Posters

Thinking about the future: a QI project to educate and improve the understanding of advance care planning in the AMU. A Fisher; C Bruce; M Leyton; M Rainbow; J Evans Acute Medical Unit; Torbay Hospital; Torbay and South Devon NHS Foundation Trust Introduction: Advance care planning (ACP) allows patients with serious illness or deteriorating health to discuss future care preferences, supporting a more holistic, patient-centred approach. However, public awareness of ACP remains low and is cited as a key barrier to its uptake in clinical practice. A 2014 audit by the Royal College of Physicians

Background: Hip fractures represent a significant global health burden, leading to substantial morbidity, mortality, and healthcare costs. Delays in surgical intervention are consistently linked to poorer patient outcomes. This audit aimed to evaluate and enhance hip fracture management at Southampton General Hospital (SGH) through targeted quality improvement initiatives. Methods: An interventional clinical audit was conducted at SGH, a Major Trauma Centre, comparing a pre-intervention period (December 2023 – March 2024; n=272 patients) with a post-intervention period (September 2024 –

Introduction: An accurate stool chart is crucial to the care of older patients. Monitoring of bowels movements can help to avoid complications such as constipation, urinary retention, delirium, faecal impaction, diarrhoea, dehydration and AKI which all can lead to extended hospital admissions and deconditioning. Clear recording of bowel movements might allow the medical team to recognise the problem and promptly take action. Our project aimed to increase the accuracy of stool chart documentation on geriatric medicine wards, promoting earlier recognition of these complications. Methods: Initial

Introduction Parkinson’s disease (PD) is the second most common and fastest-growing neurodegenerative condition globally. Many older adults with PD reside in care homes, where staff may lack the necessary training to manage the condition effectively. This scoping review aimed to examine the evidence on education and training interventions for care home staff in relation to PD care. Method A scoping review was conducted in accordance with the PRISMA-ScR framework. Six databases were searched for empirical studies focused on PD-related training or education for care home staff. Inclusion

Introduction: The British Geriatric Society has been a forerunner in describing the potential benefits of a comprehensive geriatric assessment and advance care planning for all patients and focusing on wellbeing strategies for this vulnerable patient group. QIP project was undertaken with the aim to look at the fast track discharges and advance care planning documentation in accordance with the EOL care strategy 2008. Through reviews of individual cases, it is thought that advance care plans (with recognition and interventions for patients thought to be in their last year of life) would

Background The study was set in a 15-bed older adult psychiatry ward. Staff involved were doctors, ward manager, nurses and nursing associates. Introduction Overall pain assessment was poor due to the under-recognised importance of recording pain. The aim of this quality improvement project was to implement strategies to improve rates of pain assessment and assess for effective change. Methods An initial review of patient records was done prior to intervention, recording when a pain assessment template used by the trust (Abbey pain scale) was documented using the following criteria: 1. within

Introduction Early identification and multidisciplinary management of frail patients in acute care is a national priority, as reflected in the NHS Long Term Plan1, NHS Improvement (NHSI)2, and Getting It Right First Time (GIRFT)3. Sunderland Royal Hospital’s acute frailty services run daily from 08:00–20:00 across the Emergency Department (ED) and Emergency Admissions Unit (EAU), assessing patients with a clinical frailty score (CFS) ≥5. Morning duties are primarily dedicated to reviewing overnight admissions on EAU, which can lead to a delay in assessment of new patients arriving in ED. As

A Quality Improvement Project in Managing AKI in post operative femur fracture and other orthopaedic patients. Authors:; B Khoshnaw1; W Y Ooi1; M Motsara1 Provenance: 1. Lincoln County Hospital, United Lincolnshire Teaching Hospitals NHS Trust. QIP supervised by Dr P Mathew, Orthogeriatric Consultant, Lincoln County Hospital. Introduction Acute Kidney Injury (AKI) is a serious and preventable complication in older adults following orthopaedic surgery. At Lincoln County Hospital, inconsistent AKI recognition and response led to a Quality Improvement Project (QIP) aiming to embed the trust’s AKI

Introduction The Clinical Frailty Score (CFS) allows appropriate frailty assessment to guide management plans for oncology patients. CFS documentation is not standard at our trust. We aimed to introduce CFS documentation in the Acute Oncology Service (AOS) clerking proforma and evaluate its use in patients aged >65 to help guide management. Methods Data was obtained from inpatients on the oncology wards via NerveCentre. Three PDSA cycles were completed: Cycle 1: An evaluation to identify how many patients had a documented CFS. Based on this, a poster was created, emailed to oncology staff, and

Introduction Parkinson’s disease increases fracture risk due to higher fall rates and increased osteoporosis prevalence. This two-cycle bone health audit assessed adherence to the BONE-PARK algorithm at Florence Nightingale Community Hospital’s Parkinson’s clinic and evaluated improvements over 12 months. Methods Fifty patient records were reviewed to assess bone health management, focusing on fracture risk assessments (FRAX/QFracture), serum calcium, vitamin D, and follow-up actions, establishing a baseline before intervention. A re-audit of 39 patients after 12 months assessed progress

Introduction: Delirium is a common acute presentation among older adults, particularly following acute illness or surgery e.g. neck of femur fractures. Early recognition is crucial, as delirium is associated with increased morbidity, mortality, and prolonged hospital stays. NICE guidelines recommend the use of a validated tool, 4AT, for delirium screening in all patients aged ≥65 upon admission. Aim & Objectives: Compliance with 4AT screening on admission 4AT assessment on new onset of confusion Train nursing staff on 4AT screening for early identification of delirium Methods: Prospective data

Introduction: Syncope is a common clinical problem[1] posing a diagnostic and therapeutic challenge, due to varied presentations and underlying pathologies[2]. Although an MDT approach is a recognised key component in patient care[3], there is no current guidance in the context of syncope. The Syncope Service in QEUH Glasgow is run by Geriatricians with a specialist interest in Syncope. A formalised monthly MDT, introduced in November 2017, involves Geriatricians, Cardiologists, a Neurologist and Cardiac Physiologists. Method: A retrospective case note analysis undertaken for patients reviewed

Introduction This Quality Improvement Project aimed to increase patient engagement and improve documentation of individual care preferences on geriatric wards. The focus was on enhancing communication—particularly for patients with cognitive impairment—to support personalised, patient-centred care. This was achieved by promoting the use of the "Getting To Know Me" (GTKM) form and "What Matters To Me" (WMTM) icon through dedicated staff support and visual aids. Method Activity Coordinators were assigned specific days to assist patients in completing the GTKM form and WMTM icon. Laminated visual

Background: Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use. Older adults are at higher risk of antibiotic associated complications, especially C. diff infection. Methods: Baseline data were collected from the hospital's electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance

Orthogeriatrics: Improving Assessments and the use of Bisphosphonates Introduction At Doncaster Royal Infirmary we targeted an improvement in the care of patients admitted with a hip fracture. The first objective was to deliver more consistent Orthogeriatric Assessments. The second objective was to improve bone health assessments and the use of bisphosphonates for secondary prevention of fragility fractures. Method After a period of limited Orthogeriatric service, from January 2025, new medical support was provided in the form of 12 hours per week of Consultant time and support from a recently

Introduction. Our perioperative service for older people undergoing surgery (POPS) commenced inpatient reviews in September 2024. Method. Patients being considered for laparotomy aged 80 and over were prioritised as part of the national emergency laparotomy audit (NELA) recommendations1. Other patients reviewed were multi-morbid and frail patients with other pathologies, aged between 65-80. All patients reviewed had a comprehensive geriatric assessment (CGA) and shared decision making (SDM) as required2. Results. In 3 months, 115 patients were seen. Median age 83, median clinical frailty score

Introduction: Care home residents and staff have limited, though increasing, opportunities to participate in research. This project aimed to describe motivating and limiting factors for research participation and priorities in Scottish care homes. Methods: In a cross-sectional study, a 21-item questionnaire was distributed to Scottish care homes for older people by ENRICH (Enabling Research in Care Homes) Scotland. It included questions on demographics and previous research involvement, with multiple choice and free-text response options. Mixed methods analysis was used including non

Introduction Approximately 70,000 hip fractures occur annually in the UK, costing the NHS over £2 billion each year. These injuries carry significant morbidity and up to 30% one-year mortality. One in five patients will sustain another further fragility fracture within five years - most commonly in the first year. Zoledronic acid, a parenteral bisphosphonate, significantly reduces subsequent fracture risk and mortality. Although timely inpatient use is supported by National Osteoporosis Guideline Group (NOGG) guidance and a 2023 British Geriatrics Society Call To Action, uptake remains low

THE EFFECT OF UNILATERAL, LOW-INTENSITY, UPPER LIMB MOTOR CONTROL TRAINING ON COGNITIVE FUNCTION IN HEALTHY OLDER ADULTS: A PILOT STUDY Introduction Age-related cognitive decline, particularly in executive function and processing speed, is a major concern. Physical exercise is recognised as a strategy to support cognitive health (1), however not all older adults are physically able to perform the ‘traditional’ forms of exercise (i.e., resistance and endurance exercise), which have been shown to elicit this benefit. Motor control training (MCT) is emerging as a potential alternative exercise

Introduction: Frail older adults with diabetes are particularly vulnerable to harm from tight glycaemic control. Hypoglycaemia can increase the risk of falls, delirium and prolong hospital stay especially in those with frailty. Regional and National guidelines (NICE NG28, JBDS) recommend individualised HbA1c targets based on frailty status, yet in routine inpatient practice this is often overlooked. The aim of this quality improvement project (QIP) was to improve frailty scoring and individualised HbA1c targets in frail diabetic inpatients Method: This quality improvement project was conducted