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May 2025 RDS newsletter now available. Expand this announcement to view.

Welcome to the May 2025 update from the RDS team

1.     RDS deployments

Three small-scale releases took place during April and May, including the following fixes and improvements:

  • Applying moderate severity security patch to Umbraco.
  • Fixes to:
    • Random ordering of tiles on mobile app
    • Simultaneous issuing of multiple copies of content review alerts
    • Content display on mobile app for the left hand menu navigation option
  • Whitelisting of Jotforms outcomes pages so that recommendations for action can be displayed following completion of a form or calculation.

2.     RDS performance

Two short outages took place on the mornings of 12th and 22nd May. Tactuum is still investigating the root cause and will report on this shortly.

3.     Redesign of Gentamicin and Vancomycin calculator interfaces

New designs have been produced which make the health board name and calculator title clear to the user on these calculator pages, with a warning message and link to ensure users access the right calculator for their board. These designs have been implemented in a test environment and are now under review.

4.     RDS Redesign, archiving and version control

We now plan to release at end of July 2025 the following major enhancements:  redesigned Right Decision Service homepage, new search and browse interface, upgraded archiving and version control, and capability to edit content adopted from the Shared Content Library. We will provide slides and demos in advance of the release to introduce users and editors to the new functionality.

5. Training sessions for RDS editors

Introductory webinars for RDS editors will take place on:

  • Monday 16 June 12.30-1.30 pm
  • Tuesday 24 June 3.45-4.45 pm

Running usage statistics reports using Google analytics

  • Wednesday 11th June: 2-3pm

 To book a place on any of these webinars, please contact Olivia.graham@nhs.scot providing your name, role, organisation, title and date of the webinar you wish to attend.

6.New RDS toolkits

The following toolkits were launched during March 2025:

7.New RDS developments

Work is progressing on a number of decision support systems that are part of the wider Right Decision Service platform, beyond the web and mobile apps:

  • The Patient Reported Outcome Measures system. A minimum viable product version will be available for functional testing by key stakeholders at end of July.
  • Pharmacogenomics decision support as an extension of the current high risk prescribing decision support integrated with primary care electronic health record systems. This is part of a European research and innovation project.
  • Planned Date of Discharge decision support system to be tested in NHS Lanarkshire. Will undergo user acceptance testing in July with a view to piloting from November.

8. Implementation projects

Public library services in Inverclyde, East Renfrewshire, Glasgow Life, Angus, Falkirk and Stirling have come forward to work with the RDS team, the Scottish Library and Information Council and local Realistic Medicine leads, to develop their role in engaging citizens in Realistic Medicine. This includes promoting the Being a partner in my care app: Realistic Medicine Together. This provides tools and resources to support conversations about what matters to the person,  shared decision-making and self-management.

 

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.

 

 

 

Postpartum Blood Transfusion in Stable Patients (325)

Objectives

To develop a policy of prescription of blood transfusion based on symptoms and signs rather than based on haemoglobin value. To minimize the number of units transfused without comprising the benefits of transfusion.

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

Blood transfusion though life saving is not without hazards. The risk of complications (immunologic, non immunologic) increases with the volume of transfusion. It is important to avoid unnecessary exposure to allogenic blood products. Due to safety concerns, many recent studies on restrictive transfusion policy have been published and they have been shown to be effective.2,3,4 Moreover the number of red cell units ordered are not always utilised and can lead to significant wastage.1

Evaluation for transfusion in post natal ward

  • Haemodynamically stable
  • No evidence of ongoing haemorrhage, underlying medical disorder
  • Symptoms and signs of anaemia(palpitations, fatigue, fainting spells, shortness of breath, pale skin)
  • Haemoglobin value

Management

Haemoglobin
≥ 90g/l		Haemoglobin
70 - 89g/l		Haemoglobin
<70g/l
Iron therapyEvaluate signs & symptomsEvaluate signs & symptoms
Asymptomatic - alternative therapyDiscuss with senior
Symptomatic – prescribe single unitSymptomatic – transfuse as
indicated
Re evaluate after single transfusionSingle/multiple units
Still symptomatic – discuss with Senior
regarding further transfusion		Alternative therapy
  • Discuss the potential risks and benefits of blood transfusion with the patient and clearly document in the case notes.
  • Fully complete the Blood Component Prescription and Record of Transfusion form.
  • Alternative therapy – oral iron therapy, parenteral iron therapy
  • Seniors - Registrar, Consultant
  • Patient declining transfusion- Discuss with Seniors

Editorial Information

Last reviewed: 01/08/2022

Next review date: 31/08/2027

Author(s): Judith Roberts.

Version: 4

Approved By: Obstetrics Clinical Governance Group

Document Id: 325

References
  1. Retrospective study of postnatal ward blood transfusion in the Southern General hospital 2010
  2. Postpartum Blood Transfusion. Maternity Services Lothian guidelines, Departmental audit.
  3. Ma M, Eckert K, Ralley F, Chin- Yee I. A retrospective study evaluating single – unit red blood cell transfusions in reducing allogenic blood exposure. Transfuse Med 2005; 15(4): 307-312
  4. Naylor JM, Adie S, Fransen M, Dietsch S, Harris,I. Endorsing single – unit transfusion combined with a restrictive haemoglobin, transfusion threshold after knee arthroplasty. Qual Sa Health Care BmJ 2010; 239- 243
  5. UK Blood transfusion and Tissue transplantation guidelines