Posters

Background: Language is a social determinant of health, as constituted by the World Health Organisation (WHO) back in 1948. UK migration rates have risen exponentially recently, and with it the inability for patients to speak functional English is a growing concern. Poorer health information and avoidance of service use creates fundamental health inequity within this demographic. The UK’s ever-changing sociodemographic landscape necessitates a growing focus on health outcomes within non-English speaking patients. Aim: To explore the barriers towards interpreter service use within South

Introduction Frailty and persistent pain are both common amongst OAs and together contribute to disability and emotional distress. The impact of pain on everyday life is potentially modifiable with appropriate pain management techniques, but current services do not always take account of the needs of frail OAs. The Pain in Older People with Frailty Study (POPPY) is a mixed-method study to develop the content and implementation strategies for services to optimise the support available for OAs living with frailty and pain. Initial objectives of the POPPY study included seeking views from

Introduction: The Gloucestershire Frailty Virtual Ward (FVW) is a novel multidisciplinary collaborative project which seeks to improve care for frail older patients. We describe our experience, reflect on lessons learnt and plans for future service development. Methods: The Gloucestershire FVW was started in early 2023. It arose from an understanding that the needs of frail patients can often be better met in their own homes, by utilising a combination of digital technology combined with improved working across organisational boundaries at the primary/secondary care interface. We reviewed data

Objectives: The objective of this study was to examine participant’s experience with remote delivery during SYNERGIC@Home/SYNERGIE~Chez soi (NCT04997681), a home-based, double-blind, randomized controlled trial targeting older adults at risk for dementia. Metrics included study adherence, adverse events (AEs), participant’s attitudes towards technology, and protocol deviations (PDs) due to technological difficulties. Methods: Participants underwent 16 weeks of physical and cognitive interventions (three sessions/week) remotely administered in their homes via Zoom for Healthcare TM

Introduction: Wearable technology that continuously monitors physiological metrics has become increasingly popular and allows remote patient monitoring in virtual ward settings. Wearable technology has been shown to be effective in disease monitoring among younger adults. However, its use among older adults, including those with cognitive impairment, is yet to be explored. Aim: We aim to explore the acceptability of remote monitoring using wearable technology among older adults with delirium. Methods: Participants were recruited from an in-patient rehabilitation unit. Inclusion criteria

Introduction Preoperative systemic inflammation has been shown to worsen postoperative outcome in emergency surgical patients. C-reactive protein (mg/L)/Albumin (g/L) ratio is a well validated inflammation marker. Studies have shown an inverse relationship between 25-hydroxyvitamin D level and markers of inflammation. Vitamin D deficiency has been previously shown to be associated with inflammation. Aims and Objectives To determine the relationship between 25-hydroxyvitamin D level and CRP/Albumin ratio in older acute hip fracture patients. To explore the impact of gender on this relationship

Introduction: Functional decline and restricted mobility are common issues among nursing home residents with dementia, resulting in frequent use of physiotherapy services. While these residents can typically articulate their therapy needs and preferences, these have not been investigated properly regarding physiotherapy and exercise, which may compromise therapy adherence. This study aims to explore the needs and preferences of nursing home residents with mild to moderate dementia in relation to physiotherapy and exercise interventions. Methods: Semi-structured individual interviews were

In hospital incontinence increases length of stay (1), in orthopaedic patients is associated with increased likelihood of discharge to an institutionalised setting (2) and can have a major negative impact, with many rating bowel and bladder incontinence as a health state the same or worse than death (3). Yet of the Geriatric Giants, it is given relatively little attention. At a busy teaching hospital, we sought to raise awareness and improve management of incontinence across our 167 beds, by using a standardised, multi-disciplinary approach involving identification of patients and use of the

Introduction We proactively reviewed nursing home residents using a multidisciplinary team (MDT) approach within a Primary Care Network (PCN). We aimed to enhance care coordination, reduce inappropriate medication use and ensure all residents had current advanced care plans in place. Method An MDT comprising a geriatrician, prescribing pharmacist, general practitioner, and nurse reviewed residents proactively. This involved reviewing the residents' current health and care needs, falls risk, medication regimens and advance care plans. We then performed medication reviews, reviewed advanced care

Introduction: Advance care planning (ACP) supports individuals to express their values and goals regarding future care, playing a crucial role in patient-centred approach. The Gold Standard Framework (GSF) recommends offering ACP to those with declining health, functional deterioration, or major health transitions. Prior to this project, Harrogate District Foundation Trust (HDFT) had not evaluated ACP quality for >2 years, relying solely on DNACPR forms and patient notes. This QIP assessed the impact of implementing the nationally recommended ReSPECT documentation on ACP quality. Objective: To

Aim: To achieve compliance in > 90% of patients with the NHS Lothian protocol for 'Management of MSK pain in frail elderly’. Background: NHS Lothian Medicine of the Elderly Department expenditure review showed a 3-fold rise in Lidocaine 5% patch costs the last year. Lack of adherence to the protocol and monitoring of patches prescriptions’ effectiveness felt to contribute. Methods: A doctors’ team with pharmacy support reviewed expenditure report from April 2023 to April 2024. A prescribers’ survey was sent to evaluate current practises, and another one to nursing staff who administer patches

The National Institute for Health and Care Excellence (NICE) guidelines for management of head injuries on anticoagulation were updated in 2023, to maximise detection of clinically important falls whilst minimising unnecessary scans. They recommend computed tomography (CT) imaging to be considered within 8 hours if clinically appropriate [NG232]. [1] The Newcastle upon Tyne Hospitals NHS Foundation Trust (NUTH) current local inpatient falls protocol recommends that all patients who have fallen with suspected head injury, on anticoagulation but in the absence of neurological changes or other

Introduction National guidance suggests that all patients with neck of femur fractures (NOFF) should be mobilised day one post-operatively ( NICE, 2023, QS16). This reduces rates of delirium, pneumonia and length of stay ( Sallehuddin & Ong, Age and Ageing, 2021, 50, 356-357). Hypotension is a leading cause of immobilisation post-operatively. National guidance advises appropriate fluid resuscitation and review of polypharmacy when indicated ( British Orthopaedic Association, 2007). This quality improvement project aimed to reduce post-operative hypotension and improve day one post-operative

Background: There is limited understanding of the confidence of nurses and allied health care professional management of acute medical problems on rehabilitation wards. Health Education England (HEE) has developed a teaching resource named ‘Bitesized Teaching’, originally developed for mental health staff. We aimed to review ward staff access to teaching and implement a quality improvement project to improve access to teaching in a multidisciplinary team setting. Methods: An questionnaire was administered to staff to understand the frequency of teaching they receive. A ‘bitesize teaching’

INTRODUCTION Death certification is a legal requirement. By law, deaths must be registered within 5 days of receipt of the MCCD by the registrar unless there is to be a coroner’s investigation. Prompt and accurate completion is essential because it enables the death to be registered and provides a permanent legal record of the fact and cause of death. It allows the family to make funeral arrangements and to begin the process of settling the deceased person’s estates. Delays in producing death certificates can cause significant distress to grieving families . This QIP looked at a ward’s speed

INTRODUCTION A treatment escalation plan (TEP) should be established for patients at risk of clinical deterioration, particularly when the risks or benefits of specific therapies are uncertain. This plan should be formulated considering inputs from both the patient and their family (SIGN 167). In hospital-at-home setting, TEP was not routinely completed during admission, leading to unclear anticipatory care plans. However, after emphasizing the importance of TEP, we observed significant improvements that positively impacted patient care. METHODS Over the course of a month, we collected data

Introduction Board round is essential in geriatric care for clinical prioritisation, planning discharges and identifying any barriers to discharge. This process can be limited by poor handover, lack of roles and a defined structure. This project aimed to improve board round efficiency in an inpatient acute frailty setting. Methods The project involved a 2 stage PDSA cycle including data collection at baseline and after each successive intervention. Stage 1: Role allocation and Board round proforma Stage 2: Doctor education Data related to several outcomes was collected retrospectively over 4-5

Introduction Advance care planning (ACP) offers patients the opportunity to plan their future care. There is an increasing role for ACP in the community, where there may be more time and chance to build rapport, than in hospital. We aimed to assess ACP engagement within our “Hospital@home” service. Methods Data was collected for patients referred to @home in December 2023. Those appropriate for ACP had a Clinical Frailty Score (CFS) >=6, or a comorbidity with a poor prognosis. Interventions included interactive seminars, and the creation of lanyards and posters. Senior clinicians also prompted

Background: This improvement activity was done within the Geriatrics/ Stroke department and aims to meet the following adopted standards: all DNACPR forms must be signed by a senior clinician and have clear documentation of the review status, if not “indefinite.’ Local problem: Incomplete DNACPR forms with lack of senior clinicians’ signature and unclear review status, which would affect clinical effectiveness of the document. Methods: To gather baseline and post-intervention measurements, snapshot data was collected eighteen days apart to identify patients with a DNACPR in place that includes

AIM As doctors rotate through the busy stroke unit at Fairfield General Hospital (FGH), there is a chance that some important information may be overlooked while undertaking the daily ward rounds or reviewing a patient on the unit. It is essential that documentation is compliant with the Royal College of Physician’s guidelines for ward round documentations, including the ‘SOAP criteria’ (Subjective, Objective, Assessment and Plan). We designed a ‘Stroke Ward Round Proforma’ to improve efficiency and standardisation of documentation on the stroke ward. METHODS The proforma was developed with