Does the wound need cleansing?
Only cleanse if there is visible debris on the wound bed that needs removed. Use warm potable tap water or warmed sterile solutions if immunocompromised such as saline 0.9%. PHMB if infected, colonised.
Welcome to the Right Decision Service (RDS) newsletter for August 2024.
Following the recent RDS outages, Tactuum and the RDS team have been reviewing the learning from these incidents. We are committed to doing all we can to ensure a positive outcome by strengthening the RDS to make it fully robust and clinically resilient for the future.
We would like to invite you to a webinar on 26th September 3-4 pm on national and local contingency planning for future RDS outages. Tactuum and the RDS team will speak about our business continuity plans and the national contingency arrangements we are putting in place. This will also be a space to share local contingency plans, ideas and existing good practice. We would also like to gather your views on who we should send communications to in the event of future outages.
I have sent a meeting request for this date to all editors – please accept or decline to indicate attendance, and please forward on to relevant contacts. You can also contact Olivia.graham@nhs.scot directly to register your interest in participating.
2.National IV fluid prescribing calculator
This UK CA marked calculator is now live at https://righdecisions.scot.nhs.uk/ivfluids . It has been developed by a multiprofessional steering group of leads in IV fluids management, as part of the wider Modernising Patient Pathways Programme within the Centre for Sustainable Delivery. It aims to address a known cause of clinical error in hospital settings, and we hope it will be especially useful to the new junior doctors who started in August.
Please do spread the word about this new calculator and get in touch with any questions.
The following toolkits are now live;
We have updated and simplified this guidance within our standard operating procedures. We have clarified the guidance on how to determine whether an RDS tool is a medical device, and have provided an interactive powerpoint slideset to steer you through the process.
We have developed a guide to support editors and toolkit leads through the process of scoping, designing, delivering, quality assuring and implementing a new RDS toolkit. We hope this will help in project planning and in building shared understanding of responsibilities throughout the full development process. The guide emphasises that the project does not end with launch of the new toolkit. Implementation, communication and evaluation are ongoing activities throughout the lifetime of the toolkit.
To book a place, please contact Olivia.graham@nhs.scot, providing your name, organisation, job role, and level of experience with RDS editing (none, a little, moderate, extensive.)
7 Evaluation projects
Dr Stephen Biggart from NHS Lothian has kindly shared with us the results of a recent survey of use of the Edinburgh Royal Infirmary of Edinburgh Anaesthesia toolkit. This shows that the majority of consultants are using it weekly or monthly, mainly to access clinical protocols, with a secondary purpose being education and training purposes. They tend to find information by navigating by specialty rather than keyword searching, and had some useful recommendations for future development, such as access to quick reference guidance.
We’d really appreciate you sharing any other local evaluations of RDS in this way – it all helps to build the evidence base for impact.
If you have any questions about the content of this newsletter, please contact his.decisionsupport@nhs.scot If you would prefer not to receive future newsletters, please email Olivia.graham@nhs.scot and ask to be removed from the circulation list.
With kind regards
Right Decision Service team
Healthcare Improvement Scotland
Appropriate use Social care workers in care homes and care at home services will not carry out full wound assessments. However, this tool will help you to describe a wound to nursing staff and other clinical colleagues so that appropriate action can be taken.
General wound assessment chart
This chart is provided by Healthcare Improvement Scotland.The National Association of Tissue Viability Nurse Specialists NATVNS (Scotland) examined this resource in 2019. It is to be reviewed in 2023.
This guide presumes that Standard Infection Control Precautions (SICPs) are applied at all times when providing healthcare when there is a risk of exposure to blood, other body fluids, secretions or excretions (except sweat), non-intact skin or mucous membranes.
Does the wound need cleansing?
Only cleanse if there is visible debris on the wound bed that needs removed. Use warm potable tap water or warmed sterile solutions if immunocompromised such as saline 0.9%. PHMB if infected, colonised.
Document type of wound, location, duration. Measure wound length, width, depth and undermining and tracking as applicable.
Document peri-wound skin condition, pain or any clinical signs of infection.
Do not estimate.
Use a scale such as:
A. What tissue type and levels of exudate does the wound have?
Dressing choice must accommodate tissue type, exudate level, odour, expected wear time, peri-wound skin, area to be dressed, pain at dressing change and patient/client need.
Consider intrinsic and extrinsic factors also – past medical history, age, and cognitive ability.
B. Select secondary dressing if required.
See Step 3A above
Document in wound chart.
A wound chart must be completed for every patient/client with a wound.
Points to remember:
© Healthcare Improvement Scotland 2021
Published February 2021
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