Posters

Background: TEP’s are a tool used in acute hospital admission to guide appropriate care in the event of deterioration. TEP’s, a gold standard in the SIGN 167 guideline, help ensure that care aligns with the patients’ and families’ wishes. Though all patients should ideally have one on admission, this can be challenging to achieve. Patients with CFS (Clinical Frailty Scale) >5, NEWS >5, DNACPR, or progressive conditions, however, are at higher risk of deterioration and ensuring a valid TEP is in place is vital. Aim: To increase the number of patients in the Orthopaedic ward with a valid TEP in

INTRODUCTION Calcium-sulphate beads (CSB) are bio-absorbable antibiotic carriers which are used to manage surgical site infections as well as fill dead space. Iatrogenic hypercalcaemia from using CSB is a rare but potentially serious adverse effect. METHOD In this case report, we describe a patient who developed symptomatic hypercalcaemia secondary to using CSB during a Girdlestone excision arthroplasty. RESULTS An 86-year-old woman with a recent hip hemiarthroplasty for hip fracture developed a deep wound infection. Despite debridement and washout and prolonged intravenous antibiotics, her

Introduction: The anticholinergic burden (ACB) has been increasingly recognized as a modifiable risk factor that can contribute to falls, cognitive impairment, and frailty in older adults. Reducing ACB through medication review can potentially lower fall risk and ease strain on healthcare systems. This study aims to identify common contributors to ACB in older adults admitted with falls and evaluate whether ACB assessment was documented at hospital admission. Methods: We conducted a retrospective audit of patients aged >75 years admitted with a coded diagnosis of falls to an elderly care unit

A Project on Inpatient Falls: Are We Adequately Addressing Bone Health? Introduction Inpatient falls in older adults frequently lead to fragility fractures, with femoral fractures occurring in up to 82% of cases (RCP, NAIF 2023). These injuries significantly impact long-term morbidity and cost the NHS an estimated £4.4 billion annually (ROS, 2022). Despite tools like FRAX and national guidance (NOGG, 2021; NICE, 2022), bone health assessments remain inconsistently performed in the inpatient setting after a fall. Objectives To evaluate whether inpatients who experienced falls received

Introduction: Frailty is common among older surgical patients and associated with poorer post-operative outcomes. Therefore, identifying at-risk patients for peri-operative optimisation is vital to improve surgical outcomes, yet national audits reveal it remains under-assessed (1). A review of a surgical ward showed that 0% of patients aged over 65 had a Rockwood Clinical Frailty Score (CFS) documented within 48 hours of admission. This QIP aimed to increase timely CFS documentation to 50% by January 2025 and 80% by June 2025 through structured interventions. Method: Following initial

Introduction The POPS (Perioperative medicine for Older People undergoing Surgery) service at Wye Valley NHS Trust has been established since August 2024. During this year, the service has been evolving, and we have been evaluating its impact. This has also involved working with NHS Elect through the POPS-SUp project. As well as the data we have gathered, during the past year there have been many learning points about starting a new service. Method Throughout this year we have used quality improvement methodology to help shape our projects, such as driver diagrams and statistical process

Introduction Medications with anticholinergic burden are associated with falls and cognitive decline in elderly. About 30% of people aged 65 years and over in the UK have a fall at least once each year, increasing to 50% at the age of 80 and over. Method The last 100 patients admitted to the Frailty unit with falls were identified and Anticholinergic Burden (ACB) scores calculated on admission and at discharge. Patients were defined as having a positive (ACB≥1) or negative (ACB=0) ACB score. Drugs responsible for ACB score were identified and medication changes assessed. Results 75 out of 100

Introduction: With an ageing population, identifying frailty aids reduction of adverse postoperative outcomes. Centre for Perioperative Care - British Geriatrics Society ‘Care for People Living with Frailty’ guidelines state all patients aged >65 should have a documented Clinical Frailty Scale (CFS) score at pre-operative assessment. If CFS≥5, cognitive assessment should be documented and Comprehensive Geriatric Assessment performed. This audit aimed to assess frailty documentation at pre-operative anaesthetic assessment to support introduction of a specialist perioperative frailty pathway

Introduction Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in older adults. More than 70% of adults develop CVD by 70 years of age, among whom more than two-thirds also develop non-CVD comorbidities. There have been recent advances in CVD management but how we apply these to deliver integrated care to the elderly population is key. Thus, there is a clear need for educational strategies that integrate geriatric principles into cardiovascular training. Objectives To design and pilot a structured six week teaching programme in geriatric cardiology addressing

Background: ​Frailty is a multidimensional syndrome characterised by diminished strength, physiological reserve and increased vulnerability. Psychiatric inpatients are a high‑risk, often overlooked population. They typically have reduced life expectancy and are frequently excluded from most research, which leaves their complex healthcare needs unmet. By identifying frailty in this cohort, clinicians can more accurately stratify risks and tailor interventions to each patient’s unique vulnerabilities, and ensure that frailty considerations inform best‑interest decisions. Closing this critical

Introduction: The head-up tilt test (HUTT) is a common diagnostic test in patients presenting with syncope. A fast Italian protocol for HUTT shortens the traditional protocol from 40 to 25 mins (5 min supine phase, 10 min passive phase, 10 min GTN phase). This has been demonstrated to be as sensitive and specific in identifying vasovagal syncope in young adults as the traditional protocol, but not in older adults. We aimed to determine in our practice what proportion of positive results identified using the traditional Italian protocol, could have been identified using the fast Italian

INTRODUCTION Postural hypotension is a significant modifiable risk factor for inpatient falls in older adults. National guidelines recommend lying and standing blood pressure (LSBP) measurement for patients at risk of falls. On our geriatric wards, which care for acute, long-stay and orthogeriatric patients, we observed inconsistent LSBP documentation and delays in identifying postural hypotension. Staff reported difficulty locating LSBP records and a perception that fall prevention was being deprioritised in comparison to post-fall care. This project aimed to assess current practice and

Introduction: One-third of people aged ≥65 years fall at least once a year. Exercise on land reduces falls by up to 34% and fallers by >15%. Exercise on land may sometimes be challenging, e.g., for very frail people with high risk or fear of falling, people with painful joints, obesity and other comorbidities. Aquatic exercise may have positive effects on falls reduction, but research on it is sparce. The aim of this study was to design and deliver an aquatic exercise therapy intervention for falls prevention, and investigate its feasibility and acceptability for older adults with high fall

Introduction Delirium is a recognised complication of emergency surgery and is associated with unfavourable clinical outcomes. Previous work has suggested that delirium is under-diagnosed. Here we describe risk factors for, and the clinical impact of delirium in an older-adult emergency laparotomy cohort. Methods Routinely collected data on emergency laparotomy patients ≥ 65 years admitted to The Grange University Hospital from November 2021 to April 2025 were included. Delirium was scored prospectively using the 4-AT score. Frailty was defined as Clinical Frailty Score (CFS) ≥ 5. Analysis was

Introduction Head and Neck surgery is complex, often requiring prolonged anaesthesia and careful postoperative care to ensure good functional recovery. The surgical pathway can be challenging for older patients living with frailty, who have longer inpatient stays and higher rates of postoperative complications and mortality. We have developed a new Geriatrician led service within the Head and Neck surgical pathway, which started in July 2024. This consists of a multidisciplinary outpatient preassessment clinic (geriatrician, anaesthetist and clinical nurse specialist) and weekly ward round

Introduction The perioperative journey for People with Parkinson's is a high-risk period. The current lack of unified guidance often leads to inconsistent care and unmet patient needs, despite advancements in Parkinson's disease (PD) diagnosis and long-term management. To address this gap, this qualitative study aimed to explore the lived experiences of people with Parkinson's undergoing surgery to inform our clinical guidelines for perioperative PD care that are currently under development. Methods Four patients, recruited from the Parkinson’s UK Patient Network, participated in the study

Introduction Reducing the time people wait for elective care is one of NHS England’s priorities. [1] It is projected that by 2030 there will be 1.4million Londoners aged over 65 [2] and increasing numbers of older people are undergoing surgery. [3] Frailty is a significant risk factor for surgical complications. [4] , [5] Non-electiveOrthogeriatrics is well established, this is not the case for elective orthogeriatrics or indeed other specialities The Centre for Perioperative Care (CPOC) and the British Geriatric Society developed evidence-based guidelines on perioperative care for people

Stevens-Johnson syndrome (SJS) is a serious, potentially life-threatening condition affecting the skin and mucous membranes. This syndrome occurs twice as frequently in females compared to males and affects individuals across all age groups. The most common triggers are drugs. Here, we present a case of SJS linked to doxycycline/flucloxacillin-induced SJS. A 76-year-old woman with Sjögren’s syndrome, rheumatoid arthritis (RA), chronic obstructive pulmonary disease (COPD), and osteoarthritis (OA) was referred by her General Practitioner (GP) with a rapidly spreading, itchy, hyperkeratotic rash

Abstract Content - Introduction Vitamin D is a fat-soluble vitamin essential for bone and muscle health through its role in regulating calcium and phosphate homeostasis. It exists in two main forms: vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol). Approximately 90% of vitamin D is synthesized in the skin via exposure to ultraviolet B (UVB) radiation, with the remaining 10% obtained from dietary sources (Holick, 2007). Both forms are biologically inactive and must be enzymatically converted in the liver and kidneys to 1,25-dihydroxyvitamin D (1,25[OH]₂D) (DeLuca, 2004). In addition

Introduction: Certain medications increase the risk of falls in older adults and there is evidence that identification and review of Fall Risk Increasing Drugs (FRIDs) in older adults using a structured approach can significantly reduce falls risk. Anticholinergic burden (ACB), the cumulative effect of medications with anticholinergic activity, is associated with an increased risk of falls in older adults. Studies show that higher ACB scores are linked to higher rates of falls and fractures. Method: Patients admitted to an Older People’s admission ward with a fall as their presenting complaint