References | Right Decisions

Announcements and latest updates

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

Contingency planning for RDS outages

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 26^th 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.

New toolkits

The following toolkits are now live;

Gender identity healthcare: adults and young people standards. (https://rightdecisions.scot.nhs.uk/genderidentity ) Note that this toolkit includes self-evaluation forms for each standard. A Scottish Government launch of these standards, together with the toolkit and NES educational resources, is planned for 3^rd September.
Care Inspectorate staffing method framework.
Vascular surgery pathways from the Modernising Patient Pathways Programme within the Centre for Sustainable Healthcare Delivery.

Updated guidance on current and future Medical Device Regulations

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.

Guide to six stages of RDS toolkit development

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.

Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:

Thursday 5 September 1-2 pm
Wednesday 24 September 4-5 pm
Friday 27 September 12-1 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.)

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

The journal article references below link to their record in Pubmed which will allow access to the full text, where available, for users with an NHS Scotland Athens password. See here for information about accessing content not available online.

WINSTON,P and VINCENT,D. Atlas of Ultrasound-guided nerve-targeted procedures for spasticity. Maximising outcomes for the patient with spasticity through optimal muscle selection. 2023: P4.

DAUNTER A.K. et al, 2017. Long-term impact of childhood selective dorsal rhizotomy on pain, fatigue and function: A case controlled study. Developmental Medicine and Child Neurology, 59, pp. 1089-1085.

FUNK J.F. et al, 2016. Monosegmental laminoplasty for selective dorsal rhizotomy – operative technique and influence on the development of scoliosis in ambulatory children with cerebral palsy. Child’s Nervous System, 32(5), pp.819-825.

AILON, T. et al, 2015. Long-term outcome after selective dorsal rhizotomy in children with spastic cerebral palsy. Child’s Nervous System, 31(3), pp.415-42)

AQUILINA, K., et al, 2015. Selective dorsal rhizotomy: an old treatment re-emerging. Archives of Disease in Childhood, 100(8), pp. 798-802.

FUNK, J.F., et al, 2015. Predictors for the benefit of selective dorsal rhizotomy. Research in developmental disabilities, 37, pp. 127-134.

MCFALL, J. et al., 2015. Changes in gait which occur before and during the adolescent growth spurt in children treated by selective dorsal rhizotomy. Gait and Posture, 42 (3), pp. 317-322. 10

GIGANTE, P., et al., 2013. Reduction in upper-extremity tone after lumbar selective dorsal rhizotomy in children with spastic cerebral palsy. Journal of Neurosurgery, Pediatrics, 12(6), pp.588-594.

NOVAK, I., et al, 2013. A systematic review of interventions for children with cerebral palsy: state of the evidence. Developmental Medicine & Child Neurology,55(10), pp. 885-910.

LANGERAK, N.G. et al, 2009. Functional status of patients with cerebral palsy according to the International Classification of Functioning, Disability and Health model: a 20-year follow-up study after selective dorsal rhizotomy. Archives Physical Medical Rehabilitation 90:pp. 994-1003.

LANGERAK, N.G.et al, 2008. A prospective gait analysis study in patients with diplegic cerebral palsy 20 years after selective dorsal rhizotomy. Journal of Neurosurgery, Pediatrics 1:pp.180-186.

COLE, G.F., et al, 2007. Selective dorsal rhizotomy for children with cerebral palsy: the Oswestry experience. Archives of Disease in Childhood, 92(9), pp. 781-

GOLAN, J.D., et al, 2007. Spinal deformities following selective dorsal rhizotomy. Journal of Neurosurgery, 106 (6 suppl), pp.441-449

ALBRIGHT A.L.et al, 2006. Best-practice surgical techniques for intrathecal baclofen therapy. Journal Neurosurgery 104, pp. 233-239.

STEINBOK P., 2006. Selection of treatment modalities in children with spastic cerebral palsy. Neurosurgical Focus, 21(2), pp. e4.

HICDONMEZ T. et al., 2005. Hip joint subluxation after selective dorsal rhizotomy for spastic cerebral palsy. Journal of Neurosurgery, 103 (1 suppl), pp.10-16.

O’BRIEN, D.F., et al., 2005. Orthopaedic surgery after selective dorsal rhizotomy for spastic diplegia in relation to ambulatory status and age. Journal of Neurosurgery, 103 (1 suppl), pp. 5-9.

STEINBOCK P., et al., 2005. Spinal deformities after selective dorsal rhizotomy for spastic cerebral palsy. Journal of neurosurgery, 102 (4 suppl), pp. 363-37.

BUCKON C.E., et al., 2004. Selective dorsal rhizotomy versus orthopedic surgery: a multidimensional assessment of outcome efficacy. Archives in Physical Medical Rehabilitation 8 pp.:457-465.

MCLAUGHLIN J. et al, 2002. Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials. Developmental Medicine and Child Neurology, 44, pp.17-25.

STEINBOCK P., 2001: Outcomes after selective dorsal rhizotomy for spastic cerebral palsy. Child’s Nervous System 17, pp.1-18.

TAN T.C. et al 2001. The contributions of Otfrid Foerster (1873-1941) to neurology and neurosurgery. Neurosurgery 40, pp.1231-1235; discussion 1235-

PEACOCK W.J. et al, 1982. Selective posterior rhizotomy for the relief of spasticity in cerebral palsy. South Africa Medical Journal, 6, pp.119-124,

FASANO V.A. et al, 1978. Surgical treatment of spasticity in cerebral palsy. Childs Brain, 4, pp.289-305.

Last reviewed: 10/06/2024

Next review date: 10/06/2029

Author(s): Jacqueline Clark.

Approved By: SDR Governance Group