Read on Twitter
Saw some information on safety-netting recently but couldn't find it- saving this thread for future reference!
#Safetynetting
@neiljlangridge @LaurafinucaneB @mercephysio1 @sue_greenhalgh @AndrewVCuff
https://www.sciencedirect.com/science/article/pii/S2468781220303131?dgcid=coauthor
https://www.researchgate.net/publication/338336567_SAFER_A_mnemonic_to_improve_safety-netting_advice
#Safetynetting
@neiljlangridge @LaurafinucaneB @mercephysio1 @sue_greenhalgh @AndrewVCuff
https://www.sciencedirect.com/science/article/pii/S2468781220303131?dgcid=coauthor
https://www.researchgate.net/publication/338336567_SAFER_A_mnemonic_to_improve_safety-netting_advice
SAFER:
S = What SERIOUS causes and complications do I need to make the patient aware of?
A = What ALTERNATIVE diagnoses do I need to make the patient aware of?
F = What specific FINDINGS do I need to make the patient aware of that would mandate the need for a medical re-Ax?
S = What SERIOUS causes and complications do I need to make the patient aware of?
A = What ALTERNATIVE diagnoses do I need to make the patient aware of?
F = What specific FINDINGS do I need to make the patient aware of that would mandate the need for a medical re-Ax?
SAFER:
E = What EARLY/atypical presentations of serious illnesses do I need to make the patient aware of?
R = What RED FLAG symptoms and signs do I need to make the patient aware of?
E = What EARLY/atypical presentations of serious illnesses do I need to make the patient aware of?
R = What RED FLAG symptoms and signs do I need to make the patient aware of?
Nice video from our GP colleagues + clinical reasoning + use of clinical systems to aid this.
Documented actions/concerns with specific followup actions.
Safetynet cues + active monitoring
Documented actions/concerns with specific followup actions.
Safetynet cues + active monitoring
Principal features of safety netting include:
• Providing information for patients
• Empower patients to recognise Red Flags and seek timely and appropriate health care
• Advice on how and where to seek help if Red Flags develop
• Likely natural Hx and time scale of illness
• Providing information for patients
• Empower patients to recognise Red Flags and seek timely and appropriate health care
• Advice on how and where to seek help if Red Flags develop
• Likely natural Hx and time scale of illness
If patient 'reticent to ‘bother’ the clinician' SN should include plans for follow-up as well as important administrative aspects, such as the communication of test results and management of hospital letters. (Jones et al 2019)
Important during COVID https://bjgp.org/content/69/678/e70.abstract
Important during COVID https://bjgp.org/content/69/678/e70.abstract
Fails to improve/changes. Specific vs general safety-netting in primary care
via @BJGPjournal @capcbristol
-Rare to provide written advice
-specific (specific new symptoms+sign/set time period/action)
-generic (gets worse/persist/unwell/concerns vs no time period).
- Return location advice
-<50% documentation even when given
(some limitations in study)
RE Watchful Wait (mini learning point)
'Symptoms resolve or become more florid'
Florid definition: fully developed : manifesting a complete and typical clinical syndrome
CC @_lewadam
'Symptoms resolve or become more florid'
Florid definition: fully developed : manifesting a complete and typical clinical syndrome
CC @_lewadam
#TherapyLive webinar by @CombatSportPhys via @TPMPodcast / @LearningwithTLC facilitated by @thomas_jesson
HT: @_lewadam
Managing risk, levels of concern and index of suspicions
'What's your Patter' clear language
https://doi.org/10.2519/jospt.2020.9971
https://www.therapistlearning.com/
HT: @_lewadam
Managing risk, levels of concern and index of suspicions
'What's your Patter' clear language
https://doi.org/10.2519/jospt.2020.9971
https://www.therapistlearning.com/
Further CES papers/info
@NHSGIRFT https://gettingitrightfirsttime.co.uk/wp-content/uploads/2019/01/Spinal-Services-Report-Mar19-L1.pdf
'white flags' https://www.tandfonline.com/doi/full/10.1080/02688697.2017.1297364
'shades of grey'
https://www.csp.org.uk/system/files/cauda_equina_syndrome_-_multi_shades_of_grey_-_susan_greenhalgh_christopher_mercer_and_laura_finucane.pdf
Video:
Safety-netting Card CES: https://www.ifompt.org/site/ifompt/English.pdf
@NHSGIRFT https://gettingitrightfirsttime.co.uk/wp-content/uploads/2019/01/Spinal-Services-Report-Mar19-L1.pdf
'white flags' https://www.tandfonline.com/doi/full/10.1080/02688697.2017.1297364
'shades of grey'
https://www.csp.org.uk/system/files/cauda_equina_syndrome_-_multi_shades_of_grey_-_susan_greenhalgh_christopher_mercer_and_laura_finucane.pdf
Video:
Safety-netting Card CES: https://www.ifompt.org/site/ifompt/English.pdf
CES podcasts:
https://twitter.com/PhysioMACP/status/1184855948541726722?s=20
https://chewshealth.co.uk/session-65-cauda-equina-syndrome-with-chris-mercer/
https://twitter.com/PhysioMACP/status/1184855948541726722?s=20
https://chewshealth.co.uk/session-65-cauda-equina-syndrome-with-chris-mercer/
Previous similar discussion
HT @k8purcellphysio https://twitter.com/k8purcellphysio/status/1199759229336326145?s=20
HT @PhilCharlesBar
https://ep.bmj.com/content/99/2/48
HT @k8purcellphysio https://twitter.com/k8purcellphysio/status/1199759229336326145?s=20
HT @PhilCharlesBar
https://ep.bmj.com/content/99/2/48
5Cs
-Capable to check the criteria that determine need for medical reAx/review
-Competent assess/monitor themselves
-Comply with advice- practically/logistically
-Comprehend advice/instructions
-Confirmed pt fully understood + significance https://www.researchgate.net/publication/263651691_Effective_Safety-Netting_In_Prescribing_Practice/link/0f31753b69a208fbe3000000/download
-Capable to check the criteria that determine need for medical reAx/review
-Competent assess/monitor themselves
-Comply with advice- practically/logistically
-Comprehend advice/instructions
-Confirmed pt fully understood + significance https://www.researchgate.net/publication/263651691_Effective_Safety-Netting_In_Prescribing_Practice/link/0f31753b69a208fbe3000000/download
Example of clear Safety-Netting advice sheet via @NICEComms
What to expect, what to look out for and what to do/how quickly to do it?
https://www.nice.org.uk/guidance/cg176/resources/head-injury-suggested-written-discharge-advice-pdf-191717245
What to expect, what to look out for and what to do/how quickly to do it?
https://www.nice.org.uk/guidance/cg176/resources/head-injury-suggested-written-discharge-advice-pdf-191717245
@taylorstoronto @RandevPawan @GatewayC_ @cancerressearchuk @CRUKHCPs
"explored safety netting patients with suspected cancer and the particular challenges posed by COVID-19"
HT @ChrisMartey
"explored safety netting patients with suspected cancer and the particular challenges posed by COVID-19"
HT @ChrisMartey
Some great further resources and links from @CRUKHCPs
https://www.cancerresearchuk.org/health-professional/diagnosis/suspected-cancer-referral-best-practice/safety-netting#Safety_netting1
https://www.cancerresearchuk.org/health-professional/diagnosis/suspected-cancer-referral-best-practice/safety-netting#Safety_netting1
