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Towards an international consensus on safety netting advice for acutely ill children presenting to ambulatory care: a
Ruben Burvenich1,2, Stefan Heytens2, An De Sutter2
1Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium ruben.burvenich@kuleuven.be.
Insights
Safety netting advice (SNA) for parents of acutely ill children should include expected illness course, alarm signs, and help-seeking information. This advice should be delivered verbally and in writing by healthcare professionals or digital platforms, empowering parents.
Area of Science:
- Pediatric Emergency Medicine
- Health Communication
- Patient Safety
Background:
- Effective safety netting advice (SNA) is crucial for parents managing acutely ill children at home.
- Current SNA practices vary, leading to potential inconsistencies in parental understanding and care-seeking behavior.
- A consensus on optimal SNA content and delivery is needed to improve pediatric care outcomes.
Purpose of the Study:
- To establish a consensus on the essential content and preferred format of safety netting advice (SNA) for parents of acutely ill children.
- To guide healthcare professionals in providing clear, actionable, and empowering advice to parents.
- To enhance the safety and effectiveness of pediatric ambulatory care.
Main Methods:
- A modified e-Delphi methodology involving four rounds of online questionnaires and feedback.
- Inclusion of 41 clinical and research experts (physicians, general practitioners, nurses, pediatricians) from 13 countries.
- Focus on ambulatory care settings within high-income countries.
Main Results:
- Content consensus: SNA must cover expected illness course, diagnostic uncertainty, critical alarm signs, and access to medical help.
- Form consensus: SNA should be delivered verbally with written/digital resources by a trusted source at every encounter.
- Delivery should be concise, empowering, child-specific, and include feedback confirmation from parents.
Conclusions:
- Safety netting advice for acutely ill children requires comprehensive content on illness trajectory and warning signs.
- Verbal and written/digital delivery by healthcare professionals or reliable platforms is recommended for optimal parental understanding.
- Future research should assess SNA effectiveness, co-produced resources, and provider training needs.
Objective:
Develop a consensus on the content and form of safety netting advice (SNA) for parents of acutely ill children.
Design:
Four-round modified e-Delphi using online questionnaires and feedback among clinical and research experts.
Setting:
Ambulatory care in high-income countries.
Participants:
Forty-one experts from 13 countries: 3 emergency physicians, 15 general practitioners, 4 nurses and 19 paediatricians.
Results:
The experts defined the content of SNA as advice on the normal, expected disease course of the provisional diagnosis, diagnostic uncertainty, alarm signs that indicate the need for medical help and information on where and how to find such help. Regarding the form of the SNA, the experts agree that a reliable source should give SNA verbally with paper or digital written or video/image resources at every appropriate healthcare encounter in a short and simple empowering fashion, specific to the child's situation and seek confirmatory feedback from parents.
Conclusions:
SNA needs to contain advice on the expected disease course, alarm signs and where and how to find help. It should be given verbally with written resources by a reliable healthcare professional or digital platform. Short, simple and specific, SNA needs to empower the parent whose understanding of the advice should be checked. The effectiveness of SNA resources coproduced by parents and experts should be assessed in different settings and those providing SNA require up-to-date and reliable training.
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