How do general practitioners use safety netting in acutely ill children?
Bertheloot K., Deraeve P., Vermandere M., Aertgeerts B., Lemiengre M., De Sutter A., Buntinx F., Verbakel JY.
© 2015 Taylor & Francis.Background: Safety netting advice allows general practitioners (GPs) to cope with diagnostic uncertainty in primary care. It informs patients on red flag features and when and how to seek further help. There is, however, insufficient evidence to support useful choices regarding safety netting procedures.Objectives: To explore how GPs apply safety netting in acutely ill children in Flanders.Methods: We designed a qualitative study consisting of semi-structured interviews with 37 GPs across Flanders. Two researchers performed qualitative analysis based on grounded theory components.Results: Although unfamiliar with the term, GPs perform safety netting in every acutely ill child, guided by their intuition without the use of specific guidelines. They communicate red flag features, expected time course of illness and how and when to re-consult and try to tailor their advice to the context, patient and specific illness. Overall, GPs perceive safety netting as an important element of the consultation, acknowledging personal and parental limitations, such as parents interpretation of their advice. GPs do not feel a need for any form of support in the near future.Conclusion: GPs apply safety netting intuitively and tailor the content. Further research should focus on the impact of safety netting on morbidity and how the advice is conveyed to parents.