Posters

Introduction: Ischaemic stroke has a poor prognosis, and hemorrhagic transformation after intravenous thrombolysis may increase morbidity and mortality in these patients. Methods: By means of a retrospective analysis, related risk factors were recruited for the analyses, including: smoking, alcohol, hyperlipidemia, and diabetes, among others. The statistical analysis was performed by ANOVA for quantitative variables and the Chi-square test for qualitative variables. Results: The study was carried out on 52 patients with acute ischaemic stroke treated with recombinant tissue-type plasminogen

Introduction: It is still debated whether hypothyroidism is an independent risk factor for cardiovascular events. Our objective was to evaluate the association between hypothyroidism and the risks of cardiovascular events and mortality through 3 stratification systems. Methods: A retrospective study was carried out by reviewing medical records in the period of January 2015 - December 2017 in a South American hospital. Geriatric patients who had fasting total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, and plasma glucose were included. Quantitative variables are

Introduction We plan fast-track discharges when a person has limited life expectancy and is reaching end of life. When such patients are identified, we use a simple fast-track tool to minimise the delay and reduce the need for in-depth assessments and paperwork. Despite being used very widely, there is very little data in literature regarding the indications for fast-track discharges and life expectancy of patients following discharge. We conducted this observational study to answer these questions. Methods We collected data over a three month period from the fast-track applications focusing

Introduction Postural BP readings are important in assessing older people, but are infrequently measured (1) The National Audit of Inpatient Falls (NAIF) 2022 has shown measurement of lying standing blood pressure (LSBP) remains below 50% (2) NICE guidelines suggest checking LSBP in patients with: 1) Hypertension and postural hypotension symptoms 2) Hypertension and Type 2 diabetes 3) Hypertension and age ≥ 80 years (3) 4) Patients presenting with falls (4). We aimed to update local data for LSBP recording and investigate LSBP measurements in hypertensive patients. Method Data was collected

Introduction: Delirium is a common presentation in older people and associated with falls risk, longer inpatient stay, post-discharge institutionalisation, accelerated cognitive decline and higher mortality. While median duration of delirium is reported as 1 week but for one third patients, symptoms may persist 3 months or more, even a proportion of patients will never fully recover to their pre-delirium cognitive baseline. It is essential we are sharing the diagnosis with people and their relatives in order to provide information, facilitate discussions around the risks of hospital versus

Introduction: Urinary incontinence, one of the original geriatric giants, is frequently overlooked despite its potential for reversibility and profound impact on older adults. The purpose of this audit was to evaluate the prevalence of continence and utilisation of incontinence wear among inpatients in a rehabilitation facility. Methods: Continence care quality in a medical gerontology ward was evaluated using the Royal College of Physicians (RCP) National Audit of Continence Care (NACC) standard. A prospective audit was conducted over a five-day period, documenting continence wear and urinary

Around 40% elderly patients need urinary catheters during hospital stay. Most common indications are acute urinary retention(due to constipation), AKI and sepsis. According to NHS and trust guidelines, the review should be performed by the medical team to establish whether catheter is still required,when to remove and plan following TWOC of the catheter during every ward round. For example if catheter was inserted due to acute retention due to constipation,catheter should be removed after adequate bowel movement.The aim of audit was to gauge whether elderly patients with catheter are managed

INTRODUCTION: Constipation is common in older individuals and becomes prevalent in elderly inpatients. Those recovering from a hip fracture experience worsening constipation due to poor mobility, changes in diet and hydration, general anaesthesia and opioid use. This study explores the feasibility of the pelvic radiographs (PXR) already available in this population in assessing the severity of constipation in order to guide post-operative bowel management. AIM: To evaluate the effectiveness of diagnosis and management of constipation based on PXR findings of elderly patients presenting with

Background This healthcare evaluation focussed on the effectiveness of an orthoptic-led inpatient vision screening service at Nottingham University Hospitals for older adults admitted with a fragility hip fracture. The service was developed in response to national guidance, which recommended a multifactorial assessment, including a vision assessment for older adults presenting following a fall. Method Vision screening was carried out by orthoptists on eligible patients ≥65 years of age admitted to the Trauma and Orthopaedic wards with a hip fracture. Retrospective data for patients screened

Introduction: Inappropriate catheterisation poses a risk to orthogeriatric patients both in the pre-op and post-op phase. Introducing a foreign object increases the risk of infections, sepsis and seeding of infection to the newly implanted prosthetics for surgical neck of femur (NOF) fracture patients. Furthermore, catheterisation also increases the length of hospital stay and risks of bladder deconditioning and failed attempts at trial without catheter. Therefore, it is essential that nursing and medical staff are aware of the appropriate indications of catheterisation. Method: We

Introduction Falls in older people are common and can lead to significant harm including death. Coroners in England and Wales have a duty to report cases where action should be taken by organisations to prevent deaths, but dissemination of the findings from these Prevent Future Deaths (PFD) reports remains poor, limiting their possibility to effect change. We set out to identify preventable fall-related deaths, classify coroners’ concerns, and explore organisational responses to these deaths. Methods A protocol for a retrospective case series of fall-related PFDs was pre-registered. A novel

Introduction: A scoping exercise in a residential dementia care home identified high numbers of falls occurring in residents’ bedrooms at night. Assessment and reduction of risk was often difficult since many falls were unwitnessed, and residents had poor recall. Collaborative working between Lewisham Community Falls Service (CFS); and Lewisham Linkline Service; involved the use of the ‘Just Checking’ monitoring system to enhance multifactorial falls assessment. Method: The Occupational Therapist (OT) in the CFS completed an initial multifactorial falls assessment. This helped to determine if

Introduction: Dizziness and vestibular symptoms are common in older adults. However, many older adults do not seek assistance for these symptoms. This study set out to explore the barriers and enabling factors to accessing healthcare in this population. Method: Semi-structured, one to one interviews were undertaken via video conference. Older adults (≥65 years old) were recruited organisations that support older adults, via purposeful sampling to recruit participants with a range of severity of vestibular symptoms (measured using the dizziness handicap inventory) alongside those who had and

University Hospital Plymouth (UHP) provides secondary care to 475,000 people with a wider population of almost 2,000,000 people who can access its specialist services. COVID pandemic had a significant impact of the outpatient list within the UHP NHS Trust and demonstrated that previously well-established model of Falls clinic was no longer fit for purpose. This resulted in a significant delay in waiting times for patients awaiting a specialist review. A new model was designed to address issues and reduce waiting times for patients with Falls in the catchment area. The Pilot Multidisciplinary

Background Postural hypotension is defined as a reduction in systolic blood pressure of ≥20mmHg or diastolic blood pressure of ≥10mmHg that occurs within 3 minutes of standing [1]. Given that postural hypotension can result in unexplained falls [2,3], current NICE guidance recommends measurement of postural blood pressure (BP) in patients aged 65 years and over that present to secondary care following a fall [4]. Aims To record outcomes related to postural BP measurements, all-cause and fall-related readmission and mortality. Methods We conducted an audit of patients aged over 80 attending ED

Introduction Older adults are at risk of falls, which increases further in care homes. Due to the complexity of care home residents’ conditions and an increasing ageing population, it is important for care staff to have knowledge and understanding in falls awareness, prevention, and management in order to support their residents. Literature searches identified that barriers to care staff implementing falls prevention strategies included limited knowledge of staff and insufficient resources (including lack of staff training). There is scarce research regarding methods to deliver training to

Introduction A suspected urinary tract infection (UTI) is the most common reason to prescribe antibiotics in a frail older patient. Therefore, correct recognition and documentation of UTIs, as well prescribing of antibiotics, is important for optimising patient care. Methods We reviewed UTI antibiotic prescribing practice across the Health and Ageing Unit (HAU) wards at Kings College Hospital over a two-month period. Weekly data we collected from all patients commenced on antibiotics for a suspected UTI highlighted key areas for improvement. We designed and delivered a multifaceted educational

Introduction: Orthostatic hypotension (OH) is common in both community dwelling and hospitalised older adults. It is associated with significant morbidity, falls and all cause mortality. A spot audit of inpatients across all care of the elderly wards in Gloucester Royal Hospital and Cheltenham General Hospital revealed only 67% of appropriate patients where having documented lying and standing blood pressure measurements. Of those with documented orthostatic hypotension 44% had no documented action plan. Methods: Using quality improvement methodology this project aimed to achieve 100% of

Introduction: Falls in older people are associated with multifactorial risks which are often preventable. Last year there were over 220,000 emergency admissions for falls in people aged 65 years and over in the UK. Improving how we assess such patients on admission may help to ameliorate these risks and prevent future admissions. Method: The aim of this quality improvement project was to identify weaknesses in our acute risk assessment of multifactorial falls and to improve on these. We completed a retrospective case note review for 68 patients in their first 48 hours of admission. As an

Background An important modifiable risk factor associated with falling is the use of falls-risk inducing drugs (FRIDs). The World Falls Guidelines identified this as a key domain and recommended that a validated tool should be used in medication reviews targeted to falls prevention in older adults (1). A proforma was created based on the STOPPFall Tool (2) to aid doctors in performing structured medication reviews in patients with falls. The research question was ‘in older adult inpatients with falls, does use of the STOPPFall screening tool increase deprescribing of FRIDs?’ Methods The