Posters

Introduction The importance of nutritional support has been extensively investigated in studies of people with hip and fragility fractures. Hospital nutritional assessments vary in quality, and this limits the extent to which risk assessment can be viewed as a meaningful indicator of nutritional support. Provision of supplements is an alternative measure, but only if known to have been consumed. For this reason, we developed a protocol to capture actual consumption of prescribed supplements. Methods Following nutritional risk assessment, the prescription and distribution of supplements was

Introduction: Musculoskeletal (MSK) injuries are a common factor in acute presentations to the emergency department (ED). Effective pain management is crucial for patient comfort and recovery, yet pain control for MSK injuries admitted under the medical team often falls short of optimal standards. This quality improvement project aims to evaluate and enhance the prescription practices for pain relief in elderly patients with MSK injuries at the Wrexham Maelor Hospital (WMH) ED. Methods: A two cycle project was completed in which patients with MSK injuries were identified and reviewed regarding

INTRODUCTION People with Parkinson’s disease (PwPD) often report low levels of physical activity and poor health and 90% of PwPD will fall at least once[1]. Interventions to reduce falls in PwPD often involve physical therapy and exercise, however the environment is an independent risk factor for falls[2]. Exploring whether fall circumstances differ in PwPD due to health status and physical activity level will inform occupational health services and the design and development of environmental modifications. METHODS An online survey was developed to evaluate falls in adults ≥60y. Of 358

Introduction The Action Falls programme has demonstrated effectiveness in reducing falls amongst care home residents in a trial but has not been implemented widely (Logan et al, BMJ, 2021, 375, e066991). Co-production of implementation has been identified as a mechanism for achieving buy-in. This study aimed to co-produce an implementation model. Methods Systemic action research with an appreciative approach framed co-production workshops in three stakeholder groups: residents and relatives, care home staff and representatives from health and social care organisations. Topics explored were

Introduction A good discharge summary for a patient is an important clinical record that narrates and communicates clinical information about the patient's entire hospitalisation. Discharge communications between healthcare facilities play a pivotal role in the coordination of patient care. As geriatric patients’ physical health is intricately woven into their social circumstances, mobility, and available care facilities, the mention of these parameters becomes quite important as it informs the community medical team of the patient’s condition more comprehensively. Crafting a good summary is

Introduction: Polypharmacy is commonly defined as the concomitant use of five or more medications. This is a common problem in frail elderly patients and more so on the surgical inpatients where it is not regularly reviewed by the surgical team. Methods: We reviewed retrospectively the data on vascular inpatients from 2015-2016 and after the set-up of the perioperative services in 2022-23. Patients above 65 years of age with a clinical frailty score of 4 or more or with two or more co-morbidities were selected from both groups. In total 130 patients were selected from each group and their

Pain management is essential for quality care in all inpatient settings, where pain may stem from trauma, acute medical conditions, or surgery. Patients with cancer or chronic pain often experience acute exacerbations or may develop acute pain related problems. This audit aimed to assess adherence to best practices in pain management for hospitalized patients and compare current pain management services in UK. We conducted an 8-week audit at Derriford Hospital, Plymouth, using patient records from seeEHR. We assessed the effectiveness, safety, and immediacy of pain relief actions and whether

Abstract Content - 'The number of patients being diagnosed with Heart Failure (HF) on a global scale continues to rise, placing a huge strain on the National Health Service (NHS). Caring for patients with HF comes with huge cost implications and exacerbates an already growing economic burden for healthcare systems. HF care needs to be standardised and integrated if we are to provide optimal care. Evidence shows that there is potential to improve the detection, diagnosis and management of HF care through innovative care pathways when delivered consistently through strong leadership and

Introduction This project aims to explore the diagnostic experiences of people with Parkinson’s disease (PD) and compares this with the experiences of healthcare professionals diagnosing PD, to inform areas of improvement to increase patient satisfaction. Method A quality improvement project conducted using two surveys, one aimed at clinicians, and one aimed at people with PD, which were distributed via email and in person, to allow insights to be gained from conversation. Results 31 patients and 24 professionals completed the surveys. 63% of patients were happy with the diagnosis

Abstract Content - Introduction Falls are the leading cause of preventable death in older adults and can also lead to psychological consequences, including concerns about future falls. Although literature traditionally focuses on those over 65 yrs, recent research shows adults as young as 50 yrs could be at risk. Most falls occur at home and are often due to environmental hazards. Despite evidence supporting a 38% reduction in falls through home modifications, their efficacy in not fully understood. Exploring barriers and facilitators to home modifications aimed at reducing falls and concerns

People from ethnic minorities face additional challenges in hospital. These contribute to poorer progress and outcomes. We set out to develop an online resource to help hip fracture teams provide answers to questions commonly posed by people presenting with hip fracture, and to address inequalities in patients’ and their families’ access to information. Method In 2021 we surveyed all 167 hospitals in England, Wales, and Northern Ireland which look after people with hip fracture – to identify which provided printed or digital information, and which made this available in languages appropriate

Introduction: Maintaining good postural stability is considered important to prevent falls in the elderly. We evaluated factors associated with good postural stability. Methods: We evaluated 33 patients (6 males and 27 females) over 65 years old. The average age was 76.1 years old ranging 65 to 85. We measured Index of Postural Stability(IPS) using gravicoder GW-5000 manufactured by ANIMA. The IPS was advocated by Mochizuki in 2000. It was defined following this equation; IPS=log[(area of stability limit + area of postural sway)/area of postural sway). Larger IPS means better postural

Untreated osteoporosis increases the risk of fragility fractures; a major cause of morbidity and mortality worldwide. Bisphosphonates have been shown to reduce fracture risk yet can be associated with adverse side-effects . As such, their long-term use should be monitored so that maximal benefit is obtained with minimal harm to the patient. Despite this, the management of osteoporosis in primary care remains poor. The purpose of this audit was to evaluate the long-term management of patients on bisphosphonate therapy. It assessed whether individuals were placed on appropriate treatment at

Introduction: Osteoporosis is a known consequence of stroke, associated with an increased incidence of fractures and leading to further disability. The pattern of bone loss seen in stroke patients is different from that usually seen with postmenopausal osteoporosis. It depends on the degree of paresis, gait disability, and the duration of immobilisation. Methods: We retrospectively analyzed data from 20 patients admitted to the stroke ward. All patients with stroke aged more than 65 years were included in the data. Patients who were less than 65 years old, non-stroke patients, and patients who

BACKGROUND Counter-intuitively, a systematic review identified general walking aid use to be a risk factor for falling; some research even linked falls directly to use of walking aids. Hence walking aids’ effectiveness remains suboptimal. Yet a lack of innovation, especially with regard to indoor walking frames, persists: the front-wheeled Zimmer frame has not changed in design for decades. It was the aim of this work to completely re-think and innovate indoor walking frame design for enhanced user stability and mobility. New features include: 1) swivel wheels at the front to help turning, but

Introduction: Concerns about falling (CaF) is a psychosocial concept, precipitating a spiral of increasing inactivity, social isolation and falls, and is common in those who have experienced, or are at risk of, a fall. One method of assessing CaF is the Falls Efficacy Scale International version (FES-I),with previous studies finding associations between higher FES-I scores and poor scoring on commonly used clinical assessments of functional mobility and balance (Gait speed (GS), Timed up and Go test (TUG), and Five time sit to stand (FTSS)). Using the FES-I to predict poor functional mobility

Introduction: Approximately a third of community dwelling adults over the age of 65 fall each year, with around half experiencing more than one fall per year. Currently within North Tyneside older adults who have had a fall, or are at risk of falling, may be invited to attend a specialist falls clinic; if appropriate they may be referred to Age UK North Tyneside’s Strength and Balance Class. Improving strength and balance in those at risk is an established intervention, yet adherence to programmes, and the subsequent adoption of exercise post-intervention varies. This work aims to explore why

Introduction: Inpatient falls are the most common adverse patient safety incidents in hospitals in the UK. The assessment and management following an inpatient fall is often the responsibility of the most junior doctor on call, particularly out of hours. Frequently, there are key omissions in the assessment of these patients, leading to missed diagnoses, poor management and avoidable patient harm. This study aimed to improve the knowledge and confidence of foundation doctors in the assessment and management of inpatient falls. Method: 31 patients were identified who had suffered ‘severe harm’

Introduction Malnutrition is common in patients with hip fractures. Early post-operative ONS (oral nutritional supplements) have been shown to reduce the length of stay in hospital and improve post-operative outcomes. The aim of this audit is to determine the number of people within the Royal Victoria Hospital Fracture Unit with NOF (neck of femur) fractures who are receiving ONS; it also determined the reasons for doses missed. Additionally, it covers if baseline refeeding bloods were done as per Trust Guidelines. Method A two cycle audit was completed on the use of ONS in patients with NOF

Introduction: Falls account for 17% of emergency department (ED) attendances and cause significant morbidity and mortality in older people. An accurate falls risk assessment can identify those at risk of inpatient falls. At Northumbria Healthcare NHS Foundation Trust, the ‘Avoiding Falls Level of Observation Assessment Tool’ (AFLOAT) was developed to identify patients requiring higher levels of observation to prevent falls (Richardson DA. ClinMed (Lond). 2020; 20(6): 545-550). Whilst AFLOAT was commonly used for inpatients, it was rarely completed in ED. A multi-disciplinary and inter