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Announcements and latest updates

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

  1. 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 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.

 

  1. New toolkits

The following toolkits are now live;

  1. 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.

 

  1. 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.

 

  1. 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

Parvovirus Guideline (593)

Please report any inaccuracies or issues with this guideline using our online form

Parvovirus B19 virus responsible for erythema infectiosum (fifth disease/ slapped cheek syndrome), 50-75% women of reproductive age are immune.

There is no specific treatment or prophylaxis available against B19 infection, but counseling of non-immune mothers and active monitoring of confirmed maternal infections with intervention to correct fetal anemia is likely to decrease mortality. At present there is no vaccine or treatment with immunoglobulin available.

Spread by respiratory droplets or hand to mouth contact. Epidemics can occur spring and mainly affects children. Viraemia occurs 4-14 days after exposure. “Slapped cheek” rash occurs 1-4 days and is associated with appearance of parvovirus B19 IgM antibodies.

Signs and Symptoms, Mild fever, flu like symptoms, slapped cheek rash, arthralgia. Up to 70% of infected pregnant women are asymptomatic.

Fetal Effects of Parvovirus

This can lead to spontaneous miscarriage and stillbirth. Spontaneous loss before 20 weeks is 13% and after 20 weeks is 0.5% 

Incidence of hydrops fetalis is 3%. Positive parvovirus infection in the absence of hydrops or anaemia does not seem to cause long term neurological morbidity. There is no increase in congenital abnormailty. The peak risk is 5 weeks post infection (range 2-12).

Exposure/Infection

If a woman is exposed to or develops signs or symptoms of parvovirus check immunity

  1. Request IgM ( current) and IgG ( past ) antibodies from booking blood virology

Contact Laboratory: 211-0080 (50080)

  1. If not yet had booking bloods then should attend GP ( NOT to attend maternity unit due to risk of infection)
  2. Email/ contact patients named Consultant informing of test, chase result.

IgM appears after 2 weeks and may last 4 months. IgG appears after 3-4 weeks and lasts for life

IgG + means immune  ( previous parvovirus)

IgG – means not immune (susceptible to parvovirus )

IgM + means infected ( has current infection- needs action)

IgM – means not infected ( no current infection) 

Editorial Information

Last reviewed: 12/10/2017

Next review date: 01/10/2022

Author(s): Laurie Anderson.

Version: 2

Approved By: Obstetrics Clinical Governance Group

Document Id: 593

References

SOGC Clinical Practice Guideline 2002
Parvovirus B19 infection NICE-CKS April 2010