Posters

Introduction: Care home residents are increasingly presenting to hospitals. In October 2022, a frailty team was formed in our district general hospital, consisting of two SHOs, one SpR and one consultant, with support from pre-existing care home ANP and community resource team (CRT). Focusing on patients presenting to the Emergency Department, their aims were early identification of care home residents in order to optimise their care by facilitating discharge, tackling polypharmacy and seizing opportunities for advanced care planning. Method: Care home residents were highlighted on the ED

Introduction: Patients with learning disabilities (LD) often have complex medical needs resulting in onset of frailty at younger ages. This increases risk of morbidity and mortality following emergency admissions, such as acute fractured neck of femur (FNOF). This risk is further increased by communication difficulties experienced in this group. There is little information about how LD affects the quality of care of patients with FNOF as defined by the national hip fracture standards (NHFS). Methods: This retrospective audit reviewed notes of patients with LD admitted to a teaching hospital

Introduction Verbal autopsy (VA) is a tool used to determine cause of death (COD) in regions lacking routine medical certification. Automated algorithms are widely used to interpret VA data. This study aimed to investigate potential differences in COD between frail and non-frail older people in northern Tanzania. Method This work forms part of a longitudinal study investigating the clinical outcomes of 308 consecutive adults aged ≥60 years following admission to four hospitals in northern Tanzania. Frailty status was established on admission using the Clinical Frailty Scale (CFS) and

Introduction Little is known about how Health Care Professionals (HCPs) conducting Comprehensive Geriatric Assessment (CGA) assess spiritual needs. The aim of this study was to better understand how UK HCPs understand and incorporate assessment of spirituality into CGA for community dwelling frail older people. Methods Semi-structured interviews were undertaken with HCPs who regularly undertake CGA in the community as well as Anna Chaplains (ACs) whose remit is to provide chaplaincy to community dwelling older people. An inductive approach was taken using a topic guide to structure the

Introduction Community-based comprehensive geriatric assessment (CGA) reduces hospital admissions but the optimal way in which CGA can be delivered is not well understood. Digital and Remote Enhancements for the Assessment and Management of older people living with frailty (DREAM) is a programme of research seeking to develop an enhanced community CGA intervention. We aimed to identify candidate cognitive assessment tools (CATs) that could be undertaken remotely and enhance CGA. Methods Searches were carried out on Medline, PsycINFO, CINAHL and Cochrane databases. Papers published since 2008

Introduction There are around 250,000 inpatient falls in English hospitals each year. Inpatient falls are associated with poor outcomes. Evidence suggests multifactorial assessment and intervention is the most effective way to prevent inpatient falls. There are National Institute of Health and Care Excellence (NICE) quality standards for safe post fall management. National audit supports improvement in the quality and safety of clinical care. Methods The National Audit of Inpatient Falls (NAIF) began collecting continuous data from all femoral fractures (as identified on the National Hip

Introduction Treatment escalation plans (TEP) guide level of life sustaining therapeutic interventions that should occur for each patient admitted to hospital and can prevent inappropriate and undignified interventions. However, implementation of TEP in routine clinical practise has been ad hoc partly due to the paucity of literature on their benefits. Our aim was to systematically review the literature to ascertain the use and benefits of TEP in adults. Methods A systematic search for studies reporting TEP use were performed in the databases OVID Medline, Embase, Scopus and Web of Science

Introduction Identification of pain generally relies on patient self-reporting of symptoms. Patients with limited communication, advanced dementia or learning disabilities are unable to self-report pain. This results in pain being under-recognised and under-treated. Consequences of this are serious and include physical and psychological distress, longer length of stay and worse outcomes.1 Methods Abbey Pain Score (APS) (Figure 1)was introduced on a single Healthcare of the Older Person ward.2,3 It was used as the primary means of assessing pain in non-verbal patients (NVP) in place of the

Background Deconditioning in the acute setting is associated with adverse outcomes, that cannot always be mitigated by increasingly stretched MDT workforce. We partnered with the Saints Foundation (SF), to test the feasibility and acceptability of a non-clinical Exercise Practitioner (EP) to work alongside therapies to promote physical activity (PA) of hospitalised older people. Methods Charity funded joint appointment of an NVQ3 EP with Postural stability Instructor (PSI) qualifications delivered quality education and rehabilitation programmes to hospitalised older patients. These took place

Introduction: Poor oral health is linked to multiple health conditions, for example pneumonia, cardiovascular and cerebrovascular disease, cancer and diabetes. Older people are particularly vulnerable to developing poor oral health due to comorbidities, medications used, and access to dental services, an effect magnified during hospital admissions. The aim of this project is to improve oral health and care received by inpatients on Healthcare for Older People (HfOP) wards. Methods: A baseline audit of patient-response surveys on oral health access and behaviours, and care during hospital

Background: Non-communicable disease, multimorbidity and frailty are posing considerable challenges as global populations age. Healthcare systems in Low- and Middle-Income Countries are having to rapidly adapt services to meet the needs of older people. Objective: This study, the first of its kind in sub-Saharan Africa, aimed to establish whether screening older people for frailty on admission to hospital could be used to identify those at greatest risk of adverse outcomes. Methods: At baseline assessment, 308 participants aged ≥60 years, admitted to medical wards at four hospitals in the

Background: Frailty is becoming increasingly prevalent in Low- and Middle-Income Countries (LMICs). However, little is known about the lived experience of older people with frailty in their interactions with the healthcare systems in LMICs. This study aimed to explore the experiences, attitudes and needs of hospitalised older people with frailty in a low-income setting, from the perspective of service users and providers. Methods: A purposive sample of older people with frailty recently admitted to hospital, their carers, and healthcare providers, were recruited from four hospitals in the

Background  University Hospital Southampton (UHS) partnered with Saints Foundation (SF), to test the feasibility and acceptability of a non-registered Exercise Practitioner (EP) to work alongside the therapy team to promote physical activity (PA) of hospitalised older people. Our aim was to collect trust level data to review the impact the EP had on outcomes such as length of stay (LOS) and discharge destination (DD) and identify and address any additional challenges that arose.   Methods  The EP delivered twice weekly gym-based group interventions as well as regular 1:1 rehabilitation and

Introduction Receptive music listening has been shown to reduce depression, anxiety, and agitation in older adults. However, unfiltered and disruptive noise can increase confusion and agitation. Yet, during hospitalization older patients often have little control over when and for how long they are exposed to music, the genre which is heard, or they may have no access to music. Furthermore, older persons have reduced ability to use modern technology to counter this and their sensory and functional impairments may further isolate them. This study aimed to assess the feasibility of offering two

Introduction The UK is expanding provision of acute medical care in peoples’ own homes through Hospital at Home (H@H) and virtual wards. Our H@H service is training junior doctors to meet the growing clinical need in this environment. We describe the use of simulation training to improve the H@H induction process. Methods From their experiences in H@H, junior doctors identified specific training needs to build relevant competencies. From this feedback, PDSA cycle one involved junior doctors designing a dedicated simulation training (H@H-SIM). Stations addressed clinical, practical and advanced

Background: This study aims to investigate the relationship between frailty and in-hospital cardiopulmonary resuscitation (CPR) outcomes in the COVID-19 pandemic. Methods: The study was carried out in a tertiary hospital in Scotland and included all patients over the age of 18 who had an in-hospital CPR attempt between April 2020 and March 2022. Patients were identified via the pre-existing National Cardiac Arrest Audit Database which was collected prospectively. Data collected from this included age, sex, initial arrest rhythm, return of spontaneous circulation (ROSC) and in-hospital

Introduction 1 in 4 older individuals having emergency general surgery live with frailty, are more likely to have a longer hospital stay, readmission rate, morbidity and mortality. This underscores the importance of individualised approaches to care through Shared Decision Making (SDM). We introduced SDM into our surgical liaison service aiming to measure effectiveness and patient outcomes. Methods Between October 2021 and September 2022, patients aged >70 years living with frailty admitted to the surgical unit were identified by an Older Persons Clinical Nurse Specialist (CNS). Involvement in

Introduction It is increasingly recognised within oncogeriatrics that standard fast-track pathways for suspected malignancy can be inappropriate for frail and elderly patients (Thomas et. al.; Age and Ageing; 2021; 50; ii8-ii13). Specifically for colorectal referrals, following standard pathways can mean undergoing invasive and expensive endoscopic investigations which may be unwanted and not alter overall management. Streaming frail patients to elderly medicine may increase opportunities for comprehensive geriatric assessment whilst reducing unwanted invasive tests and time spent on fast

Introduction: Sedentary behaviour has been associated with several deleterious health outcomes and older adults are the fastest-growing and most sedentary group in society. This review aimed to systematically review quantitative and qualitative studies examining interventions to reduce sedentary behaviour in community-dwelling older adults. Methods: This mixed-method systematic review (PROSPERO registration number: CRD42021264954) considered quantitative articles (randomised-controlled trials (RCTs) and cluster RCTs), qualitative articles (semi-structured interviews and focus groups) and mixed

Septum pellucidum is a double-membrane separating the frontal horns of the lateral ventricles of the brain. [1] Cavum septum pellucidum (CSP) refers to a potential space between these membranes. CSP is associated with some psychiatric disorders. [2] Radiological CSP has been evaluated as a possible in-vivo biomarker for chronic traumatic encephalopathy (CTE), a neurodegenerative condition affecting, particularly, retired athletes who experienced repetitive, low impact head trauma. [3] Our study evaluated the incidence of radiological CSP among a cohort undergoing investigation for cognitive