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Formation of a Frailty Assessment Unit - From Pilot to Reality

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E Mwendwa; A Falconer; H Morgan; B Adler; I Hynd; M Gallagher; E Burnett
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Background According to Healthcare Improvement Scotland, all hospitals should have an established frailty assessment area with access to a specialist frailty team within 4 hours of admission (or within 12 hours when out of hours). Timely CGA on admission is linked to improved patient outcomes. Last year at University Hospital Wishaw (UHW), a Rapid Access Frailty team (RAFT) with dedicated frailty beds was introduced over a 10-day period. They found an improvement with length of admission and discharge rates as well as positive feedback from staff. Following this pilot, a new Frailty Assessment

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Prediction of thirty day mortality using clinical risk scores in patients over sixty-five receiving systemic anticancer cancer therapy

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N Lander1, P Jenkins2
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Introduction: One third of cancers are diagnosed in patients over the age of 65 (1), given we have an ageing population this is going to increase. Tools have been developed to identify older patients at risk of increased morbidity when receiving SACT such as Geriatric 8 (G8) and Cancer and Ageing Research Group chemotherapy toxicity tool (CARG-TT). This project aimed to assess the ability of these and other frailty assessment tools to predict 30 day mortality amongst older oncology patients. Method: Morbidity and Mortality data from a regional oncology department was reviewed to identify

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Accuracy of doctors' decision of fast-track discharges: a prospective audit

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C Hayes1, R Shah1, A Summerbell1, M Tarek1, F Hendry2, A Abdelhafiz1
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Introduction: With an ageing population, more people are living with terminal illness, giving opportunities to identify those with predictable shortened life expectancy. The fast-track pathway was developed to speed up funding of care for people expected to die within 12 weeks. Our aim was to investigate the accuracy of doctors’ prediction of death for patients admitted to hospital and referred to the fast-track pathway. Methods: A prospective audit of hospitalised patients who were referred to the fast-track discharge pathway with an expected death within 12 weeks from the date of discharge

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CGA: Improving communication at discharge

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C Gribbon1; A Ucheoma2; K Maxwell2; E Nelson2; B McCann3
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Introduction: The most recent national frailty benchmarking audit showed that many discharge letters from our Frailty Ward did not document a clinical frailty score (CFS), advanced care planning (ACP) or functional status. This project aimed to improve documentation of the comprehensive geriatric assessment (CGA) for patients seen by the Frailty Intervention Team (FIT) in Craigavon Area Hospital. Methods A baseline audit of 20 discharge letters from the FIT team was performed, assessing whether core aspects of the CGA were documented. Aspects of the CGA included were: CFS, ACP, cognitive

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Are Older Adults with Chronic Kidney Disease Receiving the Correct Gabapentinoid Dose Based on Creatinine Clearance?

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Janaki Chaountharagnanan1,2; Rachael Fosuah1,2; Conor Symington1,2
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Introduction: Chronic Kidney Disease (CKD) affects around 10% of the Scottish population and is particularly prevalent among older adults. As renal function declines with age, drug clearance decreases, increasing the risk of systemic toxicity. Gabapentin and pregabalin, commonly used for neuropathic pain in older adults, are renally excreted and can accumulate, leading to sedation, confusion, and falls. Appropriate dose adjustment according to creatinine clearance (CrCl) is therefore essential. Despite national guidance from NICE, BNF, and SIGN, dosing errors in renal impairment remain a

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Biochemical mechanisms driving the clinical features of frailty

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Ethan Clifford1, John Burthem2
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Introduction Frailty is a common syndrome characterised by reduced physiological reserve and increased vulnerability to stressors presenting with hallmark features of sarcopenia, fatigue, neurodegeneration and immune dysregulation. This may result in adverse outcomes such as falls, disability and hospitalisation. Although frailty is routinely identified phenotypically, the biological mechanisms underpinning its clinical features are not always integrated into clinical understanding. This poster aims to explore the roles of these pathways in the development of frailty and to illustrate how

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From Fall to Follow-Up: Improving Post-Fall Assessment Timeliness and Documentation with NICE and NAIF Standards

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H Anderson1; D Campen1; C McCleary1; J Tsang1
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This project aimed to educate foundation (FY) doctors regarding post-fall assessments and develop a proforma to enhance documentation, within an acute hospital trust. NICE Quality Standard QS86 for adults aged 65 and over in a care setting states that a fast-track examination (under 30 minutes) should occur for highly vulnerable patients, or those showing signs of serious injury. The National Audit of Inpatient Falls (NAIF) Report 2024 found that 65% of patients who had a fall-related inpatient femoral fracture (IFF) received a fast-track medical review. In our hospital this was only 30%. The
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Treating Vitamin D Deficiency Empirically

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Ayah Assadi Shekrobat1, Adam El Khouja2, Simon Langridge2, Habib Rehman3
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This quality improvement project evaluated the clinical utility of routine vitamin D testing in frail elderly patients admitted to the Acute Surgical Unit. Baseline data demonstrated that the majority of patients had suboptimal vitamin D levels, with significant variability in repeat testing and frequent prescribing errors, particularly confusion between loading and maintenance regimens. Testing rarely altered management, as patients with sufficient levels were typically already on supplementation. In response, an empirical supplementation pathway was developed, removing vitamin D testing from

How can we Improve Multi-factorial Falls Assessments in Patients at Risk using Health Pathways and Other Measures?

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Laura Rozier
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How can we Improve Multi-factorial Falls Assessments in Patients at Risk using Health Pathways and Other Measures? Background All admitted patients require completion of a multifactorial falls risk assessment (MFRA) within 6 hours; in order to identify at risk patients and implement a care plan to aim to reduce the risk of falling. Hospital Health Pathways have a ‘Falls prevention and risk assessment’ pathway which can be used to perform a multifactorial falls assessment. Objective We planned to evaluate how effectively we perform multifactorial falls assessments on the Older Persons Acute

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Opioids in the frailer adult: Are we prescribing them safely?

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Yee Ton Shek1, Sarah Keir2
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Introduction: Chronic pain is common and increases with age. It is challenging to treat and opioids are frequently used. However, these come with potentially dangerous side effects. We sought to review the prevalence of these drugs across our Medicine of the Elderly department, our prescribing practice and our communication with primary care regarding them. Method: Between the months of April and May 2025, we reviewed all patient records across the MoE footprint (142 patients) recording presence of opioid, type, whether present on admission, started ourselves, frequency of review, plan and
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Barriers and facilitators in care home training implementation: A rapid review to inform rollout of a mealtime care intervention

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Jakarin Ali 1, James Faraday 1 2, Annette Hand 2 3
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Introduction Care homes face growing pressures in delivering high-quality, person-centred care. Effective and sustainable training can enable staff to develop the knowledge, skills, and confidence required to provide this care. This rapid review aimed to identify the barriers and facilitators in implementation of training programmes in care home settings. The findings will inform rollout of a training intervention to improve mealtime care for people living with dementia. Method Methods were informed by Cochrane Rapid Reviews Methods Group guidance. A structured literature search was undertaken
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ISiTO - Improving Sight Therapy for Older-people - A Quality Improvement Project (QIP) at a Tertiary Hospital

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C Claydon 1; S Mansoor 1; I La Chapelle 1; P Fletcher 1; S Azigiri 1; Z Pruszowska 1; T Daubeney 1; J Ingham 1; W Tai 1; R Claassen 1
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Introduction Reduced visual acuity is a frequent contributing factor to admission to an acute hospital for older people yet there is little attention paid to its importance. Vision assessment is meant to be offered to all adults at risk of falling as per Montero-Odasso et al 2022(1). The NHS funds vision assessments in the community for all adults >65 years of age. Aims This project aims to assess current understanding and uptake of vision assessment in the community for patients admitted to a tertiary hospital, and whether targeted information giving can improve uptake of primary care

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Grip strength testing to identify sarcopenia in lower limb amputee outpatients: a quality improvement project.

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Joshua Turnbull, Charlotte Buckland, Sarah Tate, Katie Bell
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Introduction: The demand for lower limb amputation is growing due to factors including rising rates of diabetes and vascular disease as well as an ageing population. Sarcopenia, the loss of muscle mass and strength associated with ageing, can exacerbate the risk of unfavourable health outcomes and mortality. Consequently, early detection and management of sarcopenia is important in the rehabilitation of older people who have had lower limb amputation. Clinical practice guidelines recommend using grip strength testing to identify probable sarcopenia in high-risk patients during routine care and

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Nurse Scientists’ Success: Implementation of Bed-side Fall Injury Attenuation Solutions

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Patricia Quigley
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Nurses Across All Levels and Organization will learn: 3 strategies to utilize barriers to practice as solutions for invention and population-based approach to fall injury prevention. 4 organizational priorities to separate fall injury prevention as separate and distinct from fall prevention. 3 patient safety priorities to use of bedside floor mats Practical takeaways that address: Nurses know that patients who fall in their care are at risk for injury and injury severity is dependent on the circumstances and characteristics of falls, intrinsic and extrinsic injury risk factors by patient and
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Shared educational sessions between UK and Dutch trainees: can boundary-crossing experiences equip us for demographic change?

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H Keevil1,2; M Kessler3; M Van Eijk4; J Kraamer4; A Koffeman4; B Evans 2
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Background Demographic change poses global challenges, yet healthcare professionals are often trained within a single, siloed system. Boundary-crossing experiences promote innovative thinking by exposing trainees to different external solutions. We evaluated a shared educational session, now in its second year, for UK and Dutch geriatric/elderly care medicine trainees, aiming to equip future healthcare leaders to meet these challenges. Methods A shared, case-based online teaching session for UK and Dutch trainees included brief talks on their respective healthcare systems, followed by breakout

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AnchorWell: Maintaining Health Stability - Proactive Care in Extra-Care Facilities: A Quality Improvement Initiative to Reduce Unplanned Healthcare Demand - Pilot

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Emma Jayne Coleman-Jones1&3, Ann-Marie Morrissey1, Jennifer Gray1, Curtis Wadey2 & Phil Evans1 
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Introduction Urgent community interventions are disproportionately required by residents of independent or extra care living facilities, a small but high-need population. These settings attract individuals seeking more support than available in own homes; Whilst the need initially is often care related this is frequently driven by underlying medical conditions and the ageing process. Unlike nursing or care homes, extra-care living facilities lack enhanced primary care agreements, leaving rising needs unmet. With healthcare shifting from acute to community settings, addressing this gap is

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Diagnostic test accuracy of outpatient blood pressure measurement to detect hypertension in older people

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Conor Murphy1; Amalia Morris2; Ellen Tullo1,3
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Introduction Older people presenting to outpatient (OP) clinics require blood pressure (BP) measurement to consider morbidity contributing to falls and long-term cardiovascular risk. However, BP measurements taken in the outpatient setting (OBPs) may not correlate with BP patterns obtained using ambulatory measurements (ABPMs). ABPM is considered a more accurate method of diagnosing hypertension than OBP in the general population. Using OBPs for clinical decision-making in isolation risks either under or over-diagnosis of hypertension. This study aimed to investigate the diagnostic test

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Simulation-Based Training to enhance Medical trainees Communication, Ethical reasoning ,and Teamwork in End-of -Life Care

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Imola Bargaoanu1, Anna Fletcher1 ,William Lea 2, Michaela Cullen 2
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Introduction: Delivering compassionate, patient-centred care at the end of life requires internal medicine trainees to demonstrate effective communication, ethical decision-making, and multidisciplinary teamwork. Simulation-based education offers a safe, structured environment to practise these skills and reflect on their ethical dimensions. Method : A survey was conducted before and after the simulation session. This survey evaluated the impact of simulation-based training on internal medicine trainees interpersonal, ethical, and collaborative competencies in end-of-life (EOL) care for older
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Simulation-Based Training to enhance Medical trainees Communication, Ethical reasoning ,and Teamwork in End-of -Life Care

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Imola Bargaoanu1, Anna Fletcher1 ,William Lea 2, Michaela Cullen 2
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Simulation-Based Training to Enhance Medical trainees Communication, Ethical Reasoning, and Teamwork in End-of-Life Care I Bargaoanu1; A Fletcher1; W Lea2; M Cullen2 York and Scarborough Teaching Hospital Foundation Trust Introduction: Delivering compassionate, patient-centred care at the end of life requires internal medicine trainees to demonstrate effective communication, ethical decision-making, and multidisciplinary teamwork. Simulation-based education offers a safe, structured environment to practise these skills and reflect on their ethical dimensions. Method : A survey was conducted
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Creating a delirium-friendly space: improving environmental factors on a Care of the Elderly ward

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Aiysha Chaudhry, Susan Zheng, Hannah Freeman, Anna Street
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Background Delirium is an acute neuropsychiatric syndrome characterised by fluctuating cognition, consciousness, and attention, affecting up to 55% of older inpatients. It is associated with falls, prolonged admission, functional decline, mortality, and long-term cognitive impairment. Environmental factors such as disorientation, sensory deprivation, noise, disrupted sleep, and poor lighting increase delirium risk, particularly among frail or cognitively impaired patients. NICE CG103 recommends orientation aids (clocks, calendars, signage, lighting, and family contact) as key delirium
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