GIRFEC – Getting It Right For Every Child is the national approach in Scotland to improving outcomes and supporting the wellbeing of our children and young people by offering the right help at the right time from the right people. It supports them and their parent(s) to work in partnership with the services that can help them.
At NHSGGC we have a key role to play, whenever we come into contact with children and young people – whether we are caring directly for them, or other members of their family or household. Where extra support is needed, the GIRFEC approach aims to make that support easy to access and seamless, with the child at the centre.
GIRFEC Frequently Asked Questions – start here for answers to the most commonly asked questions about Getting it right for every child
The decontamination of near patient equipment and medical devices is crucial to the prevention of healthcare associated infection (HAI). In recent years the Scottish Government have issued guidance and Health Department Letters to provide NHS Boards with information to ensure that this type of equipment is dealt with in line with current standards and guidance.
This page is divided into sections to ensure that staff with a direct responsibility for particular equipment, have the most up-to-date information and training available. Decontamination practice is continually evolving and those with a responsibility for decontamination need to ensure that they are aware of current developments.
This document has been prepared to provide guidance on the technical requirements for the decontamination of flexible endoscopes and the options available. The document is intended to summarise key information on best practice in a manner which is readily accessible to the user/manager.
This guidance has been prepared by utilising published guidance from expert bodies, existing best practice guidance and standards, both published and in draft form. Many of the referenced standards are harmonised standards in respect of the Medical Device Directive.
Caused by unconventional agents thought to be infectious proteins – known as prions. Disease in humans are:
Sporadic – classical
Familial – including Fatal Familial Insomnia (FFI) and Gerstmann-Straussler-Scheinker (GSS)
Acquired – iatrogenic, variant.
There is evidence that these disorders can be transmitted in specific situations associated with medical interventions, e.g. transfusion of contaminated blood and blood products, surgery with contaminated instruments. During routine clinical care, Standard Precautions are sufficient to prevent cross-infection in healthcare settings. Transmission Based Precautions must be applied when operations or specific invasive procedures are to be undertaken on high-risk tissues or patients identified as being at risk of vCJD.
Hand Hygiene is one of the most effective actions to reduce the spread of pathogens and prevent infections, including the COVID-19 virus. Conducting hand hygiene at the right time, using the right technique, with either Alcohol-Based Hand Rub (ABHR) or soap, water and disposable towels is critical.
Infection Prevention and Control (IPC) staff collaborated to produce an informational video regarding 5 Moments of Hand Hygiene. This was developed to highlight the common failures that medical staff incur, as reported in audits of compliance. The video also highlights various anecdotal responses when challenged, given by existing medical staff members within NHSGGC. It features an introduction and closing statement by David Stewart, Lead Director for Acute Medical Services.
Staff involved in making this video were recruited from the North East IPC Team and Glasgow Royal Infirmary (GRI). Recording and post-production was carried out by GRI Medical Illustrations.
Infection Control training modules, including those offered by NES, can be accessed via learnPro.
Hand Hygiene Audits
Hand Hygiene audits should be carried out on a monthly basis within NHSGGC wards and departments. The audit tool should be utilised in conjunction with the information contained in the documents. The audit should not be carried out by the SCN as awareness of senior staff can change practice in clinical areas. 2-3 auditors should be chosen from a mixture of grades, including Bands 5 and 6 and HCSWs.
The data gathered should then be uploaded to the CAIR Dashboard.
Please note, exactly 20 observations must be recorded to complete an audit; any more or less will result in an error.
Patient Experience and Public Involvement (PEPI) support NHSGGC to listen and understand what matters to people. This allows us to improve our services using your experiences of care. The team help staff and members of the public to listen and learn from each other.
PEPI support staff and services to engage with people on care and service delivery. They apply best practice when informing and involving patients, carers and the public.
The team also provide expertise and support around the organisation’s public engagement and consultation activities. This is in line with statutory duties and national guidance.
In the first instance your call will be assessed by the referral management centre. If an appointment is required a telephone consultation appointment will be arranged for you.
Infected toe nail surgery cases and wound/ulcers are exceptions to this and will require you to attend a face to face consultation or have a virtual (telephone/video) consultation.
New patient telephone appointment
You will be given a day and time for the podiatrist to phone you. Please ensure you have provided us with the correct contact number when making this appointment. If further treatment is required a virtual consultation may be offered.
Virtual (Near Me) consultations
You will be allocated an appointment time to log into our virtual waiting room. Instructions and guidance will be provided for accessing these clinics. If further treatment is required a face to face consultation may be offered. Learn more about our virtual clinics here.
Face to face appointment
If you are asked to attend the clinic for an appointment please read the following guidance to help keep you safe:
Wear a face covering within the building
Use hand sanitiser when entering and leaving clinical areas and after touching furniture or equipment
Maintain the recommended physical distance wherever possible
Attend for appointments at your appointment time. Please do not attend early for these as physical distancing must be maintained within waiting areas
You should attend your appointment alone unless you require assistance. This will allow physical distancing to be maintained within our waiting areas and clinical rooms
You should only attend our department if you have an appointment. We will not be able to accommodate seeing anyone out with allotted clinical times and cannot appoint people who attend the department for booking appointments
It is essential that you do not attend if you have a persistent cough, fever, or loss of taste or smell. In this instance you should contact us to reschedule your appointment.
If you are an existing patient
Return appointments
These are gradually being reintroduced on a phased return basis dependent on your previously assessed need (see figure 1 above). You will receive a phone call offering you an appointment. These may take a different format from what you have previously been used to. Appointments may be phone calls, virtual (Near Me) consultations or face to face. You will be advised by our call centre as to your appointment type.
Telephone appointment
You will be given a day and time for the podiatrist to phone you. Please make sure you have provided us with the correct contact number when making this appointment
Virtual (Near Me) consultations
You will be allocated an appointment time to log into our virtual waiting room. Instructions and guidance will be provided for accessing these clinics.
Face to face
When attending
Wear a face covering within the building
Use hand sanitiser when entering and leaving clinical areas and after touching furniture or equipment
Maintain the recommended physical distance wherever possible
Attend for appointments at your appointment time. Please do not attend early for these as physical distancing must be maintained within waiting areas
You should attend your appointment alone unless you require assistance. This will allow physical distancing to be maintained within our waiting areas and clinical rooms
You should only attend our departments if you have an appointment. We will not be able to accommodate seeing anyone out with allotted clinical times and cannot appoint people who attend the department for booking appointments
It is essential that you do not attend if you have a persistent cough, fever, or loss of taste or smell. In this instance you should contact us to reschedule your appointment.
Approximately 30% of our Adult Acute Hospital in-patients will have a Peripheral Venous Catheter (PVC) in place during their stay and in order to minimise the risk of bloodstream infections (bacteraemia) it is important that clinical staff are aware of the salient education points:
Skin is cleansed with an antiseptic containing chlorhexidine 2% in 70% isopropyl alcohol and left to dry before VAD insertion for all adult and paediatric patients.
Skin decontamination for neonates is either 0.5% aqueous chlorhexidine or chlorhexidine 2% in 70% isopropyl alcohol and left to dry before VAD insertion.
Access should be via the needlefree access device and not the port at the top of the device. Before accessing this you should “scrub the hub” for at least 15 seconds with chlorhexidine 2% in 70% isopropyl alcohol wipe. This should be allowed to dry before connection to other equipment.
A single or multi-lumen needlefree access devices must be primed with 0.9% normal saline before attaching to VADs. Needlefree access devices used on Peripheral Venous Cannulas (PVC) should have an integrated tubing.
A VAD care plan should be commenced as soon as possible after VAD insertion. PVCs must be checked once per shift, or twice per day. Central Venous Catheters (CVC) must be checked once per day. The VAD care plan must be fully completed to ensure optimal practice to avoid patient harm.
The Infection Prevention and Control Team (IPCT) are working in conjunction with Practice Development to ensure that staff are supported and have the knowledge and skills to care for a patient with a urethral urinary catheter.
The UUC Hub is where you will find all of our information and resources concerning Urethral Urinary Catheters.
Many of our patients will require an indwelling urinary catheter to be inserted during their stay in hospital. It is important that staff involved in the insertion and maintenance of these devices have access to training and guidance to ensure the comfort and safety of their patient.
UUC guidance for Acute in-patients is under development.
Catheter Passport
The National Catheter Passport (NCP) is an information resource given to patients and was created to improve both care and communication around urinary catheters.
Staff can order the National Catheter Passport via PECOS (SKU code 223848) whenever they order their supply of catheters and should be used once the decision has been made for the catheter to remain in situ – this may be on discharge from hospital or whilst at home.
Education
Staff caring for a patient who requires an indwelling urethral urinary catheter should complete the NES module entitled ‘Urinary catheterisation’. Staff should log in to LearnPro NHS and add the NES Urinary catheterisation to their programme.
The Healthcare environment inspection team may visit your ward to inspect the care and maintenance of these devices. Published on the HEI website are the methodology and inspection aide memoir. We recommend that staff familiarise themselves with these two documents.
The IPCT have developed a tool to measure compliance with the urethral urinary catheter care plan. This tool can be used by staff to measure their own ward compliance.
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
What is MERS-CoV?
MERS-CoV is a viral respiratory disease. It is a strain of coronavirus first identified by the Netherlands in 2012. Symptoms include fever and cough that progress to a severe pneumonia causing shortness of breath and breathing difficulties. In some cases, a diarrheal illness has been the first symptom to appear. There is currently no vaccine available for MERS-CoV.
Since April 2014, there has been a marked increase in reported infections with MERS-CoV outside the UK. There continues to be a risk of imported cases to the UK, and health professionals should remain vigilant. Early identification and rapid implementation of appropriate infection control measures for suspected cases is crucial.
While the risk of MERS-CoV in individuals who meet the case definition for a possible case in the UK following travel to/from the Middle East is low, testing for MERS-CoV is warranted together with rapid implementation of appropriate infection control measures while awaiting results of testing.
Patient Assessment: Assessment and initial management of travellers presenting with febrile respiratory illness, returning from an area where infection with MERS-CoV could have been acquired in the 14 days before symptom onset.
Close Contacts: The risk to contacts of confirmed cases of MERS-CoV infection is low but contacts should be followed up in the 14 days following last exposure and any new febrile or respiratory illness investigated urgently for MERS CoV.
A precautionary principle must be applied for novel or emerging respiratory pathogens of high consequence when the mode of transmission is incompletely determined.
Droplet, contact and airborne precautions (including the use of correctly fitted FFP3 respirators) should be applied for all patients admitted with a suspected or confirmed novel or emerging respiratory pathogen (e.g. MERS-CoV or Avian Influenza).
The link below, outlines the infection prevention and control advice for healthcare workers involved in receiving and caring for patients, who are suspected or confirmed cases of MERS-CoV.
This is where you find our information and resources concerning water safety.
The SOP below and risk assessment provide direction and guidance for ward based staff, to meet their responsibilities for the control of risks associated with water systems in NHS premises.
This service cares for women who have conditions affecting the vulval area, where initial treatment has not been successful.
We see women with a range of different conditions which include (but are not limited to):
Lichen Sclerosus
Lichen Planus
Lichen simplex chronicus
Rare vulval skin conditions
Vulval pain.
What to expect at the vulval clinic
This is a specialist multidisciplinary clinic run by two gynaecologists and a dermatologist. Due to the nature of the conditions, you may also be seen by other specialists from sexual health and oral medicine.
You can expect to undergo a consultation and examination, which will include looking at the vulval skin. You may be asked if we can monitor your condition with photographs, available via our clinical photography service. These would form part of your confidential clinical record and access is limited to clinicians involved in your care.
We may need to perform a vulval biopsy, under local anaesthetic.
How to access this service
You will be referred by a consultant dermatologist or gynaecologist who will have reviewed you first. In some instances, you may be directly referred by your GP.
If you have previously been seen in this clinic, you can refer yourself back if necessary. This is called a patient initiated referral.
Where will I be seen?
The vulval clinic is located in clinic area K at the New Victoria Hospital.
Clinic times
The clinic is usually held on the first Friday of the month. Both gynaecologists and our dermatologist are available 9am – 1pm. Our gynaecologists are also available 1.00pm – 5.00pm.
Our one-stop hysteroscopy service sees women for a range of different conditions including:
Postmenopausal bleeding ( bleeding which happens more than a year after the change of life)
Heavy or irregular periods
Bleeding after intercourse
Lost coil threads/ need a hormone coil inserted.
As well as clinics to investigate these things we also have treatment clinics for:
Removal of endometrial (womb) polyps
Endometrial ablation (a minor surgical treatment for heavy periods).
What will happen in the clinic?
Before you attend the clinic you will be sent a leaflet explaining what to expect and outlining possible procedures which may be carried out during your visit.
There are currently 2 hospitals that have a ‘One Stop’ clinic, Stobhill Hospital and the Royal Alexandra Hospital (RAH).
On arrival
When you arrive at Stobhill you can either check-in at the self-service points in the entrance hall or go straight to Clinic F to check in there.
When you arrive at the RAH you need to go to the reception in the Maternity Building where you will be directed to Clinic B.
The consultation
Once you have checked in you will be seen by a consultant. They will take your medical history and ask about your symptoms. You will then be shown to your private diagnostic suite. Each suite has a private changing room and separate treatment area. A nurse will help you get ready and explain things to you.
Most women will have a vaginal scan carried out. Some women will have a hysteroscopy examination (tiny telescope used to check the lining of the womb) and some women will have a sample of tissue taken from the lining of the womb (pipelle biopsy). Your consultant will discuss all of these things with you before carrying them out.
After your examination, you can stay in the recovery area for a hot drink or, if you prefer, leave immediately.
You will be given an information leaflet about any tests you have had and also given a card with the telephone number for the service in case you need more advice following your appointment.
Your consultant will write to you and your GP with the results of your investigations and will arrange any further treatment that is needed.
How do I access this service?
You can be referred by your GP or by a hospital consultant.
Where will I be seen?
The clinics are held in Stobhill Ambulatory Care Hospital, Level 2, Clinic F and the Royal Alexandra Hospital, Maternity Building, Ground Floor, Clinic B.
The Gynaecology Oncology Department at Glasgow Royal Infirmary is the referral centre for the West of Scotland.
Our service offers diagnosis and specialist treatment for all types of gynaecological cancer.
Women are cared for by a multidisciplinary team (MDT) of specialists which includes oncological surgeons, clinical and medical oncologists, radiologists, pathologists, clinical nurse specialists (CNS) and pharmacists. The clinical team is supported by the Single Point of Contact (SPOC) Service who will help you navigate your treatment journey.
How will my care be managed?
The team meet once per week to discuss all patients with a suspected or confirmed gynaecological cancer. Decisions regarding further investigations and potential treatment plans are made at this meeting. You will be informed of the recommendations from this meeting by your gynaecology consultant or your clinical nurse specialist.
Your care may be delivered at the following locations:
Hospitals
Glasgow Royal Infirmary
Stobhill Ambulatory Care Hospital (Stobhill ACH)
Beatson West of Scotland Cancer Centre.
Outpatient clinics
Outpatient clinics are held in:
Stobhill ACH
Glasgow Royal Infirmary
Beatson West of Scotland Cancer Centre.
Inpatient surgery
Inpatient surgery is based in Glasgow Royal Infirmary.
Other treatments
Chemotherapy, radiotherapy and clinical trials are delivered from the Beatson West of Scotland Cancer Centre.
What if I need surgical treatment?
If you require surgical treatment you will be referred to the Gynaecology Oncology Department at Glasgow Royal Infirmary. You will then receive an appointment for a clinic with the Gynaecology Oncology Consultant who will discuss the proposed treatment plan with you. This may be in the form of a face to face clinic appointment, a telephone or video consultation.
Preoperative assessment
You will receive an appointment for a preoperative assessment (POA) clinic at either Glasgow Royal Infirmary or Stobhill Hospital. This will be a face to face appointment with a trained pre-operative assessment nurse.
They will ask you some questions regarding your general health, past medical history and medication history.
They will check your pulse and blood pressure and take some routine blood tests. Further specific tests may be required.
Your surgical appointment
You will receive details of the date and time for admission for surgery by letter and/or telephone.
What if I need chemotherapy or radiotherapy?
If you require chemotherapy or radiotherapy you will receive this treatment at the Beatson West of Scotland Cancer Centre. The department is actively involved in research and clinical trials. The clinical trials unit is also based at the Beatson.
Our staff
We have a dedicated team made up of consultants, advanced nurse practitioners, clinical nurse specialists and support staff.
The gynaecology oncology consultants based at Glasgow Royal Infirmary are:
Dr Kevin Burton
Dr Rhona Lindsay
Dr Nadeem Siddiqui
Dr Malcolm Farquharson
Dr Michelle Kent
Dr David Smith
The Gynaecology Oncology Nurse Specialists are:
Clinical Nurse Specialist Lesley Kelly
Clinical Nurse Specialist Nicola Fisher
Single Point of Contact Service
The Single Point of Contact Service are available to support you through your treatment journey and are the first point of contact if you require assistance or additional information relating to your treatment. The SPOC team are not clinically qualified, but they work alongside and support clinical members of the team.
The SPOC team are available Monday to Friday from 08:00 to 17:00.
You can email the team at: ggc.spocteam@ggc.scot.nhs.uk or you can telephone 0141 201 3473 / 0141 242 9479.
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