Posters

Background: This QIP was held in the hospital respiratory medicine and infectious disease wards at UHCW NHS Trust which was focusing on patients who was admitted with increased Oxygen demand. Introduction: Oxygen is a commonly administered medication in acute care, yet inappropriate prescription can be harmful, especially for patients at risk of hypercapnia. The British Thoracic Society and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust’s guidelines mandate clear documentation of oxygen therapy, including target saturation on patients’ records. After the respiratory medicine

Hospital-Acquired Infections in Older Vascular Inpatients (≥60 Years): A Single Center Cohort Study and outcomes analysis A Sargious1, M Shaikh1, M Mohsin2, A Williams2, B Eckley2, L Papp2 Department of Vascular Surgery, North Wales, BCUHB BACKGROUND Older adults undergoing vascular surgery are particularly vulnerable to hospital-acquired infections (HAIs) due to frailty, multi-morbidity, and the high prevalence of emergency interventions. HAIs in this population significantly affect recovery, length of stay, and survival. This study aimed to evaluate the burden, risk factors, and outcomes of

Introduction: Falls are a major health risk for older adults, often resulting in serious injury and long-term care (Montero-Odasso et al., 2022). Adults aged 50+ may also be vulnerable due to age-related changes in physical and cognitive function, highlighting the importance of early intervention (Karvonen-Gutierrez et al., 2020). Home modifications are an effective preventative measure (Clemson et al., 2023), yet many individuals resist making changes to their environment . Qualitative findings from our recent mixed methods systematic review identified emotional attachments and resistance to

Background: Pain management following falls is frequently inadequate, especially in non-verbal or cognitively impaired patients. Poor analgesia can contribute to worsened delirium, delayed mobilisation, and longer hospital stays. This project aimed to evaluate and improve the use of regular analgesia in such patients. Methods: Over three audit cycles, we reviewed 20 consecutive patients per cycle admitted with falls or collapse over 96-hour periods. Data collected included age, sex, analgesia regimen (regular, PRN, or none), and verbal status. After cycle one, interventions such as educational

Introduction Neck of femur (NOF) fractures in older adults result in significant morbidity, delayed mobilisation, and increased opioid exposure. Effective, early analgesia is essential for preoperative optimisation and enhanced recovery. Fascia Iliaca Block (FIB), especially when performed under ultrasound guidance (USS), offers targeted pain relief. This quality improvement project (QIP) aimed to increase adherence to RCEM guidelines on ultrasound use for FIB, thereby improving perioperative analgesia. Methods A closed-loop audit was conducted over two cycles (Cycle 1: November to December

Background This QIP was conducted within the complex care department at Royal Bolton Hospital, led by a resident doctor under consultant supervision. Introduction Regular mobilisation during hospital admission is essential for maintaining independence, supporting mental wellbeing, and reducing length of stay. On the complex care ward, many patients were observed wearing hospital pyjamas and remaining in bed for much of the day. Staff perceived a lack of emphasis on mobility. This QIP aimed to assess and improve mobility by raising awareness of its importance and encouraging patients to wear

The Surgical Frailty Journey – An Education Programme to Enhance Surgeon Confidence in Managing Frail Patients Introduction: Consultant surgeons of the future will need to manage patients with increasing levels of complexity and comorbidity as the population ages. National Emergency Laparotomy Audit (NELA) data highlights that patients over 70 constitute over 50% of emergency laparotomies, with frailty being a key determinant of outcomes 1. Previous surgical curricula have included recognition and management of frailty 2. Updated versions have deviated from such specifics, and surgical

Introduction: Falls in older adults are a common presentation to A&E. As per a report, over 1300 people experienced femoral fracture following a fall in 2021. Falls can be multifactorial, and evaluating this is important. A patient with a new inpatient fall can develop complications like fractures and prolonged hospital stay, leading to higher morbidity and mortality. We noticed that patients admitted with different illnesses develop new inpatient falls in the wards. Hence, we decided to conduct a QI project to review the condition and the circumstances surrounding the falls as an inpatient

Introduction Heart failure with reduced ejection fraction (HFrEF) remains an important topic within geriatric populations due to its high prevalence. The European Society of Cardiology (ESC) recommends the four pillars, namely ARNI/ACE inhibitors/ARB, beta-blockers, mineralocorticoid receptor antagonists (MRA) and SGLT2 inhibitors. Frailty and co-morbidities often complicates management, yet the benefit is substantial, with an estimated 73% relative risk reduction in mortality. This project evaluated compliance to the four pillars on hospital discharge, following interventions including

Introduction Orthostatic hypotension, a fall in blood pressure (systolic drop of 20mmHg, diastolic drop of 10mmHg) on standing up from lying or sitting position, is an important risk factor for fall among elderly population. In this quality improvement project, we assess the proportion of eligible patients who had lying and standing BP measurement. We made some interventions to improve this rate and reassess the proportion of patients who had their lying and standing pressure done afterwards. Method This is a prospective quality improvement project that recruited patients older than 65 years

Background: Falls are common among older people and are associated with serious sequelae, including hip fractures, physical injury, institutionalisation, and death. Data from the National Hip Fracture Database and the Trauma Audit and Research Network (TARN) reveal a significant financial liability for the NHS, driven largely by prolonged hospital stays. NICE guidelines recommend that all patients aged 65 and over should be routinely asked about any falls in the past 12 months during healthcare interactions. This practice is not consistently implemented during surgical admissions. Methods: A

Introduction: Continence optimisation, investigation and management is an essential part of any CGA 1, and its importance in Geriatric Medicine is reflected in the Higher Specialty Curriculum 2. Despite this, training in continence care is inadequate with limited opportunities to develop expertise and practical skills. As a result, few HSTs pursue Continence as a Theme for Service or feel equipped to lead on continence care post-CCT. Fragmented service provision by Urology, Gynaecology and Geriatric services undermines a holistic approach required when caring for the complexities of a frail

Background Constipation is a common yet under-recognised issue in older hospitalised adults, often driven by reduced mobility, inadequate hydration, poor dietary intake, and polypharmacy. It contributes to significant complications, including discomfort, delirium, and avoidable escalation to pharmacological interventions. Despite national guidelines, bowel care remains inconsistently addressed in routine practice. This project aimed to evaluate current inpatient constipation management and promote guideline-aligned, holistic care for older people. Methods A hospital-based quality improvement

Introduction: Polypharmacy and inappropriate prescribing are responsible for a significant number of inimical events in elderly patients, including falls and adverse drug reactions. Given the ageing population in the UK, it is now more essential than ever to ensure medication burden is addressed and potentially inappropriate prescribing is reduced. The START/STOPP criteria for prescribing is a validated, evolving criteria that guides appropriate pharmacotherapy for elderly patients, with the aim of supporting safe prescribing. In this project, our objective was a 20% reduction in inappropriate

Introduction LGMD populations have an increased fracture risk. LGMD populations also have a lower muscle mass and therefore abnormal serum creatinine levels, making it more difficult to assess renal function via conventional means, potentially leading to delays in care. Serum Cystatin-C, produced by all nucleated cells, is an alternative way to assess renal function in these patients. Clinical Case A 46-year-old woman with LGMD presented to hospital after a sudden fall from standing to the floor. X-ray imaging confirmed an extracapsular left NOF# and she was operated on the next day with a

The Iliaca Fascia block (IFB) is a crucial regional anaesthetic technique primarily used for providing analgesia in Femoral Fractures. The block targets the femoral, lateral femoral cutaneous, and obturator nerves by depositing local anaesthetic beneath the Fascia Iliaca. The British Orthopaedic Association Standards for Trauma (BOAST) guidelines for management of neck of femur fractures recommend "offering immediate and regular analgesia on presentation” Our Primary aim was to assess whether the block has been completed. If not completed; was a rationale/contraindication appropriately

Introduction: Hospital-acquired deconditioning is a major contributor to inpatient falls, with evidence showing that immobility imposed to prevent falls can paradoxically increase fall risk. In response, the 2024 National Audit of Inpatient Falls (NAIF) advocates a shift from falls prevention to promoting safe activity through a structured Multifactorial Assessment to Optimise Safe Activity (MASA), encompassing six domains: vision, lying and standing blood pressure (LSBP), medication review, delirium, mobility, and continence. Method: A two-cycle quality improvement project was conducted on

Title: The Complexity of Missed Fractures and Postural Instability in an Elderly Fall Patient: A Case Study Introduction: Falls in the elderly population are a significant cause of morbidity and mortality, often leading to fractures, reduced mobility, and decreased quality of life. Diagnosing fractures can be challenging, particularly in frail or cognitively impaired individuals who may not report or recognize pain, or when the fracture is subtle on initial radiographs. Missed fractures, combined with postural instability, present unique challenges for clinicians, requiring a multi-faceted

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 –

Background "Dignity in death" (DiD) refers to avoiding suffering at the end-of-life by meeting individuals' physical, emotional, and spiritual needs compassionately and respectfully. This includes upholding autonomy, preserving individuality, and fostering open discussions about death while aligning care with the person’s values. Holistic care prioritises comfort and dignity, treating death with understanding rather than fear (Ignacio et al., 2016). However, little is known about how care home staff perceive "dignity in death," despite extensive research on hospital and hospice staff (Hemati