References

Beckmann A, Hamilton-Giachritsis C, Johns N, Kenyon S. PA.24 The inter-rater reliability of the Birmingham symptom specific obstetric triage system (BSOTS). Arch Dis Childhood. 2014; 99:A24-A25 https://doi.org/10.1136/archdischild-2014-306576.68

Chi C, Bapir M, Lee C, Kadir R Puerperal loss (lochia) in women with or without inherited bleeding disorders. Am J Obstet Gynecol. 2010; 203:(1)56.e1-56.e5 https://doi.org/10.1016/j.ajog.2010.02.042

Colliers A, Philips H, Bombeke K, Remmen R, Coenen S, Anthierens S. Safety netting advice for respiratory tract infections in out-of-hours primary care: a qualitative analysis of consultation videos. Eur J Gen Pract. 2022; 28:(1)87-94 https://doi.org/10.1080/13814788.2022.2064448

Cooper A, Brown J, Eccles S, Cooper N, Albrecht M. Is nursing and midwifery clinical documentation a burden? An empirical study of perception versus reality. J Clin Nurs. 2021; 30:(11-12)1645-1652 https://doi.org/10.1111/jocn.15718

Dancing in the grey zone between normality and risk. 2016. https://www.all4maternity.com/dancing-in-the-grey-zone-between-normality-and-risk/ (accessed 27 June 2022)

Edwards P, Ridd M, Sanderson E, Barnes R. Safety netting in routine primary care consultations: an observational study using video-recorded UK consultations. Br J Gen Pract. 2019a; 69:(689) https://doi.org/10.3399/bjgp19X706601

Edwards P, Ridd M, Sanderson E, Barnes R. Development of a tool for coding safety-netting behaviours in primary care: a mixed-methods study using existing UK consultation recordings. Br J Gen Pract. 2019b; 69:(689)e869-e877 https://doi.org/10.3399/bjgp19X706589

Fletcher S, Grotegut CA, James AH. Lochia patterns among normal women: a systematic review. J Womens Health. 2012; 21:(12)1290-1294 https://doi.org/10.1089/jwh.2012.3668

Gray S, Wacogne I, Roland D. Fifteen-minute consultation: safety netting effectively. Arch Dis Childhood. 2019; 104:(5)226-230 https://doi.org/10.1136/archdischild-2018-315991

Greenhalgh S, Finucane LM, Mercer C. Safety netting; best practice in the face of uncertainty. Musculoskelet Sci Pract. 2020; (48)102179-102179 https://doi.org/10.1016/j.msksp.2020.102179

Hanley G, Munro S, Greyson D Diagnosing onset of labor: a systematic review of definitions in the research literature. BMC Pregnancy Childbirth. 2016; 16:(1)71-71 https://doi.org/10.1186/s12884-016-0857-4

Horton K, Johns N, Goodwin L, Kenyon S. Transforming triage. RCM Midwives. 2018; 21:50-53

Hundley V, Downe S, Buckley S. The initiation of labour at term gestation: physiology and practice implications. Best Pract Res. 2020; 67:4-18 https://doi.org/10.1016/j.bpobgyn.2020.02.006

Jones C, Neill S, Lakhanpaul M, Roland D, Singlehurst-Mooney H, Thompson M. The safety netting behavior of first contact clinicians: a qualitative study. BMC Family Pract. 2013; 14:(140) https://doi.org/10.1186/1471-2296-14-140

Jones D, Dunn L, Watt I, Macleod U. Safety netting for primary care: evidence from a literature review. Br J Gen Pract. 2019; 69:(678)70-79 https://doi.org/10.3399/bjgp18x700193

Kenyon S, Hewison A, Dann SA The design and implementation of an obstetric triage system for unscheduled pregnancy related attendances: a mixed methods evaluation. BMC Pregnancy Childbirth. 2017; 17:(309) https://doi.org/10.1186/s12884-017-1503-5

Khan R, Hinshaw K. We are only human – effective training in human factors. Best Pract Res. 2022; 80:67-74 https://doi.org/10.1016/j.bpobgyn.2022.02.003

Knight M, Bunch K, Tuffnell D Saving lives, improving mothers' care - lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2017-19.Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2021

Marchant S, Alexander J, Garcia J, Ashurt H, Alderdice F, Keen J. A survey of women's experiences of vaginal loss from 24 hours to three months after childbirth (the BLiPP study). Midwifery. 1999; 15:(2)72-81 https://doi.org/10.1016/S0266-6138(99)90002-5

Marchant S, Alexander J, Garcia J. Postnatal vaginal bleeding problems and general practice. Midwifery. 2002; 18:(1)21-24 https://doi.org/10.1054/midw.2001.0288

Ménage D, Chapman M, Raynor M, Essat Z, Wells R. Decolonising midwifery education part two: neonatal assessment. Pract Midwife. 2021; 24:(6)44-49

Moudi A, Iravani M, Najafian M, Zarelyan A, Forouzan A, Mirghafourvand M. The development and validation of an obstetric triage acuity index: a mixed method study. J Mat Fetal Neonat Med. 2022; 35:(9)1719-1729 https://doi.org/10.1080/14767058.2020.1768239

Mukwende M, Tamony P, Turner M. Mind the gap: a handbook of clinical signs in black and brown skin.London: St George's, University of London; 2020

Mulholland RH, Wood R, Stagg HR, Fischbacher C, Villacampa J, Simpson CR. Impact of COVID-19 on accident and emergency attendances and emergency and planned hospital admissions in Scotland: an interrupted time-series analysis. J Royal Soc Med. 2020; 113:(11)444-453

Müller M, Jürgens J, Redaèlli M, Klingberg K, Hautz WE, Stock S. Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ Open. 2018; 8:(8)e022202-e022202 https://doi.org/10.1136/bmjopen-2018-022202

National Institute for Health and Care Excellence. Head injury: assessment and early management. 2019a. https://www.nice.org.uk/guidance/cg176/chapter/Recommendations#discharge-and-follow-up-2 (accessed 21 September 2022)

National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. 2019b. https://www.nice.org.uk/guidance/ng133 (accessed 21 September 2022)

The code: professional standards of practice and behavior for nurses and midwives.London: Nursing and Midwifery Council; 2018

Nursing and Midwifery Council/New standards of proficiency for midwives. 2019. https://www.nmc.org.uk/standards/standards-for-midwives/standards-of-proficiency-for-midwives/ (accessed 21 September 2022)

Nursing and Midwifery Council. Standards for pre-registration midwifery programmes. 2020. https://www.nmc.org.uk/globalassets/sitedocuments/standards/standards-for-pre-registration-midwifery-programmes.pdf (accessed 21 September 2022)

Public Health England. Guidance: perinatal mental health. 2019. https://www.gov.uk/government/publications/better-mental-health-jsna-toolkit/4-perinatal-mental-health (accessed 27 June 2022)

Public Health England. Guidance 4 clinical governance. 2021. https://www.gov.uk/government/publications/newborn-hearing-screening-programme-nhsp-operational-guidance/4-clinical-governance (accessed 27 June 2022)

Raynor M, Essat Z, Menage D, Chapman M, Gregory B. Decolonising midwifery education part 1: how colour aware are you when assessing women with darker skin tones in midwifery practice?. Pract Midwife. 2021; (24)

Silverston P. SAFER: a mnemonic to improve safety-netting advice. Pract Nurs. 2020; 31:(1)26-28 https://doi.org/10.12968/pnur.2020.31.1.26

Steen M, Jackson K, Brown A. Chapter 28: physiology and care during the puerperium. In: Marshall J, Raynor M (eds). London: Elsevier; 2020

Young P, Maclennan K. Human factors in obstetrics. Anesth Intens Care. 2019; 20:(9)506-510

Safety netting in midwifery

02 November 2022
Clinical Practice
02 November 2022
Volume 30 · Issue 11

Abstract

Providing clear, accurate and timely information to women and their families is central to the role of the midwife. It is key to empowering women to make informed decisions and promotes both safety and quality of care. The term ‘safety netting’ has been described as sharing information to help people identify the need to seek further help if their condition fails to improve, changes or if they have concerns about their health. While safety netting is a familiar term in some fields of medicine, it is rarely used in midwifery. This article discusses how safety netting could be a useful concept for midwifery and proposes a framework for providing safety net information. The article includes a clinical scenario that considers how the framework supports clear and comprehensive communication, and a student midwife perspective that reflects on different aspects of safety netting, its teaching and the practice experience. Clear teaching of safety netting has potential advantages for midwifery education and practice.

The report on lessons learnt following the UK and Ireland confidential enquiries into maternal deaths drew attention to the need to provide ‘safety net advice’ to women in the drive to prevent maternal deaths (Knight et al, 2021). The report highlighted the need to be aware of red-flag symptoms (which may indicate a serious condition) and ensure that women and their families are made aware of what they should look out for and what symptoms should be reported. This article explores the concept of safety netting in healthcare and its relevance to midwifery practice. The teaching of safety netting is considered and a personal reflection from a student midwife is included. Finally, a new midwifery-specific framework for safety netting is proposed and a clinical scenario is used to demonstrate the application of this framework to practice.

Safety netting is a practice common in healthcare settings across some specialties and is well established within general practice, emergency medicine and paediatric emergency medicine (Gray et al, 2019; Greenhalgh et al, 2020). Edwards et al (2019a) stated that safety netting advice is information shared with a service-user (or their carer) designed to help them identify the need to seek further help if their condition fails to improve, changes or if they have concerns about their health. This definition is used for the purpose of this article.

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Communication
Information
Midwifery
Midwifery education
Safety
Safety netting