Posters

Background Hospital based Quality Improvement Project focusing on adapting language used on Recommended Summary Plan for Emergency Treatment and Care (ReSPECT) forms to improve patient understanding. Introduction ReSPECT forms have been used to document patient wishes and appropriate escalation of treatment in our hospital since 2019. There continues to be a lack of understanding of phrases used amongst both patients and healthcare professionals; the hospital receives regular complaints. This project explored patients’ perceptions of language used and their thoughts on the ReSPECT discussion

Introduction The decision to admit an older patient to the intensive care unit (ICU) should reflect shared goals of care. Resource limitations during the Covid-19 pandemic highlighted challenges in selecting candidates for escalation. Patients and next of kin (NoK) who have experienced ICU are well-placed to reflect on whether the admission was right for them. Objective: To explore older patients’ (65 years) and their loved ones’ views on escalation decision making. Methods Qualitative study involving semi-structured interviews with patients, NoK of survivors and NoK of deceased who

Background: People living with dementia are more likely to move into care homes. The true prevalence of dementia among care home residents in Scotland is not known. People living with dementia often interact with multiple social and healthcare services, thus routine data may offer a way to enhance understanding. Aim: To compare national health and social care data sources recording dementia status for Scottish care home residents. Methods: A retrospective cohort study of adult (≥ 18 years) care home residents in Scotland during financial years 2012/13 and 2013/14. An indexing process linked

Introduction Heart failure (HF) is a common problem managed in our West Lothian multi-disciplinary hospital at home (HaH) service, however significant variation in practice was noted with considerable resource implications. We aimed to standardise and improve this by developing a dedicated protocol. Methods We developed a protocol to guide the assessment and management of HF within HaH. We collected baseline (n=25) and follow-up data (n=10) after protocol introduction from patients referred to HaH with heart failure. Outcomes reviewed included anticipatory care planning (ACP) decisions, length

Introduction Integrated care potentially improves coordination and health outcomes for older people with frailty. We aimed to assess the effectiveness of a new, proactive, multidisciplinary care service in improving the well-being and quality of life of older people with frailty. Methods A community-based non-randomised controlled trial. Participants (≥65 years, electronic Frailty Index ≥0.36) received either the new integrated care service plus usual care, or usual care alone. Data collection was at 3-time points: baseline, 2-4 weeks, and 10-14 weeks; the primary outcome was patient well

Whilst providing an Emergency Department based Older Person Assessment and Liaison service (OPALs), patients were identified to attend following a fall when they had previously been seen in ED following falls during the preceding 3 months. When notes were reviewed, few fall referrals had been documented. A prospective audit was conducted to identify the number of eligible patient referrals to falls team for patients who attend the emergency department. Electronic patient records were screened to identify patients' discharge diagnosis of ‘fall’ ‘elderly fall’ or ‘head injury’ (included if the

Introduction: Dementia is one of the leading contributors of disability in the UK. Evidence of a downward trend in age-adjusted incidence of Dementia has highlighted the potential impact of modifiable risk-factors in reducing the disease burden of Dementia. This research will determine how risk-factors of Dementia have varied over time, between the different countries of the UK, the different regions of England and by sex in the UK. Methods: This is a descriptive time-series of risk factors of Dementia within the United Kingdom (UK) between 1990 and 2019. Data was extracted from the Global

Background: The prevalence of urinary incontinence and frailty increases with ageing. As an adaptive mechanism patients become socially isolated resulting in worsening of mental health anxiety and depression. Aims/Objectives: We undertook a retrospective observational study of frail patients with an eFI above 0.33 to look for a correlation between eFI, GAD and phQ-9 scores. Methods: The records of 600 patients with an eFI above 0.33 ( n=600 ) were analysed for declared symptoms of incontinence using the Michigan Incontinence Score Index (MISI) to see if there was a correlation with mental

Introduction The medical intake at Morriston Hospital is accepted on two units; Rapid Assessment Unit (RAU) and Acute Medical Assessment Unit. Both were acute physician-led until July 2021 (Phase 1). From July 2021, RAU became geriatrician-led (Phase 2). This evaluation concerns the performance of RAU. Phase 1 (Acute Physician-Led Unit) Between 01/08/2020-30/06/2021, there were 3102 admissions with a median length of stay (LOS) of 2 days on RAU. 37.2% of patients were discharged directly from the unit. (SBUHB data). A detailed analysis of 496 patients consecutively assessed between November

Introduction: Large numbers of geriatric inpatients within acute settings are deemed medically safe for discharge (MSFD) but stranded within the hospital due to a lack of community services and social care packages, leading to increasing length of patient stay and reduced hospital flow. These patients do not require inpatient care and would otherwise be discharged to their home or residential care. This project aimed to identify these patients and rationalise their medical input to mirror a community setting (without routine daily medical reviews). Methods: MSFD patient were identified by the

INTRODUCTION The National End of Life Care (EOLC) Strategy highlighted the need for individualised, accessible, multi-disciplinary care plans for people nearing the end of life. Proformas provide a systematic approach to recording end of life discussions. Our Trust uses an electronic patient record (Cerner), which includes an “End of life care agreement” for people in the last days of life. An initial staff survey on a Medicine for the Elderly (MFE) ward highlighted a lack of familiarity with required documentation. The aim of this project was to improve end of life care documentation. METHODS

Hypocalcemia is seldom encountered in patients with multiple myeloma. It is usually due to secondary causes. Most reported cause amongst this population is bisphosphonate therapy. We report a case of a 65-year-old gentleman with a background of multiple myeloma presenting with worsening numbness and tingling in arms and legs. These symptoms eventually led to a fall. Blood tests revealed severe hypocalcemia. He had never been on any bisphosphonates. Despite repeated calcium replacement during admission, the severe hypocalcemia persisted, and his symptoms failed to resolve. His renal function

Introduction Objectives of this retrospective study were to describe clinical presentations and mortality outcome of hospitalised patients with COVID-19 omicron variant within two acute district general hospitals and to evaluate demographic factors associated with these presentations and mortality. Methods Data was obtained over a month in 2021-22 from a retrospective survey of all patients hospitalised and detected to have SARS-COV-2 omicron variant infection. The trust serves a diverse multi-ethnic inner-city population. Data included socio-demographic details, vaccination status, admitting

Introduction Diagnosis of Transient Ischaemic Attack [TIA] is important to minimise risk of future strokes. This retrospective descriptive study aimed to describe frequency of alternative diagnoses in a busy inner-city neurovascular clinic and evaluate processes of assessment and investigations of ‘true’ TIA patients. Methods Data was obtained over a 2-year period [2019-2020] for all new patients assessed in a busy consultant-provided daily week-day neurovascular service that serves a million multi-ethnic, population. Data collected included socio-demographic details, final clinical diagnoses

Introduction Diagnosis of Transient Ischaemic Attack [TIA] is important to minimise risk of future strokes. This retrospective descriptive study aimed to evaluate sociodemographic and risk factor differences between TIA and TIA ‘mimics’ in patients presenting to an inner-city neurovascular clinic. Methods Data was obtained over a 2-year period [2019-2020] for all new patients assessed in a consultant-provided daily week-day neurovascular service that serves a million multi-ethnic, population. Data collected included socio-demographic details, clinical risk factors, source of referral and final

Introduction Most of the patients completely recovered after COVID-19 infection. However, a substantial proportion of patients infected with COVID-19 continue to have symptoms long past the time they recovered from the initial disease. Understanding the burden of post-COVID-19 symptoms is vital in planning Post COVID care. We assessed the burden of persistent post-COVID-19 symptoms and functional status after 12-14 weeks among those who recovered from COVID-19. Method We obtained the list of COVID-19-positive cases between February 25 and March 09, 2021, from the COVID-19 surveillance unit in

Introduction Infective Endocarditis (IE) is an uncommon disease that can lead to serious complications and mortality. It is diagnosed based on modified duke criteria, with relevant findings on clinical examination, echocardiography, microbiological studies, and imaging, and the sensitivity of the same can be improved by new imaging techniques as per the European Society of Cardiology (ESC) 2015, if echocardiography/Microbiological studies are inconclusive, particularly to diagnose Prosthetic Valve Endocarditis (PVE). Case report A 79-year-old female presented with confusion and high-grade

Introduction: Primary care-based frailty identification and proactive comprehensive geriatric assessment (CGA) remains challenging. Our Devon-based Primary Care Network has developed and introduced an innovative, community-based IT-assisted CGA (i-CGA) process, which includes advance care planning (ACP). We wished to see if this process could improve effectiveness of ACP in residential care home (CH) residents. Methods/Intervention: 1) GPs clinically assessed all CH residents for frailty. 2) Proactive i-CGAs completed using our IT-assisted CGA tool, which prompts to review/consider/address

Introduction: Syncope is a common clinical problem with a lifetime prevalence of 20%. 1 Syncope shares clinical features with other disorders including seizures, metabolic disturbances and sleep disorders. 2 The assessment and management of syncope can be challenging. The syncope service at the QEUH is run by geriatricians and cardiologists with an interest in syncope. Although MDTs are recognised key components in contemporary patient care in areas such as heart failure and cancer management, there is no guidance on MDT working in syncope management. 3/4 In November 2017, a syncope MDT was

Introduction Delirium is a common condition in older hospitalised patients causing high morbidity and mortality. The neurobiological basis for delirium is uncertain and, for numerous reasons, research in this area has been limited. Several recent studies have demonstrated that functional neuroimaging in delirium is achievable and has suggested that a brain region termed the default mode network (DMN), may play a cardinal role in delirium pathogenesis. We set out to develop a pilot study to demonstrate that it is feasible to undertake functional magnetic resonance imaging (fMRI) scans in older