A further update has been released in the form of a letter from Pauline Wright (Microbiology Department, Southern General Hospital) in regards to vaginal swabs. The contents of the letter can be read below.
Letter From Pauline Wright:
Vaginal swab microbiology testing: need for clinical information
Thank you for your cooperation in adhering to the 2011 GGC guidance regarding the investigation of vaginal discharge in women of reproductive age. To recap, this recommends that a vaginal swab should be taken in the following circumstances: recurrent symptoms, treatment failure, symptoms of PID, postpartum or post gynaecological instrumentation1. In addition we will process samples from pregnant patients.
Samples from under 16’s, over 55’s and other non-vaginal genital samples will be processed as normal. Samples from postmenopausal women under 55 will also be processed if this is indicated on the request form.
In line with our previous communication via the weekly GP email, we have started processing only vaginal swab culture requests that clearly meet the defined clinical criteria. We have had some constructive feedback and would like to take this opportunity to give an update on the implementation of the guidance. The main reasons for sample rejection are listed below:
- Clinical details are left blank or “PV discharge” only. To ensure appropriate samples are processed please supply the necessary clinical details as above.
- For suspected STI, the appropriate sample is a vulvovaginal / endocervical swab in a Multi-Collect transport tube sent to the West of Scotland Specialist Virology Centre (GRI, Glasgow) for chlamydia and gonorrhoea NAAT.
- Clinical details indicate “bleeding” only. If PID is suspected, please indicate clearly on the request form.
- Clinical details indicate “? BV” or “? thrush” only. Empirical treatment should be given based on examination and vaginal pH. Samples should only be sent for culture in the event of failed treatment / recurrent symptoms.
Other samples which have been rejected included clinical details “’trying to conceive’, ‘at smear’ and ‘odour’. We have also rejected samples mentioning “persistent” discharge unless it is clear on the request form that this represents failed treatment / recurrent symptoms. GP Order Comms has been designed to reflect this guidance and will prompt the requester to indicate relevant clinical details. This should make the process more straight forward.
Advice and support on this guidance is available from the Sexual Health advisors at the Sandyford Initiative as part of the Shared Care Initiative by phoning the helpline on: 0141 211 8639. Women with troublesome recurrent symptoms can also be referred for specialist advice to the Sandyford (via SCI Gateway), where they can access in-clinic microscopic assessment of vaginal discharge and receive advice on appropriate suppressive treatments if needed.
We appreciate your continued support and cooperation, and value your feedback. Please forward this to all relevant staff. On behalf of the NHSGGC Medical Microbiology Department, in partnership with the BBV & STI Diagnostic Working group.
There have been changes made to the shingles (Herpes Zoster) vaccination programme for 2014-15 You can find out more about these changes by reading the letter provided below:
A letter has been released providing updates on the developments in Scotland related to Female Genital Mutilation (FGM). You can find out more by reading the letter provided below:
There has been a medical device alert from the MHRA that relates to all types, makes and models of breast implants. The MHRA is encouraging healthcare professionals to report cases of Anaplastic Large Cell Lymphoma (ALCL) in women who have breast implants or who have had them removed. You can read more in the document provided below:
The below message from the NHS Scotland provides an update on the current outbreak of the Ebola virus in West Africa. We remind you to be vigilant for cases imported to the UK – particularly athletes for the Common Wealth Games 2014 in Glasgow. You can find out more information within the document provided below:
The Games will take place between Wednesday 23 July and Sunday 3rd August in venues around Glasgow. Below is a short document to assist you during the Commonwealth Games:
The above document includes:
- A reminder about the criteria for Overseas Visitors entitlement to treatment
- Temporary Residents and visitor accommodation
- Travel and Transport issues including the Games Route Network, the three Road Races and the Local Area Traffic and Parking Plans around venues
- Access to Patients
- Communication and Escalation procedures
There is address and postcodes information for residents affected by event day parking restrictions, secure areas and road closures. We would recommend that you review this information and understand if you have any patients in these areas. Event Day Parking Permits are being issued to those practices that have patients within these restricted areas together with comprehensive information on the limits of these permits. These will be issued via the Glasgow CHP.
Vehicle access to restricted areas will be controlled and in some cases will not be possible. It is essential that all staff wishing to obtain vehicle access to those restricted areas where vehicle access is permissible, have photographic ID with them.
Further information can be found at www.nhsggc.org.uk/cwg2014
We would like to draw your attention to the publication on 17th June of the Court of Appeal Judgement on a case brought in England against the Cambrisge University Hospitals NHS Foundation Trust and the Secretary of Statee for Health to clarify the progress of the existing Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Scottish Policy. You can find out more in the letter provided below:
Due to holidays the LMC will be running on a reduced staffing level during the week beginning 14th July. Please note our 48 hour response time to enquiries may not be possible during this week. Please only contact the LMC for emergencies.
The PNA Team are a small team whose role is to support and develop Practice Nursing within NHS Greater Glasgow and Clyde. We are grateful to the LMC for giving us this opportunity to contribute to their website. Our PNA Team Staffnet WebPages can be accessed when logged onto a work computer via this link. The Webpages host information to support the PN role.
The NMC’s proposed revalidation model brings back to the heart of nursing and midwifery the value of reflection on the Code. The proposed self-confirmation model is based on every nurse and midwife reflecting on their practice against the Code. Feedback from peers and users will be on how nurses and midwives uphold their professional standards as set out in their Code. And a third party confirmation as part of an existing employer process, such as appraisal, will focus on how nurses and midwives follow their code of conduct.
NMC Revalidation will require every nurse and midwife to confirm that they:
Continue to remain fit to practise by meeting the principles of the revised Code.
Have completed the required hours of practice and learning activity through continuing professional development (CPD).
Have used feedback to review and improve the way they work.
Have received confirmation from someone well placed to comment on their continuing fitness to practise.
The Revalidation Consultation will address revising the Code (the standards of good nursing and midwifery practice) and implementing revalidation. This process is taking place from January to August 2014. In part one, which ran January – March, The focus was on how the proposed model of revalidation can be implemented in a variety of employment settings and scopes of practice. This will help ensure the model that is launched in December 2015 is flexible and fit for purpose. In part two, April – August, a draft code has been developed and we would encourage you to comment before 11-8-14 by clicking this link.