Welcome to the Right Decision Service (RDS) newsletter for June 2024.
Hopefully you all received the notification on Friday 28th June about the worldwide security vulnerability relating to use of code from the Polyfill.io code library – typically used to enable use of functionality in older browsers and operating systems. This vulnerability has now been addressed within RDS. Thanks to Tactuum for their prompt action on this.
This incident served as a useful reminder about the importance of making sure all devices and desktop/laptop computers have up to date anti-malware installed.
The most recent information is that final fixes and developments will take place during July, with a view to user testing taking place in August 2024.
We will be running the six-monthly usage statistics reports for all RDS toolkits during July. Please contact his.decisionsupport@nhs.scot if you would like to receive the usage report for your toolkit(s).
The Scottish Palliative Care Group is carrying out a value and impact survey of the national Palliative Care Guidelines toolkit on RDS. We would appreciate your help in circulating this survey, available at https://rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/evaluation-survey/ /
The Palliative Care Guidelines toolkit is using an adapted version of a generic impact evaluation form which the RDS team now encourages all toolkit owners to apply 6-12 months after launch of their toolkit. Please contact ann.wales3@nhs.scot if you would like to find out more.
The RDS Learning working group is in the final stages of developing and uploading new learning resources including:
We have also drafted a communication and training plan to support implementation of the redesigned RDS. The plan aims to reach both end-users and editors, who will benefit from new features such as the archiving and version control functionality.
4.1 Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:
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.)
Remember that you can also organise 1-1 training sessions with Olivia on running Google Analytics reports if you want to look at data more frequently than the six-monthly reports.
The following RDS toolkits are now live:
The following toolkits are due to go live imminently:
Some of the toolkits the RDS team is currently working on:
Please contact his.decisionsupport@nhs.scot if you would like to learn more about a toolkit. The RDS team will put you in touch with the relevant toolkit lead.
HIS is working with the Scottish Library and Information Council and the ALLIANCE to implement the second phase of the Collective Force for Health and Wellbeing Action Plan. This plan aims to strengthen the role of public, health and school libraries in empowering people to use digital tools and health information for self-management and choices about health and wellbeing. A key element of this new phase is supporting public libraries to promote the RDS citizen-facing apps for health and wellbeing.
We held a webinar on 28th June about the implementation challenge for health and wellbeing apps for citizens. This included an overview of the evidence base around implementation, the critical importance of health literacy skills, and the early findings from tests of change of implementing the Being a partner in my care app. Please contact his.decisionsupport@nhs.scot if you would like a copy of the slides or access to the recording of this webinar (NHS staff only.)
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
It is important to distinguish between alcohol dependence and harmful use/misuse in hospital patients.
Those who are dependent on alcohol are at risk of medical complications (see Alcohol Withdrawal section).
Dependence includes:
Alcohol withdrawal is a life-threatening medical emergency. There can be delay between stopping drinking and severe complications. Delirium tremens may appear after 48 – 72 hours and seizures after 24 – 48 hours.
Recognising dependence means that action can be taken early before patients start to withdraw or whilst the withdrawal is still mild.
Protocols differ by hospital - check your local guidelines.
General principles include:
Some hospitals use the CIWA protocol (see Resources below) to tailor benzodiazepine treatment and others use fixed regimes.
CIWA typically involves Diazepam. In liver failure, use Oxazepam or Lorazepam.
Utilise the alcohol liaison service to provide on-going support and relapse prevention options, especially on discharge. Remember to prescribe ongoing oral thiamine.
It is crucial to contact the pharmacy and the prescriber to confirm:
Opioid withdrawal might be uncomfortable, however, inappropriately prescribed opioids can be fatal.
Never prescribe without confirmation of the above information and objective evidence of opioid dependence using a drug screen and Clinical Opiate Withdrawal Scale (COWS) score (See Resources below). If you are unable to contact the pharmacist/prescriber, and you have a confirmed positive drug screen, treat withdrawals symptomatically e.g. Loperamide, Zopiclone. If in severe withdrawal, Dihydrocodeine can be prescribed - check your local guidelines and continue monitoring COWS.
Refer the person to your local community addiction service and consider discussion with drug liaison team if your hospital has access to this service.
Seek advice from local services for ongoing management - remember take home Naloxone kits, advice on needle exchange, local relapse prevention groups, BBV screening, contraception and STI testing.
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