Welcome to the Right Decision Service (RDS) newsletter for August 2024.
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.
The following toolkits are now live;
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.
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.
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
This section provides a step by step guide for loading a syringe onto the BD BodyGuard T syringe pump. Please ensure that Infection Prevention/Control and Occupational Exposure Procedures are followed.
Prepare prescribed medicines / syringe. If a new extension line is required, please prime the line manually.
Insert battery in pump (if required). Ensure the barrel clamp arm is down (no syringe in situ) and switch on. Check there is sufficient battery power depending on the setting i.e.50% or higher for community.
Place prepared syringe above the pump to visually align the syringe with the collar and plunger sensors. If needed, use the 
and
keys to achieve the required position.
Lift the barrel clamp arm fully, turn 180 degrees and lower the arm.
Place the syringe in position securely on the pump. Check the syringe collar and plunger are fitted and in place. Lift and rotate barrel clamp back into the original position.
A message will appear on screen to choose/confirm the brand and size of
syringe being used. Press 
to confirm the selected syringe.
When the syringe has been confirmed, the pump will calculate the rate and duration which will displayed on screen along with the total volume.
Check patient ID. Connect the syringe via the extension line to the patient using the subcutaneous infusion device in situ.
Next press . The message ‘Start Infusion’ will appear on screen - confirm by pressing again. The infusion has now commenced.
When renewing or changing the syringe, it is important to select ‘START INFUSION’ instead of ‘RESUME’ to ensure the pump delivers the infusion over a 24hr period
Press and hold the 
key to lock the keypad. Place syringe pump into the selected lockbox or cover.
Ensure all documentation has been updated.
Key Point: To reduce the risk of siphonage the syringe pump should be placed at the same level or lower than the infusion site.
Scottish Palliative Care Guidelines