Infections | Right Decisions

Announcements and latest updates

Welcome to the Right Decision Service (RDS) newsletter for August 2024.

Contingency planning for RDS outages

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 26^th 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.

New toolkits

The following toolkits are now live;

Gender identity healthcare: adults and young people standards. (https://rightdecisions.scot.nhs.uk/genderidentity ) Note that this toolkit includes self-evaluation forms for each standard. A Scottish Government launch of these standards, together with the toolkit and NES educational resources, is planned for 3^rd September.
Care Inspectorate staffing method framework.
Vascular surgery pathways from the Modernising Patient Pathways Programme within the Centre for Sustainable Healthcare Delivery.

Updated guidance on current and future Medical Device Regulations

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.

Guide to six stages of RDS toolkit development

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.

Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:

Thursday 5 September 1-2 pm
Wednesday 24 September 4-5 pm
Friday 27 September 12-1 pm

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

Sexually transmitted infections (STIs)

Many STIs can adversely affect the fetus and be more troublesome in pregnancy.
Refer to the West of Scotland Managed Clinical Network guidance:Pregnancy - STIs and group B (GBS) streptococcal colonisation

Zika

See the 'Travel' section in this guidance.

Toxoplasmosis

Caused by a parasite found in the faeces of infected cats and in infected meat, toxoplasmosis can cause serious problems in women who become infected while they're pregnant.
Toxoplasmosis can cause miscarriage or stillbirth, or the infection can spread to the baby and cause serious complications (congenital toxoplasmosis).
See 'How to avoid toxoplasmosis' and 'Foods to avoid eating during pregnancy'.

Listeriosis

An infection that usually develops after eating food contaminated by Listeria monocytogenes.
In pregnancy, women are more susceptible to severe infection than non-pregnant healthy adults.
See 'Foods to avoid eating during pregnancy'.

COVID-19

Pregnancy does not increase a women’s risk of getting COVID-19.
Pregnant women are in the moderate risk (clinically vulnerable) group as a precaution. This is based on the fact pregnancy can increase the risk from viruses like flu. It's not clear if this happens with COVID-19 but because it's a new virus, it's safer to include pregnant women in the moderate risk group.
Although it's very rare for pregnant women to become seriously ill if they get COVID-19, it may be more likely later in pregnancy with potentially premature delivery.
While the chances of having a stillbirth are low, there is some emerging evidence that the risk may be higher if a patient has COVID-19 at the time of birth.
Pregnant women should follow advice to stop the spread of COVID-19 throughout pregnancy, especially in the third trimester.
Patients from an ethnic minority group are more likely to be admitted to hospital if they get COVID-19.
There's no evidence COVID-19 causes miscarriage or fetal abnormality.
COVID-19 vaccination is strongly recommended in pregnancy. See the RCOG COVID-19 vaccines, pregnancy and breastfeeding FAQs

Last reviewed: 30/09/2021

Next review date: 30/09/2025

Author(s): West of Scotland Managed Clinical Network for Sexual Health Clinical Guidelines Group .

Version: 3.1

Approved By: West of Scotland Managed Clinical Network in Sexual Health