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Atypical Presentation of Guillain-Barré Syndrome with Preceding Severe Hyponatremia

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Razia Sultana¹, Ayodeji Afolabi²
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Background: Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy. Hyponatremia, often caused by Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH), is a recognized but underappreciated complication of GBS. SIADH typically arises after neurological symptoms; however, rare cases may present with hyponatremia preceding neuromuscular features, complicating early diagnosis and management. Case Presentation: A previously well man in his 50s presented with acute confusion and drowsiness. Initial investigations revealed profound hyponatremia (serum sodium 110
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Assessing IV Cannula Use: An Audit on Reducing Unnecessary Prolongation and Associated Risks

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M Khalid1; M Alarayedh2
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Introduction: The use of intravenous (IV) cannulas is a common clinical practice; however, their prolonged or unnecessary use can increase the risk of complications such as thrombophlebitis, infection, and patient discomfort. This quality improvement project, was undertaken to evaluate current practices within the clinical setting and to identify areas for improvement. Methods: Data was collected over the period of 2 weeks in March 2025 and it was collected every Monday, Wednesday and Friday. The inclusion criteria was patients admitted to the Stroke Unit at New Cross Hospital and the
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Bone health assessment practices in older patients and patients with a lower limb amputation on a regional vascular surgery ward

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Hannah George1, Dr Stephanie Wells2
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Introduction Increasing numbers of older people are undergoing major arterial surgery and major lower limb amputations for peripheral vascular disease (PVD). Osteoporosis and PVD share several common risk factors. In 2024, the National Osteoporosis Guideline Group (NOGG) updated their recommendations to include lower limb amputation as an additional clinical risk factor that should prompt proactive bone health assessment in this group. Perioperative Comprehensive Geriatric Assessment (CGA) provides a context where this can occur. Method Data were collected prospectively as part of a service
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Improving Advance Care Planning Completion in Primary Care

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A Biju1; E Saudella1
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Introduction Advance care planning (ACP) is a patient-centred discussion involving the patient, family, and healthcare professional to ensure future care aligns with patient wishes. In Wales, this includes two recognised documents for those with capacity, and a best interests form for those without, completed by a Lasting Power of Attorney or IMCA. ACPs in the elderly population have been shown to enhance quality of life, communication, and reduce unwanted hospital admissions. This project aimed to improve ACP completion in primary care. Method Forty-one residents, who were registered to Roath

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Vision screening in older adults who attend hospital following a fall: a scoping review.

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A Baig1,2; K Radford2; A Cowley1,2,3; J Mehta4; A Gordon5,6; J Christian7; L Ibrahim8; M Akkurt9; M Ali10; E Self2
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Introduction: The assessment of impaired vision is included in falls prevention guidance for older adults but implementation is variable. We conducted a scoping review to better understand current practice and inform future implementation research around vision assessments for older adults attending acute hospitals following a fall. Methods: JBI methodology was followed. MEDLINE, AMED, EMBASE, PsychInfo, CINAHL and WebofScience were systematically searched for literature on the assessment of vision in older adults attending acute hospitals following a fall. Sources eligible for inclusion had a

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Barriers perceived by medical students when considering a career in geriatric medicine.

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Grace Fisher [1], Sarah True [2]
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Introduction Despite the UK’s increasing life expectancy, and increase in the elderly population, there is an overwhelming lack of Geriatricians in the UK; as of 2022, there is only 1 consultant Geriatrician per 8,031 individuals over the age of 65 (BGS, 2023). To meet the complex care needs of this population, there must be a focus on increasing the interest that doctors have towards Geriatric Medicine, with the overall aim being to recruit more doctors into the speciality. Method The aim of this review was to investigate what factors medical students perceive as barriers to pursuing a career

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Reducing anticholinergic burden (ACB) within the elderly care wards through implementation of automated alerts

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N.Malik1; S.Salman1;K Ng2;N Tan2
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Introduction: Polypharmacy is a major risk for older patients aged 65 and above. Commonly prescribed medications may have anticholinergic properties causing dry mouth, constipation, and urinary retention which can exacerbate delirium in older adults1. ACB scores help quantify the cumulative effect of these medications. ACB scores of three or more are associated with confusion, falls and death2. Aim: To evaluate whether automated alerts of ACB scores help reduce scores and encourage medication reviews in older patients. Method: Over two weeks, automated alerts were set up within the hospital’s

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Case-Finding for Falls Prevention: Wigan Pilot

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B.Badrock
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Introduction Falls are a significant health concern, with one in three people over 65 experiencing at least one fall annually. Greater Manchester is leading a world-first pilot of eFalls technology to support healthy ageing and reduce fall-related injuries in older adults. The pilot aims to proactively identify individuals at moderate risk of falling and offer early interventions to maintain their independence and wellbeing. Method The eFalls pilot launched in February 2025 and will run for nine months within the South Wigan Ashton North (SWAN) primary care network in Wigan, Greater Manchester
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Compliance with Nutritional Assessment Guidelines and Its Impact in Older Adults with Neck of Femur Fractures: A Re-Audit at Medway maritime hospital

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Dr Faisal Jamil, Dr Reazun Nahar, Dr Vaskar Debnath, Dr Sarath Kumar, Dr Ayman khattak, Dr Mahnoor
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Abstract title - Compliance with Nutritional Assessment Guidelines and Its Impact in Older Adults with Neck of Femur Fractures: A Re-Audit at Med Abstract Author Name - R Nahar1; V Debnath1; F Jamil2; S Kumar3; A Khattak4; M Shoaib5 Abstract Provenance - 1. Dept of Elderly Care, Medway Maritime Hospital; 2. Dept of Elderly Care, Medway Maritime Hospital; 3. Dept of Elderly Care, Medway Maritime Hospital; 4. Dept of Elderly Care, Medway Maritime Hospital; 5. Dept of Elderly Care, Medway Maritime Hospital; 6. Dept of Elderly Care, Medway Maritime Hospital; Abstract Content - Title- Compliance

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Improving the Use of Digital Delirium Assessment Tools through Redesign and Teaching

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Nicholas Fincham, Lydia Russell
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Background Pop-Up Digital assessments utilising screening tools such as the 4AT could been seen as a method to improve early diagnosis. The aim of this project is to improve the use of the 4AT through a redesigned pop-up Delirium Assessment, and to see whether its use would improve following raising awareness though ‘Dementia Action Week’. Methods Thirty patients' medical records from emergency admissions containing the medical coding criteria ‘Confusion’, ‘Delirium’, and ‘Dementia’ were included for each cycle. Patients under 65, and those admitted for less than 24 hours were excluded. The

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Improving the number of inpatient falls by introducing inpatient falls risk assessment by doctors in geriatric wards.

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Mohammed Jamali, Phyu Phyu Thant, Siddique Adnan, Abdelmoniem Elmustafa, Thayapary Sivagnanam, Shaha Pennadam Sheriff and Dissanayake Paranathala
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Introduction Inpatient falls remain a major healthcare challenge, with an average rate of 6.6 per 1,000 occupied bed-days in NHS England and Wales hospitals. Prevention of falls during hospital stay based on identifying and managing the modifiable risks are challenging. Multifactorial falls risk assessment and prevention action plan (MFRA FPAP) is a proforma booklet adopted by ABUHB. Methodology The initial QIP (2022–2024) revealed incomplete and poor-quality MFRA. Falls champions were introduced for a period of time, it showed an improvement, but was not sustained. Due to a rise in in-patient

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Development and implementation of an acute bone health assessment toolkit for patients presenting with falls to the medical take

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S. Browne1, I. Wood2, A. Pasyar1
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Introduction Falls, in older patients living with frailty, are a common presentation to the medical take. Assessment of bone health is a key component of the comprehensive geriatric assessment and a risk factor for fragility fracture. We collected baseline data highlighting that bone health in this cohort was commonly overlooked. In response, our quality improvement (QI) project led to the development and implementation of an acute bone health assessment toolkit with overall enhancement in assessment. Methods Using QI and Plan-Do-Study-Act (PDSA) methodology, baseline data was collected for
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Improving Bone Health in Patients with Parkinson’s Disease: A Retrospective Study in a DGH

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Muhammad Shamim Hossain1, Tazim Samira1, Sam Abraham2, Yusuf Mahmood3
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Title: Improving Bone Health in Patients with Parkinson’s Disease: A Retrospective Study in a DGH Background: Parkinson’s disease (PD) is a neurodegenerative disorder primarily affecting movement, but its impact on bone health is often overlooked. Over 40% of individuals with PD experience recurrent falls, with more than a two-fold increased risk of hip fractures and nearly double the risk of non-vertebral fractures—largely influenced by mobility impairments, vitamin D deficiency, and long-term effects of medication. The aim of this study was to evaluate local compliance with bone health

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Improving Bone Health in Patients with Parkinson’s Disease: A Retrospective Study in a DGH

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Tazim Samira1, Muhammad Shamim Hossain1, Sam Abraham2
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Title: Improving Bone Health in Patients with Parkinson’s Disease: A Retrospective Study in a DGH Background: Parkinson’s disease (PD) is a neurodegenerative disorder primarily affecting movement, but its impact on bone health is often overlooked. Over 40% of individuals with PD experience recurrent falls, with more than a two-fold increased risk of hip fractures and nearly double the risk of non-vertebral fractures—largely influenced by mobility impairments, vitamin D deficiency, and long-term effects of medication. The aim of this study was to evaluate local compliance with bone health

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Improving bone health assessment in inpatients presenting with falls: an updated quality improvement project

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Nicola Heyer1, Joseph Nathan1, Bernice L Sim1, Joseph Hetherington1
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Introduction Fragility fractures are associated with increased morbidity and mortality. Early identification of patients at risk is essential for prevention. Bone health assessment tools are recommended in current clinical guidelines for those at risk. Despite this, baseline audit data showed that only 3% of patients admitted to a geriatric ward following a fall had a bone health assessment completed within 72 hours of admission. This project aimed to increase the completion rate of bone health assessments to over 90%. Methods A series of targeted interventions were implemented over four

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Visual assessment in patients admitted with falls: an audit of current practices and recommendations for improvement.

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Osman Haji1, Sarah Davidson2, Thabia Tapadar3, Chimela Nwamba3, Shyamala Manibalan4, Lillie Wylde4
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Introduction: Visual impairment is a key yet often neglected risk factor for falls in older adults. National guidance recommends that vision be assessed routinely as part of a multifactorial falls risk evaluation. This audit aimed to evaluate whether vision was appropriately assessed and documented in patients admitted with falls at Croydon University Hospital. Methods: A retrospective audit was conducted on patients admitted under the acute medical take following a fall between the 1st-12th of February 2025. Patient records were reviewed for documentation of vision assessment, history of
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Falls, frailty, and the cost of delay: a case review on prolonged hospitalisation following a non-surgical fracture

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Rhia Shah
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Background: Falls in frail older adults can cause prolonged hospital stays, raising the risk of further falls, infections, and decline. This case shows how delayed discharge and complex care planning can worsen outcomes in this group. Case Presentation An 86-year-old male with Alzheimer’s dementia, chronic kidney disease, and peripheral vascular disease sustained an unwitnessed fall at home while taking medication. He was found to have an avulsion fracture of the right anterior superior iliac spine (ASIS) with soft tissue changes and was managed conservatively under orthopaedics. His three
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Improving Structured Medication Reviews to Address Polypharmacy in Hospitalised Older Adults: A Two-Cycle QIP

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S BABURAM¹; S GOYAL¹
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Introduction: Polypharmacy—commonly defined as the use of five or more medications—is highly prevalent among older adults and is associated with increased risks of adverse drug events, falls, cognitive impairment, hospital admissions, and reduced quality of life. Inappropriate polypharmacy, where medications provide limited benefit or cause harm, represents a significant patient safety concern. Structured medication reviews (SMRs), supported by validated deprescribing tools such as STOPP/START and Beers Criteria, are essential for identifying and addressing potentially inappropriate

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“We Just Manage It with Pads”: Barriers and Facilitators to Improving Continence Care for Older Inpatients – A Review

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Ian Carmody1, Rosemary Arnott2
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Background: Urinary incontinence is common among older hospital inpatients and is associated with functional decline, skin damage, and delayed discharge. While guidelines recommend structured assessment and conservative management, continence care often remains reactive and inconsistent. This review uses behavioural science theory to explore the barriers and facilitators to implementing improvements in continence care for older people in acute hospital settings. Methods: A search strategy, across MEDLINE, EMBASE and EMCARE encompassed peer-reviewed literature from 2015–2025 using terms related
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The Impact of Floor-Rise Training on Fear of Falling & Floor-Rise Ability in Older Adults Living in the Community.

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S Seeley1; D Skelton1; CW Tan2; B Stansfield1; P Dall1.
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Introduction In older adults, the inability to rise independently after a fall increases the risk of long-lies and associated complications. Up to 65% of individuals attended by ambulance crews post-fall are assisted up without requiring further medical intervention. This study investigated the effectiveness of Floor-Rise Training (FRT) in improving floor-rise ability and reducing fear of falling in community-dwelling older adults. Method This pilot cluster-randomised controlled trial was conducted within five existing Otago exercise classes. Sixty-one participants aged ≥65 years were enrolled
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