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SAFER PRACTICES in the COVID-19 pandemic

02 May 2020
13 min read
Volume 31 · Issue 5


COVID-19 has created a wave of uncertainty for nurses and healthcare practitioners, with new information on the virus being released constantly. Paul Silverston discusses the assessment of patients with symptoms of COVID-19 and how to reduce the risk of misdiagnosis

Errors in diagnosis are relatively common in primary care which often result in serious harm to patients. The majority of these errors are preventable. This article describes a diagnostic error checklist, SAFER PRACTICES, which can be used to help clinicians prepare themselves for consulting in patients with suspected or confirmed COVID-19 disease so that they come to the consultation with the correct medical knowledge, clinical assessment plan and diagnostic reasoning required to reduce the risk of diagnostic error. It can also be used during the consultation to deliver a systematic approach to the prevention and detection of diagnostic errors.

Errors in diagnosis are relatively common in primary care and many of these errors result in serious harm to patients (Newman-Toker et al, 2013; Auraaen et al, 2018). However, up to 80% of diagnostic errors are considered to be preventable (World Health Organization [WHO], 2016). A mnemonic, SAFER PRACTICES (see Box 1), was created to bring together the most common causes of diagnostic error in primary care as a learning tool, as well as a diagnostic error checklist for use during the consultation (Silverston, 2020a). The emergence of the novel coronavirus COVID-19 has created a new set of problems for clinicians, including an increased risk of diagnostic error. This article describes why the COVID-19 pandemic may result in an increased risk of misdiagnosis in primary care and how SAFER PRACTICES can be used to reduce this risk.

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