Posters

Drugs that have anti-cholinergic affects are known to have side effects such as urinary retention and constipation. In older people these drugs can also contribute to cognitive decline and loss of functional capacity leading to older patients being at risk of increased falls. Taking multiple medications with anti-cholinergic affects create a higher anti-cholinergic burden. Hilmer and Gnjidic (2022). Drugs that have anti-cholinergic affects block acetylcholine receptors (muscles do not receive neurotransmitter and therefore not functioning properly), Brown (2019). Some of these drugs are

Background Delirium is an acute impairment of attention and cognition, precipitated by physiological stressors (Wilson et al., Nature Reviews, Disease Primers, 2020, 6(1)), associated with adverse outcomes (Huraizi et al., Journal of Clinical Medicine, 2023, 12(16), p. 5346) and often under-diagnosed in hospital (Lochlainn, Frewen and Bryant, Age And Ageing, 2018, 47(suppl_5), pp. v1–v12). Integrating early assessment into clinical practice is vital (Hopper et al., Geriatric Medicine GIRFT, 2021). This project assessed compliance with delirium guidelines from the National Institute for Health

Introduction: Inpatient falls present a significant safety concern in NHS hospitals, with approximately 247,000 inpatient falls per year in England alone (Healthcare Quality Improvement Partnership (2023), National Audit of Inpatient Falls 2022). The actions following an inpatient fall have potential to influence clinical outcomes and patient safety. This quality improvement project aimed to enhance patient safety by improving the accuracy of post-fall review documentation and increase awareness of the Trust's post-fall protocol. Methods: Data collection involved reviewing electronic notes of

Introduction: Femoral fragility fractures (FFFs) are a significant healthcare concern, with the incidence predicted to rise to 100,000 annually in the UK by 2033. Current secondary preventative strategies focus on the patient’s physical state – overlooking Hospital-associated Deconditioning (HAD), the decline in patient wellbeing post-admission. To prevent HAD, a ‘Games Area’ (GA) was introduced in December 2023 as a service improvement. This study evaluates the GA’s effectiveness in preventing HAD, by assessing patient satisfaction. Method: We evaluated all patients aged 65yrs or more during

Introduction and Background- Bowel obstruction poses a considerable medical dilemma, demanding swift identification and intervention due to its propensity for severe complications. This challenge is exacerbated in elderly individuals who may be frail and less amenable to surgical interventions. Alvimopan, a peripherally acting μ-opioid receptor antagonist renowned for its pro-kinetic effects on the bowel, has shown promise in clinical trials. Nevertheless, despite its efficacy, it remains underutilised in many clinical hospital settings. Thus, our systemic review aims to underscore the

Introduction Recent trials like ASCEND, ASPREE, and ARRIVE emphasise the limited efficacy of aspirin in primary cardiovascular prevention and its associated increased bleeding risk, particularly in the elderly. Consequently, the Screening Tool of Older Persons’ Prescriptions (STOPP) criteria does not recommend aspirin treatment for primary cardiovascular prevention in any case. This study aimed to determine the prevalence of inappropriate aspirin use among elderly patients admitted within our department and our ability to correctly identify and discontinue its use. Methods Patients aged over

Introduction With an increasing ageing population, more people are now living with multiple comorbidities and on polypharmacy. Medicines prescribed appropriately provide huge benefits; but inappropriate prescribing without safe optimisation can cause significant harm. Method We assessed current practices of reviewing and optimising medications in Elderly Care at Maidstone Hospital. 44 Patients were selected randomly from three elderly care wards. We retrospectively evaluated if medications for these patients were reviewed and optimised using the START-STOPP tool at clerking, post take and

Introduction Geriatric medicine is inherently complex and requires multi-disciplinary integration. Simulation-based training has been recognised by the Joint Royal Colleges of Physicians’ Training Board and the Royal College of Nursing as a method to enhance learning and improve patient outcomes. This project aimed to develop a multi-professional simulation programme within care of the elderly to mimic the multi-professional clinical practice that takes place on geriatric hospital wards. Methods A total of ten half-day simulation sessions have been run across two sites in two years. The

Introduction The British Geriatrics Society advocates for the development of local protocols to address frailty (1). A Cochrane Review on the use of Comprehensive Geriatric Assessment (CGA) resulted in higher survival rates at 3 months and fewer admissions to nursing homes at one year following hospital admission (2). Key components of CGA, including Treatment Escalation Plans (TEPs), Universal Care Plans (UCPs), Clinical Frailty Scores (CFS), and Abbreviated Mental Test (AMT) play pivotal roles in identifying frailty, establishing timely end-of-life care plans, preventing future inappropriate

Introduction - The British Thoracic Society Guidelines 2017 recommends oxygen delivery to achieve target oxygen saturation range between 94% and 98% of the majority of medically unwell adult patients, and 88% to 92% in patients at risk of hypercapnic respiratory failure. Oxygen is a drug which should be prescribed for patient’s just like any other medication and is often over-looked. For some older people oxygen treatment can impair mobility, increase deconditioning and the risk of falls. We conducted a re-audit and PDSA cycle expanding from one ward (Eashing) to all three geriatrics wards

The World Health Organisation lists antibiotic resistance as one of the biggest threats to global health [1]. We contribute to this as clinicians, through errors such as delayed review of prescriptions or prescribing against local trust guidelines. We have carried out a quality improvement project to improve antibiotic prescriptions on a geriatric ward at Croydon University Hospital. We carried out a fortnightly cross-sectional analysis of the antibiotic prescriptions on a geriatric ward. This included looking at the antibiotic prescribed, indication, duration, route of administration and

Introduction: Frailty Hotline Service (FHS) was set up initially in January 2021 to provide 24/7 advice and guidance to care home medical staff within the Mid & South Essex Health and Care Partnership footprint as a part of covid response. This was expanded to support GPs, Urgent Care Response Team (UCRT), community hospitals, hospices etc and later established as Community Frailty Hotline Service (FHS) with an aim for hospital avoidance and provide support to frailer older patients in their own places. Later, a Frailty Virtual Ward (FVW) was established to complement FHS within the MSE HCP

Introduction Physical and cognitive decline at an older age is preceded by changes that accumulate over time until they become clinically evident difficulties. These changes, frequently overlooked by patients and health professionals, may respond better than fully established conditions to strategies designed to prevent disabilities and dependence in later life. The objective of this study was twofold: to provide further support for the need to screen for early functional changes in older adults and to look for an early association between decline in mobility and cognition. Methods A cross

Introduction: More than 50% of patients undergoing emergency general surgery are > 65 years. The Emergency Laparotomy and Frailty (ELF) study showed strong associations between frailty (CFS ≥ 5) and increased mortality, risks of complications, and length of hospital stay. Methods: For nearly 10 years, we have had geriatric liaison input for general surgery and colorectal patients in a tertiary teaching centre. This has transformed into a fully embedded service involving consultant geriatrician, registrars and senior house offices, providing 3-day a week medical input. NELA best practice tariff

Hip fractures are a major public health issue due to ageing populations and Ireland has one of the highest hip fracture rates in Europe1. The cost of acute hip fracture care was 48.5 million euros in 20221. The Irish Hip Fracture Database in 2022 revealed that 84% of people presenting to acute hospitals with hip fracture were admitted from home, however only 29% were discharged directly home1. NICE guidelines recommend early supported discharge for patients who are medically stable and mentally fit to participate with rehabilitation and who can transfer and mobilise short distance but have not

Objective: To identify good practices and highlight areas for improvement in the prevention and management of inpatient falls. Method Fifteen patients had serious inpatient falls between April and September 2023 within the hospital. Electronic notes and fall panel meeting minutes were used to provide an analysis of the "pre-fall" and "post-fall" assessments. Data was collected and analysed using AMaT and then compared to the standards set by RCP National Audit of Inpatient Falls (NAIF) – from KPI overview, 25% of patients had good quality Multi Factorial Risk Assessment (MFRA) in our Trust

Introduction: On behalf of National Falls Prevention Coordination Group, we were tasked with creating a user friendly guide on Medicines and Falls. We delivered two sessions on this topic one at British Geriatric Society Conference in November 2023 and another to Specialist Pharmacy Service audience in January 2024. Method: Audience participation was used in both sessions as part of the discussion on “What do you consider important when completing a medication review in a person who is at risk of falls?” and “Which group of medicines do you prioritise for deprescribing discussion in patients

Poster presentation Aim: Improve the care of patients aged 65+ presenting with trauma to the emergency department by ensuring earlier senior reviews (ST4+) and consideration of trauma calls and appropriate imaging. Method: Staff survey to assess awareness of older trauma and its management. Data analysis and collection followed by use of PDSA cycles to implement change. Teaching session on primary survey assessment and management of older trauma. Development of older trauma standard operating procedure. Results: Improvement was seen in both primary outcomes over a period of 8 months

Introduction: Preoperative frailty is a key determinant of post-surgical outcomes and often co-exists with sarcopenia and malnutrition. Older patients account for a significant proportion of patients undergoing surgery for colorectal cancer and are therefore more likely to be affected by these risk factors. Methods: Patients aged 65 and over undergoing planned surgery for colorectal cancer were recruited across five sites. Participants were screened preoperatively using the Clinical Frailty Scale (CFS) and Groningen Frailty Indicator (GFI). Nutritional status was assessed using the short form

Introduction With more cases of delayed marriage, voluntary childlessness and infertility among Chinese, childless older couples are anticipated to increase. Although evidence suggests that being childless in Western societies may benefit older couples, older Chinese couples without children are marginalised as no one is available to take care of their physical, psychosocial and financial burdens because children in the Chinese societies are often responsible for caring and supporting older individuals. This ongoing study explores the lived experiences of ageing among childless Chinese older