    <p>The communication of uncertainty</p> Signup and view all the answers

    What is safety netting defined as in the review?

    <p>A consultation technique to communicate uncertainty</p> Signup and view all the answers

    What is the estimated percentage of consultations in primary care that may lead to harm?

    <p>Between 5-10%</p> Signup and view all the answers

    What is the primary focus of safety netting according to the review?

    <p>To communicate uncertainty and provide patient information</p> Signup and view all the answers

    What is a limitation of the study mentioned in the text?

    <p>The exclusion of non-English articles</p> Signup and view all the answers

    What are the components of safety netting advice?

    <p>Plans for timely re-assessment</p> Signup and view all the answers

    What was the proposed definition of safety netting based on?

    <p>The Bankhead et al recommendations</p> Signup and view all the answers

    What are the organizational components of safety netting?

    <p>Follow-up and administrative aspects</p> Signup and view all the answers

    What is needed to evaluate the effectiveness of safety netting, according to the text?

    <p>An understanding of what patients understand and want from safety-netting advice</p> Signup and view all the answers

    Study Notes

    Safety Netting in Healthcare: Components and Recommendations

    • Safety netting is recommended at every healthcare professional-patient contact, especially in acute settings like ED and OOH centers.
    • Two-thirds of the reviewed articles (n = 38) provided suggestions for safety-netting advice components.
    • The most recommended components of safety-netting advice were communicating uncertainty, advice on worrying symptoms and red flags, likely time course of illness, seeking further medical care, arranging planned follow-up, primary care investigations, and organizational components.
    • Planned follow-up is a distinct element of safety netting, involving a review in a similar setting, often with the same healthcare professional.
    • Safety netting around investigations includes explaining the purpose of tests, how they are undertaken, and ensuring patients can follow up on their results.
    • Organizational components of safety netting include documenting advice in patient's notes, ensuring abnormal results are dealt with, and updating patients' contact details.
    • Written safety-netting instructions and careful documentation in the medical notes are recommended by several articles.
    • Safety netting has been described as an essential component of the consultation since 1987 and is advocated by national guidelines.
    • Despite variations in settings and patient groups, the definitions and component parts of safety netting seem to be largely universal.
    • Safety netting includes managing uncertainty, advice on red-flag symptoms, likely time course of the illness, accessing further medical care, follow-up, and managing investigations.
    • The most recognizable part of safety netting is managing uncertainty, which may now include prognostic and management uncertainty.
    • Funding for the review was provided by the National Institute for Health Research (NIHR) Academic Clinical Fellowship (ACF), and no specific funding was attached to the review. Ethical approval was not required.

    Defining and Implementing Safety Netting in Primary Care

    • Safety netting is part of Neighbour's consultation model and the Calgary-Cambridge model, included in the section "closing the session".
    • Bankhead et al were among the first to provide recommendations for safety netting in primary care, focusing on the components related to cancer diagnosis and suggesting it may be more than a consultation technique.
    • The review aimed to collate evidence on safety netting for all patients, including defining safety netting, when it is required, and the information it should contain.
    • The literature review focused on exploring varying definitions and content of safety netting, using a narrative synthesis approach and the ENTREQ checklist for reporting qualitative research synthesis.
    • Safety netting is widely recommended in national guidelines, but there is no consensus on when it should be used and what advice or actions it should contain.
    • The review included 47 studies and defined safety netting as a consultation technique to communicate uncertainty and provide patient information on red-flag symptoms, with plans for timely re-assessment and follow-up of investigations and hospital referrals.
    • Safety netting advice may include information on the natural history of the illness, advice on worrying symptoms, and specific information on seeking help, particularly important for children, the acutely unwell, patients with multimorbidity, and those with mental health problems.
    • Safety netting is more than the communication of uncertainty within a consultation; it should include plans for follow-up and administrative aspects such as communication of test results and management of hospital letters.
    • The concept of safety netting is relatively imprecise and can be used in different patient groups and settings, with different actions.
    • The literature review used broad inclusion criteria, focusing on patients, carers, or healthcare professionals, and included English-language articles using any research design.
    • The review aimed to provide conceptual clarity and propose a common approach to safety netting in primary care, emphasizing its importance as best practice for patient safety.
    • The study conducted an extensive electronic database and grey-literature search, using search terms around the theme of safety netting and including citation searches of all included articles.

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    Description

    Test your knowledge of safety netting in healthcare with this quiz. Explore the components and recommendations for safety-netting advice, its role in primary care, and its importance in patient safety. Dive into the definitions, varying content, and best practices in implementing safety netting.

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