A Systematic Review of Interventions to Reduce Falls and Improve Staircase Safety for Older People
Supporting Safer Falls Management Through Guideline Implementation at the Whittington Hospital, London
Introduction: Inpatient falls are a common cause of harm in hospitalised older adults. National guidance from the 2024 National Audit of Inpatient Falls (NAIF) and Royal College of Physicians (RCP) outlines standards for timely and structured post-falls care. This quality improvement project aimed to assess local adherence to these standards and to implement a guideline to support safer, more consistent inpatient falls management. Method: A retrospective audit reviewed all inpatient falls reported via the Datix system in May 2024. Falls in clinical areas requiring medical review were included
Visual Assessment in Patients Presenting with Falls in a Geriatric Medicine Ward: An Audit of Current Practice
Introduction: Approximately half of individuals aged 80 years and older experience at least one fall per year, costing the NHS an estimated £2 billion annually. Visual impairment is a recognised potentially modifiable risk factor for falls and their resulting consequences including injuries and hospitalisation. Despite this, visual assessment is often overlooked by clinicians when managing these patients, potentially due to the absence of standardised guidelines. Method: A first-cycle clinical audit was undertaken in an acute Geriatric Medicine ward between January 2025 and March 2025
Opportunistic Review of CT scans to Identify Unreported Vertebral Fractures in Patients with Parkinson’s Disease
Introduction Patients with Parkinson’s Disease (PD) are at an increased risk of developing osteoporosis. Vertebral fractures (VFs) are the commonest type of osteoporotic fracture and are frequently underdiagnosed, up to 70% going unreported. Individuals with VFs are at a significantly higher risk of experiencing subsequent fractures (relative risk increase of 2.8 for hip fractures and 5.4 for additional VFs). The presence of VFs are often not formally reported. VFs are also associated with an eightfold increase in morbidity. These complications could result in reduced independence and
Quality Improvement Project on Fragility Fracture Risk Assessment using FRAX score in Older Adults in Inpatient Psychiatry Unit
A review of bone health assessment on an Older Person's Acute Medical Unit
Introduction Bone health declines with age, with almost 3 million people in the UK living with osteoporosis. Osteoporosis is a common condition affecting older people where bone density is reduced, increasing the risk of fragility fractures. Most patients are diagnosed following a fracture, and only then prescribed bone protection. Older people have an increased falls risk due to muscle weakness, impaired vision and balance, pain, postural hypotension and medications; increased falls frequency correlates to increased fracture incidence. We aimed to evaluate whether bone health was routinely
Postural hypotension in the Elderly: Audit of diagnosis and management in Frailty Same Day Emergency Care
Management of acute urinary retention in older males
‘Decaf by Default’ and Its Wider Impact: Reducing Toileting Falls, Supporting Continence and a Positive Care Environment
Introduction Caffeine can adversely affect patient safety by increasing bladder urgency and agitation, raising fall risk, especially among older people. NICE guidance (2019) recommends reducing caffeine intake for individuals with overactive bladder. However, caffeinated drinks often remain the default in healthcare settings. In 2021, University Hospitals of Leicester NHS Trust (UHL) achieved a 30% reduction in toileting-related falls after making decaffeinated hot drinks the standard. In 2023, staff at Northumbria Healthcare NHS Foundation Trust (Northumbria) identified similar concerns. A
Medication Management: An overlooked aspect of the Hospital Acquired Deconditioning Syndrome? A Quality Improvement Project
Improving opioid and laxative prescribing safety in older surgical inpatients
Introduction Older adults are particularly vulnerable to adverse drug effects from opioids, including constipation, delirium, immobility, and delayed discharge. Despite NICE guidance recommending prophylactic stimulant laxatives with opioid prescriptions, older surgical inpatients frequently receive inadequate bowel care. Prescribing must also consider comorbidities such as renal impairment and cognitive decline. This quality improvement project aimed to optimise opioid and laxative prescribing safety in an elderly surgical population. Methods A two-cycle audit was performed on a long-stay
Auditing Acute Heart Failure Management: Informing an Integrated Pathway Between Hospital at Home and Heart Failure Services
Falls Prevention Guidelines Adherence in Older People Assessment Unit- A Two-Cycle Quality Improvement Project
Improving Inpatient Falls Reviews at North Manchester General Hospital – A Local Quality Improvement Project
Does pre-operative ECG abnormality at pre-assessment predict cardiac complications in patients undergoing major non-cardiac surgery
Audit of Cardiac Arrests at Nevill Hall Hospital (October 2022 - February 2025)
Survival outcomes in patients with sigmoid volvulus
#WalkingAidMOTWeek at UHB
Implementing a standardised approach to medication review during Comprehensive Geriatric Assessment in the perioperative setting
Introduction: The Centre for Perioperative Care Guidelines for People Living with Frailty emphasises the need for routine frailty assessment and subsequent Comprehensive Geriatric Assessment (CGA) in older adults within the emergency surgical setting. Medication review and optimisation is an integral part of the CGA. The Scottish Government’s Polypharmacy Guidance provides a 7 steps structure for patient-centred medication reviews. Utilising this structure, our aim was to establish a standardised method for documentation and recording of medication reviews as part of CGAs undertaken by our