Posters

Introduction Fragility fractures are a major cause of morbidity, mortality and loss of independence in frail older adults. Early identification and management of osteoporosis and poor bone health can reduce fracture risk and improve quality of life. NICE and National Osteoporosis Guideline Group (NOGG) guidance recommend osteoporosis risk assessment as part of multifactorial falls assessment and advise bone health assessment for frail older inpatients. We undertook a quality improvement (QI) project at Glangwili Hospital to improve the assessment and management of bone health in older patients

Background: Neck of Femur fractures (NoFs) are associated with significant morbidity, mortality and prolonged hospital admission. These make up a significant portion of the Trauma and Orthopaedic admissions at Weston General Hospital. Optimal management requires multidisciplinary assessment and timely optimisation to meet the national targets for management of fractures. A review of the clerking proforma prior to this audit found variability in the documentation quality and completeness. Aim: To assess baseline documentation quality in NoF admissions and evaluate the impact of a redesigned

Introduction It is recognised that CPR should be based on an individual risk-benefit assessment, taking into account the likelihood of success, potential harms, and the patient’s wishes. RESPECT forms have been created to document personalised recommendations for emergency care based on discussions around a patient’s preferences, values, and wishes regarding future treatment and end-of-life care . This project aimed to assess and improve adherence to guidance from the Resuscitation Council UK regarding DNAR decision-making, patient + NOK discussions and documentation of these decisions with

Frailty SDEC & Front door team University Hospital of North Midlands NHS Trust is 1500 bed tertiary care hospital in Stoke-on Trent, UK Frail elderly patients account for a significant proportion of emergency attendance to our Emergency Dept. Early assessment and clinical decision making is vital for these groups of patients and specialist assessment at the front door can prevent unnecessary admissions and also reduce the risk of complications such as delirium, deconditioning and hospital acquired infections. Inorder to improve the care of frail older patients presenting to ED, we developed

Background Urinary tract infection (UTI) is frequently diagnosed in hospitalised older people, although non-specific presentations such as delirium, falls and confusion may occur without localising urinary symptoms. This can lead to unnecessary antibiotic exposure, delayed microbiological sampling and missed opportunities for antimicrobial de-escalation. Local problem An initial audit identified inconsistent assessment of urinary symptoms, delayed culture collection, variable adherence to local antimicrobial guidance and incomplete review of microbiology results. The aim was to improve

Introduction Falls are a leading cause of injury, hospital admission and loss of independence among older people. At the start of this project, NICE CG161 recommended comprehensive multifactorial falls assessment for older adults at risk of falls. During the second audit cycle, this guidance was superseded by NICE NG249 (2025). Review of the updated recommendations confirmed that the audit criteria and intervention still aligned with the current guideline. We evaluated documentation of multifactorial falls assessment and the impact of introducing a structured Outpatient Falls Risk Assessment

Introduction In 2024 we conducted a service evaluation of our new stroke AI in Wales, Brainomix. We reviewed its sensitivity and specificity at identifying large vessel occlusions (LVO’s) on CT Angiograms (CTA’s) for our stroke patients. The purpose of Brainomix being to assist in rapid detection of LVO’s and support decision making around proceeding to mechanical thrombectomy for appropriate individuals. Multiple studies in recent years have demonstrated improved functional outcomes for patients receiving mechanical thrombectomy. Brainomix was hoped to be pivotal in bringing these

Introduction Supporting Professional Activity (SPA) time and specialty clinic attendance are essential components of higher specialty training. Despite being allocated within work schedules, protected educational time was frequently interrupted by clinical service demands, limiting curriculum progression and trainee development. We aimed to improve reliable access to protected SPA and specialty clinics for Group 1 specialty registrars through low-cost system interventions. MethodA prospective quality improvement project was undertaken in a district general hospital using two Plan–Do–Study–Act

Introduction. Opioids are commonly prescribed to older adults but are associated with important adverse effects, including constipation, delirium, sedation, falls, respiratory depression and toxicity, particularly in patients with renal impairment. This quality improvement project assessed the safety and appropriateness of opioid prescribing among older inpatients. Methods. A prospective review was undertaken over four weeks across Newington and McDonald wards at Conquest Hospital, East Sussex Healthcare NHS Trust. Thirty inpatients aged ≥65 years who were prescribed an opioid were included

Background: The Gold Standards Framework (GSF) is a nationally recognised tool used to identify patients approaching the end-of-life and facilitate advances care planning (ACP). Accurate GSF assignment can improve ACP, support preferred place of care and death, and reduce unnecessary admissions. Mortality following hip fracture is currently 6% within one month and varies from 12.1%-35.8 % globally at one year, making accurate prognostication particularly important in orthogeriatric populations. We therefore evaluated the accuracy of GSF assignment in patients aged over 60 years admitted with

Introduction: Several studies explored the role of frailty in predicting outcomes in critically ill patients. Frailty has been identified as an independent risk factor for all cause morbidity poor outcomes, including mortality, longer hospital stays and complications Rockwood et al. (2005). Muscedere et al. (2017) found that frailty is associated with worse outcomes in patients receiving mechanical ventilation, however there is limited focus on NIV. While NIV is widely used for managing acute respiratory failure, its effectiveness across varying levels of frailty and comorbidity remains

Introduction Cauda Equina Syndrome (CES) is a time-critical neurosurgical emergency in which delayed diagnosis may cause irreversible neurological disability. Diagnosis in older adults is challenging because back pain, bladder dysfunction and reduced mobility commonly coexist with age-related comorbidities. This quality improvement initiative evaluated the clinical characteristics of MRI-confirmed CES in older adults and the effect of introducing routine post-void residual (PVR) measurement. Methods A retrospective clinical audit reviewed adults undergoing lumbosacral MRI for suspected CES at

Introduction Revision total hip arthroplasty (rTHA) is increasingly performed in an ageing population, but functional recovery and the need for subsequent revision remain important concerns. This study aimed to evaluate the functional outcomes, re-revision rates and mortality following rTHA in a geriatric population. Methods We retrospectively reviewed 145 revision total hip arthroplasty procedures performed in 138 patients between 2021 and 2025. Patient demographics, indications for revision, re-revision, mortality and postoperative mobility were reviewed. Results A total of 145 revision

Introduction Suspected Transient Ischaemic Attack (TIA) is a common and important reason for Emergency Department (ED) presentation in older adults. Local guidance recommends that patients should undergo CT head imaging, be prescribed aspirin and referred to the TIA clinic. However, a suspected TIA can create diagnostic uncertainty, making clinical decision-making challenging. We evaluated adherence to the local referral pathway to guide service improvement opportunities and identify variation in management according to final diagnosis. Method We conducted a retrospective audit of TIA

Introduction: Medication timing is critical for patients with Parkinson's Disease (PD). The 'Get It on Time" campaign strives to have PD patients receive their medications within 30 minutes of prescribed time. Methods: Using PDSA methodology, a list of current inpatients with PD was populated and their medicines reconciliation (med rec) repeated to check accuracy of admission prescriptions. HEMA records were analysed to ascertain how many doses in the last 3-5 days of admission were given >30 minutes late. We also collected qualitative data from patients via an in-person survey, asking how

Introduction: A Treatment Escalation Plan (TEP) is used to guide the level of appropriate care for patients at risk of deterioration. The aim is to prevent iatrogenic harm by reducing inappropriate investigations and treatments. Benefits of early escalation discussions are well-documented and TEPs are gold standard in the SIGN 167 guideline. Additionally, clarification of care escalation is undeniably beneficial for out-of-hours teams who may unnecessarily investigate and overtreat. The aim of this audit was to 1) identify barriers to TEP decisions on admission to AMU, and 2) increase the

Melatonin biomarkers and delirium in older adults: A systematic review of observational studies Introduction Delirium, a severe clinical syndrome characterised by acute disturbances in attention, awareness and cognition, affects approximately 20–50% of older adults in hospital care. Melatonin, a key regulator of circadian rhythms, has been proposed as a potential biomarker for delirium due to its role in sleep–wake regulation. However, evidence regarding the association between melatonin secretion and delirium remains inconsistent. This systematic review synthesised evidence on the association

Introduction NICE CG103 and SIGN 157 recommend non-pharmacological measures to reduce delirium risk, including visible clocks, day/date orientation, clear signage, and ensuring sensory aids are available and used. This audit assessed compliance with sensory orientation measures on an older adult delirium/dementia ward, then evaluated whether simple ward-based environmental and documentation prompts improved practice. Methods A baseline audit was performed on 14/04/26 on Ward 52, an older adult delirium/dementia ward at Queen Elizabeth University Hospital, Glasgow. Patients aged ≥65 years with

Background: The Clinical Frailty Scale (CFS) is a validated 9-point tool used to assess frailty in older adults, supporting clinical decision-making and care planning. Current guidance recommends CFS assessment at first contact with acute services; however, locally, completion often occurs after review by geriatric teams. This project explored whether a patient/carer-completed CFS questionnaire could facilitate earlier frailty assessment. Aim: To develop a self-completed CFS questionnaire for patients and carers and evaluate its accuracy compared with clinician CFS scores in patients aged over

Introduction: Nepal's older population (aged ≥65 years) represents 6.9% of the national total and is growing rapidly. In remote rural areas such as Lomanthang Rural Municipality (R.M.) in Upper Mustang — an isolated high-altitude community at 3,800 m above sea level — the older prevalence reaches 13.1%, yet health and social support infrastructure remains critically insufficient. No previous study has systematically assessed the care needs of senior citizens in this community. Methods: A cross-sectional descriptive field study was conducted in Lomanthang R.M. between May and September 2025