How Well Do We Achieve SAFER Referrals?
Surgical Case Reports
Aims: Assess the completion of Situation, Assessment, Family, Expected Response, and Recording (SAFER) referrals for paediatric dog bites under 5yrs, and burns with clinical suspicion at a trauma centre. It is a document used to communicate concern with the LSCB (Local Safeguarding Children's Board). Method: Data was collated from e-records and case notes during 1/1/18-30/10/2018. The LSCB and hospital safeguarding team do not hold databases with information regarding these referrals. Results:
... eferrals. Results: 81 were seen by Plastic Surgery with dog bites. 33 were children (40.74%). 18/81 were 5yrs or less at presentation (22.2%); 8/18 referrals were completed (44.4%). For one a referral was deemed inappropriate because the bite was sustained from a stranger's dog. 164 paediatric burns were reviewed. 7/164 (4.3%) raised suspicion and 6/7 had referrals (85.7%). Discussion: Fewer referrals were made for dog bites. Possibly due to lack of awareness of guidelines, poor availability of forms or ambiguity regarding responsibility. Referrals sent for burns were better perhaps because of a perceived greater risk assigned to this injury or because the workload was monitored by a single clinical lead with knowledge of the pathway. Data collection was difficult due to multiple recording methods, which may cause clinical errors. Solutions could include staff education, clear guidelines within departments with easy access to forms, or added checklists. Conclusion: Referrals were not completed often enough with several areas of improvement. There are easy steps that can be implemented which could lead to increased effectiveness of our communication and standard of care.