We’re pretty much fans of being clear when we discuss evidence based practice, clinical things and research topics. Being understood, sharing meanings and having a consistent view is hugely important, and we keep being told (and although silently questioning the methodologies, believe it to be true) that the majority of complaints are about failures of communication.

So.

When we say something is ‘safe’ or a side effect is ‘common’, what do we mean? And what are we heard as saying?

Consider the question of what proportion you’d accept for a child to return after discharge from a febrile neutropenia admission, as part of a shortening hospitalisation programme: what is a ‘safe’ level? Clinical teams generally wanted the chance to be 2% or lower. Parents report 30% was fine, some even as much as 50%… for them, the 50% chance of not having to come back was far more important. The reverse may be true when it comes to medication safety; we will accept that a drug may cause an adverse reaction in 1-2% and describe it as safe; ‘normal’ people may read ‘safe’ as ‘doesn’t cause harm’.

Explaining what we mean with our phrases, placing them in context and communicating well are all very important elements in this area. Also being honest with ourselves, and setting up in advance of researching what we think the limits of acceptability should be is vital. As with all EBP, it’s the combination of science, skill and patient focus that matters.

• Archi