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Scottish National Midwifery Formulary
Midwifery Formulary for Neonates

Announcements and latest updates

Right Decision Service newsletter: June 2024

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

1. Issues with RDS

Hopefully you all received the notification on Friday 28^th 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.

2.Redesign and improvements to RDS

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.

3.Evaluation

3.1 Usage statistics

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).

3.2 Palliative care

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/ /

3.3 Standard evaluation survey form

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.

4. Training and communications

The RDS Learning working group is in the final stages of developing and uploading new learning resources including:

Clinical and Care governance of RDS toolkits
The RDS toolkit development journey – from scoping to implementation and evaluation.
New 5-minute videos demonstrating key editorial functionality

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:

Thursday 1 August 11 am – 12 pm
Wednesday 7 August 4-5 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.)

4.2 Google analytics training

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.

5. New toolkits

The following RDS toolkits are now live:

SARCS (Sexual Assault Response Coordination Service)
Child protection procedures (North Lanarkshire)
NHS Lothian neonatal guidelines

The following toolkits are due to go live imminently:

NHS Grampian critical care
Care Inspectorate Safe Staffing guidance.

6. Toolkits in development

Some of the toolkits the RDS team is currently working on:

SIGN/NICE/BTS Asthma guideline – combination of old and new guidance.
New SIGN guideline around prevention and remission of type 2 diabetes
Updating of HIS national tissue viability guidance in collaboration with the and transfer to RDS as an extension to the Skin and wound care toolkit

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.

7. Implementation projects

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 28^th 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

Back to:
GGC Maternity and Gynaecology Handbook

Central Nervous System

Medicine as per BNF category	Arrangement for supply or administration	Legal status	Version of page	Scottish National Midwifery Formulary local arrangements
Opioid antagonists
Naloxone -Neonate	ME	POM	V3	In Patient. 200microgram (0.5ml) by IM injection into the anterior thigh once only.

Vitamin K Group of Medicines

Medicine as per BNF category	Arrangement for supply or administration	Legal status	Version of page	Scottish National Midwifery Formulary local arrangements
Introduction			V3
Phytomenadione (Vit K) IM 2mg in 0.2ml injection Neonate	ME	POM	V3	Scotland National Midwifery Formulary Monograph. See local guideline and PGD. Healthy infants ≥ 36+0 weeks and ≥ 2.5kg 1mg (0.1ml) IM single dose at birth. NB ampoule contains 2mg in 0.2ml.
Phytomenadione (Vit K) IM 2mg in 0.2ml injection NeonateGGC	ME	POM	V4 GGC	GGC Guideline – note variation from National Midwifery Formulary Monograph. See local guideline and PGD. Premature infants <36 + 0 weeks 0.5mg (0.05ml) IM single dose at birth. infants ≥ 36+0 weeks 1mg (0.1ml) IM single dose at birth. NB ampoule contains 2mg in 0.2ml.
Phytomenadione (Vit K) oral Neokay® Neonate	ME	POM	V3	Scotland National Midwifery Formulary Monograph. See local guideline and PGD. Oral prophylaxis in all healthy neonates including preterm babies who are not at particular risk of bleeding disorders and whose parents do not want IM vitamin K (Phytomenadione ). Give 1mg Neokay by mouth once. Continue once weekly for 12 weeks for exclusively breast-fed babies. Another dose should be given if the first dose is spat out or the baby is sick within 3 hours of the dose being given.
Phytomenadione (Vit K) oral Neokay® NeonateGGC	ME	POM	V4GGC	GGC Guideline – note variation from National Midwifery Formulary Monograph. See local guideline and PGD. Oral prophylaxis in all healthy neonates including preterm babies who are not at particular risk of bleeding disorders and whose parents do not want IM vitamin K (Phytomenadione). Give 1mg Neokay by mouth once weekly for 12 weeks. Another dose should be given if the first dose is spat out or the baby is sick within 3 hours of the dose being given.

Phytomenadione (Vit K) *oral Paediatric 2mg in* *0.2ml Konakion MM®* Neonate**	ME	POM	V3	Scotland National Midwifery Formulary Monograph. See local guideline and PGD. When Neokay capsules not available then Konakion Paediatric MM can be used as an oral solution if required. Oral prophylaxis in healthy neonates of 36 weeks gestation and older and whose parents do not want IM vitamin K (Phytomenadione). Give 2mg (0.2ml) Paediatric Konakion MM by mouth at birth and repeated between 4 and 7 days. Exclusively breast fed babies will require a further dose at 1 month. Maximum of 3 doses in accordance with local guideline. Doses must be administered by healthcare professionals.
Phytomenadione (Vit K) *oral Paediatric 2mg in* *0.2ml Konakion MM®* NeonateGGC**	ME	POM	V4GGC	GGC Guideline – note variation from National Midwifery Formulary Monograph. See local guideline and PGD. When Neokay capsules not available then Konakion Paediatric MM can be used as an oral solution if required. Oral prophylaxis in all healthy neonates including preterm babies who are not at particular risk of bleeding disorders and whose parents do not want IM vitamin K (Phytomenadione). Give 2mg (0.2ml) Paediatric Konakion MM by mouth at birth and repeat on day 7 and day 28 in accordance with local guideline. Doses must be administered by healthcare professionals.

Medicines used for Thrush Infections

Medicine as per BNF category		Arrangement for supply or administration	Legal status			Version of page	Greater Glasgow and Clyde Midwifery Formulary local arrangements
Miconazole 2% cream (neonate)		ME	POM			V1	In Patient or Out Patient. One pack of cream may be supplied on one occasion. Use in accordance with manufacturer’s instructions. Refer to a doctor if a repeat course may be required.
Nystatin oral suspension (neonate)		ME	POM			V2	In Patient or Out Patient. One original pack of oral suspension may be supplied on one occasion. Use in accordance with manufacturer’s instructions. Refer to a doctor if a repeat course may be required.

Immunological Products and Vaccines

Medicine as per BNF category	Arrangement for supply or administration	Legal status	Version of page	Greater Glasgow and Clyde Midwifery Formulary local arrangements
Introduction to monographs for medicines relating to Hepatitis B (neonate)			V3	Reader referred to table below introduction. Note included with table observing ‘NHS boards in Scotland may extend the criteria beyond those listed.’
Hepatitis B vaccine	ME	POM	V3	See local guideline. 0.5ml at birth IM in the anterolateral thigh. 1 dose by midwife, subsequent doses by Health Visitor or GP in accordance with Health Board Public Health agreed schedule of immunisations.
Hepatitis B immunoglobulin - human (HBIG)	ME	POM	V3	See local guideline. 200 international units as a single dose IM as soon after birth as possible. This is a high volume to give a neonate - ideally split the dose and site of administration. Administer at a separate site to hepatitis B vaccine. Potency varies by batch. The correct volume to give the stated potency is overprinted on the label.

Last reviewed: 27/01/2020

Next review date: 31/01/2022

Author(s): June Grant.

Version: 2020

Approved By: Heads of Midwifery