Posters

Introduction Horticultural therapy (HT) is not uncommonly used as non- pharmacological therapy for patients with dementia. However, less is known about its effects on older adults with normal cognition. This systematic review and meta-analysis synthesises available evidence to evaluate the effects of HT on psychosocial and physical function in cognitively intact older adults. Method A systematic search in 9 electronic databases for experimental and quasi- experimental studies was performed between January 1, 2001, and July 19, 2021. Studies involving participants above 60 years old with normal

Introduction: Neck of femur fractures (NOF) remain a significant cause of mortality in the elderly, especially in those who develop delirium post operatively. The aim of our study is to identify risk factors that may contribute to developing a delirium. Method: A prospective cohort study of 717 patients presenting to Morriston Hospital who underwent operative management for a NOF fracture. Results: A total of 103 patients developed a post-operative delirium, an incidence of 14.4%. Clinical Frailty Score (CFS) and Abbreviated Mental Test Score (AMTS) proved to be significantly associated with

Introduction: Falls account for one of the most common and serious issues contributing to a disability, especially among elderly individuals. (1) Injuries resulting from a fall range from mild to severe, but they are all usually painful. (2) According to RCEM ‘Recognition and alleviation of pain should be a priority when treating the ill and injured’. (3) The aim of this project was to improve pain management in patients with falls being referred to the OPAL team. Studies have shown that patients whose primary pain is well managed and treated in the ED have a higher overall satisfaction with

Introduction: Older people represent between 21 to 40% of Emergency Department (ED) users and proportionally use more ED services than any other age group. A Geriatric Ambulatory care service, in collaboration with Emergency Department, was initiated to achieve earlier identification and interventions for frail patients with geriatric syndromes. Methodology : Retrospective review was undertaken from 13th January 2022 until 23rd December 2022 in older patients discharged from the ED ambulatory area following a targeted geriatric assessment and recommended follow-up interventions at the

Introduction Emergency department (ED) frailty screening is recommended in guidelines for its potential to trigger earlier and more appropriate comprehensive evaluation and intervention for the most vulnerable patients. Post-implementation studies of the Clinical Frailty Scale (CFS) typically observe around 50% concordance with screening. Little is known regarding the characteristics of those people omitted. Methods The Frailty in European Emergency Departments (FEED) cohort study observed prevalence of frailty, administering the CFS to consecutive attenders over twenty-four hours

Introduction: A BMJ study suggested that 1 in 5 sick, older patients have a ‘do not resuscitate’ document and a large proportion only had this completed in the Emergency Department (ED) (1). Current ED pressures could cause greater delay in this discussion, resulting in inappropriate cardiopulmonary resuscitation (CPR). The ReSPECT form was established to bring consistency to the communication of patients wishes, including ‘do not attempt CPR’ (DNACPR) (2). This QUIP assessed the incidence of inappropriate CPR in two ED’s by investigating the proportion of CPR performed on those with a prior

INTRODUCTION: Frailty is common in hospitalised older patients and hospitalisation can lead to negative outcomes. Our study aimed to provide insights into current decision-making processes on treatment, care and discharge by clinical teams. METHODS: We conducted a prospective cohort study in frail older patients ≥ 65 years old admitted to acute medical and surgical wards. Clinical Frailty Scale ≥ 5 was used to identify frail patients and process mapping was undertaken to identify common themes, trajectories and potentially modifiable factors. We followed patient journeys from admission to

Introduction The aim of this study was to examine the prevalence of vitamin D deficiency in elderly patients with fragility fractures of the hip by estimating 25-hydroxyvitamin D levels, whether low levels of Vitamin D at the time of admission affects the functional outcomes and mortality at 28 day and one year. Methods A retrospective study of all the patients admitted with a fracture neck of femur from Jan 2018 to March 2021 was carried out. The data was obtained from NHFD (National Hip Fracture Database) and Medway software. A total of 1221 patients were admitted during this period. Patient

Introduction The frailty index (FI) is a frailty assessment tool calculated as the proportion of the number of deficits, or “things that individuals have wrong with them”, to the total number of variables in the index. Routine health and administrative databases are valuable sources of deficits to automatically calculate FIs. There is large heterogeneity in the deficits used in FIs. This sub-analysis of a scoping review on routine data-based FIs aimed to describe and map the deficits used in multi-dimensional FIs. Methods Seven databases were searched to find literature published between 2013

Introduction Delirium and multiple long-term conditions (MLTC) share numerous risk factors and have been shown individually to be associated with adverse outcomes following hospitalisation. However, the extent to which these common ageing syndromes have been studied together is unknown. This scoping review aims to summarise our knowledge to date on the interrelationship between MLTC and delirium. Methods Searches including terms for delirium and MLTC in adult human participants were performed in PubMed, EMBASE, Medline, Psycinfo and CINAHL. Descriptive analysis was used to summarise findings

A Scoping Review of Guidelines and Resources to Promote Evidence-Based Prescribing for Older People with Sensory Impairment (OPwSI) BC Morrison1; E Asante2; MR Lennon2; MC Watson1 1. Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow; 2. Department of Computer and Information Sciences, University of Strathclyde, Glasgow Introduction By 2030, hearing impairment is expected to affect one in four people globally (WHO, 2022) and one in five in the UK (Hearing Link, 2023). Visual impairment is projected to impact 2.7 million people in the UK by 2030 (ONS

Introduction Over 500,000 fragility fractures occur in the UK each year (1). NICE guidelines state that all women aged ≥65 and all men aged ≥75 should be considered for a fracture risk assessment. It was recognised that locally these guidelines were not being met. The aim of this quality improvement project was to improve the number of patients being assessed for osteoporosis across two medical wards. Method This quality improvement project followed two “Plan Do Study Act” (PDSA) cycles. The first cycle involved teaching sessions for junior doctors on using the FRAX tool – a tool recommended

Introduction An Acute Frailty Team pilot was launched in December 2022 at the QEH. The aim was to reduce unnecessary hospital admissions and length of stay (LOS) by providing interventions in the Emergency Admissions Unit (EAU), through comprehensive geriatric assessment. Following the pilot’s success additional recruitment was made to the multi-disciplinary team (MDT) and the service revaluated. The MDT consists of a Consultant Geriatrician, Specialist Frailty Practitioner, Frailty Fellow, Physiotherapist, Technical Instructor, Occupational Therapist, and Pharmacist. Method To allow

Introduction In 2022, 293 hip fractures had been admitted to the Bristol Royal Infirmary. As recommended by National Osteoporosis Guideline Group ( NOGG ) intravenous zoledronate is the first line treatment option following a hip fracture. Aims We wanted to improve bone health summaries on discharge summaries for the benefit of the General practitioner ( GP ), Fracture liaison service and patient. Results We used our local National Hip Fracture database to identify the patients who had had a fractured hip in September 2023. We then introduced our changes as part of the PDSA cycle. The change

Background: ‘IN REACH’ was established, having identified a significant need to improve nutrition for cognitively and physically frail hospital inpatients, admitted to the Complex Medical Units (CMU) at the John Radcliffe Hospital. The IN REACH team includes the CMU multi-disciplinary team (MDT), representatives from patient and volunteer groups, caterers and medical illustrators. Introduction: IN REACH identified that food and drink is often unreachable by inpatients. The project’s aim is to ensure food and drink is always within patient reach, improving nutritional intake, avoiding

Reported delirium prevalence in inpatients with Parkinson’s disease (PD) varies widely across the literature and is often underreported. Delirium is associated with an increased risk of institutionalisation, dementia, and mortality, but to date there are no comprehensive prospective studies in PD. We aimed to determine delirium prevalence in PD compared to older adults and its associated risk with adverse outcomes. Participants from the ‘Defining Delirium and its Impact in Parkinson’s Disease’ (DELIRIUM-PD) and the ‘Delirium and Cognitive Impact in Dementia’ (DECIDE) studies were included

Background: Delirium is a common condition in hospitals, especially among older people. This refers to a dramatic decline in mental capabilities marked by diminished concentration and consciousness. Aims: The purpose of this study is to assess the views, knowledge, and behavior of non-consultant hospital doctors about managing delirium in a large Irish hospital. Methods: Questionnaires were given to 28 healthcare professionals from various departments according to Davis and MacLullicin (2009). It was conducted between July and September 2023 with emphasis on finding out its prevalence rate

Introduction Shared Decision-Making (SDM) is increasingly expected in most aspects of UK medical practice and can be particularly important for older patients to guide goals of care. Treatment Escalation Plans (TEP) summarise medical intervention to be attempted in the event of acute deterioration. Current guidance advocates SDM in TEP but it is unclear whether this is considered practicable by clinicians. This study aims to understand clinicians’ perspectives on SDM in TEP for older patients in the acute medical setting. Methods This was a qualitative study following a relativist

Background Fragility fractures, defined as fractures resulting from low energy trauma (1), are consistent with a diagnosis of osteoporosis. When a patient is discharged from hospital, guidelines recommend principal and additional diagnoses, relevant co-morbidities contributing to primary diagnosis, medications and relevant investigations are recorded (2). Methods This audit reviewed discharge summaries of all patients discharged from a rehabilitation unit over two months, in accordance with the Health Information and Quality Authority’s (HIQA) National Standard for Patient Discharge Summary

Introduction: Delirium affects up to 50% of older individuals within hospital environments, with a notable occurrence in 30% of those aged 65 and above in emergency departments. This QIP aimed to enhance the early recognition of delirium by implementing the 4AT assessment and optimize assessments and investigations by implementing the Delirium Bundle. Methodology: A survey involving 39 doctors was conducted to evaluate their comprehension of delirium and awareness of the Delirium Bundle. PDSA 1 involved retrospective data analysis of medical records for patients admitted with delirium and used