Posters

Title: Bone health assessment audit cycle at Queen Alexandra Hospital, Portsmouth (Audit ID 5474) Background: Conducted in the Department of General Internal Medicine. Our focus group was elderly patients, especially women aged 65 and above and men 75 years and above as per NICE guidelines since these patients should have their bone health assessment done ideally. Local problems: Osteoporosis is very common affecting approximately 3 million people. Over 5,00,000 fragility fracture occurs in the UK each year. Our audit aimed to find the percentage of patients who underwent bone health

Introduction The National Quality Board published the first Guidance on Learning from Deaths in March 2017, which stated the aim of mortality review processes across NHS Trusts and provided a framework in identifying, reporting, investigating and learning from deaths in care. Homerton Healthcare NHS Foundation Trust considered how best to implement the Guidance: record mortality reviews, increase engagement within the Trust and disseminate learning. Method Whilst paper-based mortality reviews had already been conducted by some specialties, there was no Trust-wide process to record data and

Introduction: One in three hospitalised patients die within 12 months of admission, rising to 45.6% in individuals aged 85 and older. Resuscitation is rarely successful in this patient group. Most older persons are happy to engage in discussions regarding resuscitation and patients' and relatives' involvement is recommended by the General Medical Council and Royal College of Physicians. We aimed to increase the number of resuscitation and escalation of care discussions across our Ageing and Complex Medicine department to 90% by November 2022. Method: Retrospective review of randomly selected

Introduction: In 2021, there were 38,839 adults >65 years living in Brighton and Hove, 13% of the local population, compared to 18% in England. However, 56% of emergency laparotomy procedures in the UK are in the > 65s. At the Royal Sussex County Hospital, a consultant geriatrician was appointed to lead a Frailty Liaison Service to respond to the needs of frail older patients undergoing general surgery (GS). No process was in place for the early identification of these patients, so intervention decisions were being made without GS Frailty Liaison input, potentially leading to unnecessary

Introduction Xerostomia, also known as dry mouth, is prevalent in older populations and associated with key determinants such as continual use of medication, radiation, and chronic diseases. Xerostomia significantly increases the risk of experiencing demineralisation, dental caries, tooth sensitivity, candidiasis, and other oral conditions that may negatively affect quality of life. An effective strategy to manage the risk of dental caries for patients with xerostomia is the prescription of high-fluoride products with proven efficacy. The aim of this study was to provide evidence on the burden

Introduction: Elderly patients are susceptible to opioid-induced constipation (OIC) and often remain constipated despite regular laxative prescription. Naloxegol is a gastrointestinal opioid antagonist licensed for OIC in patients failing laxative therapy. Naloxegol’s higher unit price than standard laxatives may disincentivise hospital pharmacies from stocking and supplying it. We present a quality improvement project and cost-analysis on the use of naloxegol in treating OIC in the real-world setting of a post-operative geriatric ward. Methods: Initial audit- Review of inpatient notes from

Background Acutely unwell hospitalised older people have better outcomes including mortality and functional status when CGA (Comprehensive Geriatric Assessment) is performed. A previous complaint, escalated to the Scottish Public Services Ombudsman, highlighted issues with CGA documentation and recording MDT discussion. This pilot project’s aim was to create a method for documenting CGA MDT plans and to embed this as routine practice for all inpatients on a Geriatrics ward. Method Following consultation with staff on this ward, a sticker was developed detailing status of medical and therapy

Background:   Delirium is common and experienced by 20% of all admissions to hospital1. Studies have shown a link between delirium and development of dementia2 but there are not many services to follow such patients up post-discharge. A new service has been developed at New Cross Hospital run by Care of the Elderly Consultants with an interest in Cognition. Methods: A delirium follow up clinic was designed to assess these patients after 6 to 8 weeks from discharge following hospital admission or reviews in Frailty. We set up a referral criteria for prolonged or recurrent delirium follow up

Introduction People living with dementia and MCI progressively lose abilities, through increasing cognitive impairment, co-morbidities, inactivity, acute illnesses and injuries. Rehabilitation therapy may reduce disability and falls and increase resilience. Methods We co-produced a therapy intervention, comprising strength, balance and dual-task exercises, functional activity training and promoting community access, providing up to 50 therapy sessions, delivered over 12 months and underpinned by a behaviour change strategy. We evaluated the intervention in a 5-site multi-centred Randomised

Introduction: The need to develop and evaluate frailty-related interventions is becoming more pertinent as life expectancy increases. Patient-reported outcome measures (PROMs) are arguably essential in this field of research, and can be defined as “ any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else” (FDA 2009). Numerous validated questionnaires can be classed as PROMs, but seem inconsistently used, and of uncertain relevance to/for those living with frailty. This rapid

Introduction Whitehills Health and Community Care Centre (WHCCC) is a 31-bed community hospital. Weekly multidisciplinary team (MDT) meetings occur to co-ordinate care and discharge planning. The format prior to this quality improvement project was meetings twice per week using Microsoft Teams. Errors were noted such as incorrect discharge dates and missed referrals. Aims: improving information transfer during MDT meetings, reducing errors in communication, reducing meeting duration and improving staff satisfaction. Methods Data was collected in the format of surveys distributed to members of

Introduction Older adults with diabetes are at increased risk of hypoglycaemia during inpatient hospital stays. It was noted that a large proportion of diabetic patients on the care of the elderly wards at North Middlesex University Hospital were experiencing hypoglycaemia so a quality improvement project was devised to address this issue and improve patient safety. Method Baseline data was collected in October 2021 by monitoring the glucose levels of 21 diabetic inpatients across three care of the elderly wards over a 72-hour period. The project consisted of 3 interventions introduced on one

Introduction Resistance exercise is an effective intervention for older people at risk of, or living with, sarcopenia and frailty. Surveys of current UK practice in exercise prescription for these conditions found that resistance exercise was offered in only 9% of departments and was often not optimised for sarcopenia and frailty. The Benchmarking Exercise Programmes for Older People (BEPOP) project is a joint British Geriatrics Society and AGILE initiative to promote best practice in the prescription of resistance exercise for older people. Methods Using an online data collection tool, 10

INTRODUCTION Video-recordings of patients may offer advantages over text-based documentation to supplement assessment and decision-making – particularly for older patients with complex needs. Our systematic review aimed to evaluate the application, acceptability, and impact of video-based records; here we highlight current evidence on using video-recordings to support direct care delivery for older patients. METHODS Five electronic databases (Medline/Embase/PsycInfo/Cochrane/HMIC) were searched from 2012-2022. Studies involving videorecording patients aged ≥ 18 years for diagnosis, care, or

Delirium in hip fracture patients admitted from home is associated with higher mortality, longer total length of stay, need for post-acute inpatient rehabilitation and readmission to acute services: The IMPACT Delirium study RS Penfold1,2, AJ Hall2,3,4, A Anand5, ND Clement2,4, AD Duckworth4,6, AMJ MacLullich1,2 1. Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, UK 2. Scottish Hip Fracture Audit, Edinburgh, UK 3. Department of Orthopaedics, Golden Jubilee University National Hospital, Clydebank, UK 4. Edinburgh Orthopaedics, Royal

Introduction Despite the high prevalence of frailty among older people, the clinical definitions and implications of frailty are not well understood by the public. Existing communication material is predominantly technical in nature and aimed at healthcare professionals. This project integrated expertise in geriatric medicine, data science, user design and patient and public involvement (PPI) to develop an accessible visual communication resource on frailty that linked data stories, clinical perspectives and public views of frailty in later life. Methods We recruited three public contributors

Introduction: Perioperative medicine for the Older Patient undergoing Surgery (POPS) is an established, evidence based medically led service across many Trusts. However, with consultant workforce constraints, the aim was to determine if an alternative ACP led model of care, with consultant geriatrician oversight, delivered the same benefits. Method: • A senior nurse, with POPS expertise, was seconded for one year to oversee the project. NHS Elect network supported, from February to October 2022, with monthly meetings, data analysis and facilitated shared learning from other sites • An ACP from

Introduction: The study is to explore how childhood health status ( X), early life adversities ( M1), financial condition ( M2), and satisfaction with social networks ( M3) are associated with the development of suicidal ideation ( Y) over time among older adults in 13 European countries. Respondents were drawn from the Survey of Health, Ageing, Retirement in Europe (SHARE) conducted in 2013 (Wave 5), 2015 (Wave 6), 2016 (Wave 7), and 2020 (Wave 8). 56.8% (n=10043) of respondents were female, and 43.2% (n=7642) were male. The mean age at Wave 8 was 72.35 (range 60-103). Method: The conditional

Introduction: Oral nutritional supplement (ONS) prescription is commonly recommend for malnourished patients in hospital. However, compliance to ONS is often low. Ice cream may be a promising nutritional intervention. We undertook a study designed to compare the acceptability of high protein, fortified, ice cream called Nottingham-Ice Cream (N-ICE CREAM) with routinely prescribed milkshake ONS. Methods: Fifty older (≥ 65 years) inpatients with hip or spine fractures were recruited from Queens Medical Centre, Nottingham. Patients were randomised into two groups, receiving two days of N-ICE

Introduction : The delayed discharge is defined as patient is deemed medically fit to leave hospital but is unable to do so for non-medical reasons. Delayed discharges are associated with mortality, infection, depression, reduction in patients' mobility and their daily activities. Aim and Objectives: 1.Recognition of different causes of discharge delays will allow health professionals, hospital administrators to propose potential strategies for minimising delays. 2.To identify causes of prolong delays in discharge among elderly patients.3. To propose strategies for eliminating advisable delays