We asked you in January to update to v4.7.2. After the deployment planned for 27th February, this new update will be needed to ensure that you are able to download RDS toolkits even when the RDS website is not available. We will wait until as many users as possible have downloaded the new version before switching off the old system for app downloads and moving entirely to the new approach.
To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number.
To update to the latest release:
On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.
On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.
Welcome to the February 2025 update from the RDS team
A new release of RDS is planned (subject to outcomes of current testing) for week beginning 24th February. This will deliver:
The release will also incorporate a number of small fixes, including:
We will let you know when the date and time for the new release are confirmed.
There is now the capability to publish toolkits on the web with left hand side navigation rather than tiles on the homepage. To use this feature, turn on the “Toggle navigation panel” option at the top of the Page settings menu at toolkit homepage level – see below. Please note that publication to downloadable mobile app for this type of navigation is still under development.
The Benzodiazepine tapering tool (https://rightdecisions.scot.nhs.uk/benzotapering) is now available as part of the RDS toolkit for the national benzodiazepine prescribing guidance developed by the Scottish Government Effective Prescribing team. The tool uses this national guidance developed with a wide-ranging multidisciplinary group. This should be used in combination with professional judgement and an understanding of the needs of the individual patient.
Due to the intensive work Tactuum has had to undertake on the new technology infrastructure has pushed back the delivery dates again and some new requirements have come out of the recent user acceptance testing. It now looks likely to be an April release for the search and browse interface. The archiving and version control functionality may be released earlier. We’ll keep you posted.
At the end of January, Olivia completed the generation of the latest set of usage statistics for all RDS toolkits. If you would like a copy of the stats for your toolkit, please contact Olivia.graham@nhs.scot .
We have now generated reports of all RDS toolkit content that has exceeded its review date by 6 months or more. We will be in touch later this month with toolkit owners and editors to agree the plan for updating or withdrawing out of date content.
Some important toolkits in development by the RDS team include:
The RDS team and other information scientists in HIS have also been producing evidence summaries for the Scottish Government Realistic Medicine team, to inform development of national guidance around Procedures of Limited Clinical Value. This guidance will in due course be translated into an RDS 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.)
To invite colleagues to sign up to receive this newsletter, please signpost them to the registration form - also available in End-user and Provider sections of the RDS Learning and Support area. 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
09/08/19 Update - addition of umbilical artery Doppler to any scan
| Please report any inaccuracies or issues with this guideline using our online form |
Maternal perception of fetal movement is one of the first signs of fetal life and is regarded as a manifestation of fetal wellbeing. Fetal movements have been defined as any discrete kick, flutter, swish or roll. A significant reduction or sudden alteration in fetal movement is a potentially important clinical sign. It has been suggested that reduced or absent fetal movements may be a warning sign of impending fetal death. Studies of fetal physiology using ultrasound have demonstrated an association between RFM and poor perinatal outcome.
Clinicians should be aware (and should advise women) that although fetal movements tend to plateau at 32 weeks gestation, there is no reduction in the frequency of movements in the late third trimester.
Women who have normal clinical assessment and investigations after first episode of RFM should be advised to contact the maternity unit if they have a further episode.
Women who have normal clinical assessment and investigations after second (or more) episode of RFM should undergo a scan (including umbilical artery Doppler) for fetal well being (unless they have had a normal scan within 3 weeks). At the third presentation, the woman should be referred to the consultant-led antenatal clinic for consideration of increased fetal surveillance.
Those women who are still not feeling fetal movements after having a normal scan and CTG should be offered either daily CTGs as an outpatient or admission and twice daily CTGs until movements return.
Women who present on two or more occasions with RFM are at increased risk of a poor perinatal outcome. There are no studies to determine whether intervention (e.g. delivery or further investigation) alters perinatal morbidity or mortality. The decision whether or not to induce labour at term in a woman who presents recurrently with RFM when the growth, liquor volume and CTG appear normal must be made after careful consultantled counselling of the pros and cons of induction on an individualized basis (RCOG Green Top Guideline No. 57)
If a woman presents with RFM between 24+0 and 27+6 weeks of gestation, the presence of a fetal heartbeat should be confirmed by auscultation with a Doppler handheld device.
The fetal heartbeat should be confirmed to check fetal viability. History must include a comprehensive stillbirth risk evaluation, including a review of the presence of other risk factors associated with an increased risk of stillbirth. Clinicians should be aware that placental insufficiency may present at this gestation. A complete antenatal assessment including measurement of fundal height, BP and urine should be carried out. If there is clinical suspicion of FGR, or raised BP/proteinuria consideration should be given to the need for ultrasound assessment. There is no evidence on which to recommend the routine use of ultrasound assessment in this group.
If a woman presents with RFM before 24+0 weeks of gestation, the presence of a fetal heartbeat should be confirmed by auscultation with a Doppler handheld device.
A full antenatal check-up must also be completed including measurement of fundal height, BP and urine.
If fetal movements have never been felt before 24 weeks, a referral should be made to a medical sonographer to exclude any neuromuscular conditions.
Reduced fetal movements at ≥ 28+0 weeks assessment form (pdf)