Posters for 2024 Spring Meeting

The World Health Organisation lists antibiotic resistance as one of the biggest threats to global health [1]. We contribute to this as clinicians, through errors such as delayed review of prescriptions or prescribing against local trust guidelines. We have carried out a quality improvement project to improve antibiotic prescriptions on a geriatric ward at Croydon University Hospital. We carried out a fortnightly cross-sectional analysis of the antibiotic prescriptions on a geriatric ward. This included looking at the antibiotic prescribed, indication, duration, route of administration and

Introduction: Frailty Hotline Service (FHS) was set up initially in January 2021 to provide 24/7 advice and guidance to care home medical staff within the Mid & South Essex Health and Care Partnership footprint as a part of covid response. This was expanded to support GPs, Urgent Care Response Team (UCRT), community hospitals, hospices etc and later established as Community Frailty Hotline Service (FHS) with an aim for hospital avoidance and provide support to frailer older patients in their own places. Later, a Frailty Virtual Ward (FVW) was established to complement FHS within the MSE HCP

Introduction Physical and cognitive decline at an older age is preceded by changes that accumulate over time until they become clinically evident difficulties. These changes, frequently overlooked by patients and health professionals, may respond better than fully established conditions to strategies designed to prevent disabilities and dependence in later life. The objective of this study was twofold: to provide further support for the need to screen for early functional changes in older adults and to look for an early association between decline in mobility and cognition. Methods A cross

Introduction: More than 50% of patients undergoing emergency general surgery are > 65 years. The Emergency Laparotomy and Frailty (ELF) study showed strong associations between frailty (CFS ≥ 5) and increased mortality, risks of complications, and length of hospital stay. Methods: For nearly 10 years, we have had geriatric liaison input for general surgery and colorectal patients in a tertiary teaching centre. This has transformed into a fully embedded service involving consultant geriatrician, registrars and senior house offices, providing 3-day a week medical input. NELA best practice tariff

Hip fractures are a major public health issue due to ageing populations and Ireland has one of the highest hip fracture rates in Europe1. The cost of acute hip fracture care was 48.5 million euros in 20221. The Irish Hip Fracture Database in 2022 revealed that 84% of people presenting to acute hospitals with hip fracture were admitted from home, however only 29% were discharged directly home1. NICE guidelines recommend early supported discharge for patients who are medically stable and mentally fit to participate with rehabilitation and who can transfer and mobilise short distance but have not

Objective: To identify good practices and highlight areas for improvement in the prevention and management of inpatient falls. Method Fifteen patients had serious inpatient falls between April and September 2023 within the hospital. Electronic notes and fall panel meeting minutes were used to provide an analysis of the "pre-fall" and "post-fall" assessments. Data was collected and analysed using AMaT and then compared to the standards set by RCP National Audit of Inpatient Falls (NAIF) – from KPI overview, 25% of patients had good quality Multi Factorial Risk Assessment (MFRA) in our Trust

Introduction: On behalf of National Falls Prevention Coordination Group, we were tasked with creating a user friendly guide on Medicines and Falls. We delivered two sessions on this topic one at British Geriatric Society Conference in November 2023 and another to Specialist Pharmacy Service audience in January 2024. Method: Audience participation was used in both sessions as part of the discussion on “What do you consider important when completing a medication review in a person who is at risk of falls?” and “Which group of medicines do you prioritise for deprescribing discussion in patients

Poster presentation Aim: Improve the care of patients aged 65+ presenting with trauma to the emergency department by ensuring earlier senior reviews (ST4+) and consideration of trauma calls and appropriate imaging. Method: Staff survey to assess awareness of older trauma and its management. Data analysis and collection followed by use of PDSA cycles to implement change. Teaching session on primary survey assessment and management of older trauma. Development of older trauma standard operating procedure. Results: Improvement was seen in both primary outcomes over a period of 8 months

Introduction: Preoperative frailty is a key determinant of post-surgical outcomes and often co-exists with sarcopenia and malnutrition. Older patients account for a significant proportion of patients undergoing surgery for colorectal cancer and are therefore more likely to be affected by these risk factors. Methods: Patients aged 65 and over undergoing planned surgery for colorectal cancer were recruited across five sites. Participants were screened preoperatively using the Clinical Frailty Scale (CFS) and Groningen Frailty Indicator (GFI). Nutritional status was assessed using the short form

Introduction With more cases of delayed marriage, voluntary childlessness and infertility among Chinese, childless older couples are anticipated to increase. Although evidence suggests that being childless in Western societies may benefit older couples, older Chinese couples without children are marginalised as no one is available to take care of their physical, psychosocial and financial burdens because children in the Chinese societies are often responsible for caring and supporting older individuals. This ongoing study explores the lived experiences of ageing among childless Chinese older

Introduction : Pulmonary hypertension assessed by echocardiography in patients with COVID-19 has not been adequately studied and it is unknown precisely whether it is linked to worse outcomes. Materials and Methods : Retrospective study of 306 adults infected with COVID-19 by antigenic or molecular testing. The main objective was to evaluate the role of the probability of echocardiographic pulmonary hypertension and its relationship with morbidity and mortality according to the ROX index in patients with COVID-19 infection. In the inferential statistical analysis, the OR odds ratios with their

Introduction: Older adults are the fastest growing and most sedentary group in society. With sedentary behaviour associated with deleterious health outcomes, reducing sedentary time may improve overall well-being. Adults aged ≥75 years are underrepresented in sedentary behaviour research. This study aimed to qualitatively profile the sedentary behaviour of adults aged ≥75 years. This included ascertaining older adults’ understanding of sedentary behaviour; identifying the activities performed in sitting and standing and identifying the barriers and facilitators towards reducing sedentary time

Introduction: Older adults are the fastest growing and most sedentary group in society. With sedentary behaviour associated with negative health outcomes, reducing sedentary time may improve overall wellbeing. This single-arm mixed-method feasibility study explored the acceptability of an intervention to reduce sedentary behaviour in community-dwelling older adults aged ≥75 years. Methods: Participants were recruited from the Community Ageing Research 75+ Study (CARE75+) cohort, with factors such as age, frailty status, living arrangements and levels of sedentariness being considered. The

Background Delirium is associated with psychological and cognitive complications that have impacts beyond the patients. Although family members and carers can play a significant role in the management and recognition of delirium, there is limited research on the experience of family caregivers in the context of delirium. This study aims to explore the needs and experiences of family caregivers for a person with delirium and offer suggestions to support them. Method A qualitative interview study with family caregivers of persons with delirium. Data were analysed using an abductive analysis

Introduction An ageing population globally has created an escalating demand for age-attuned healthcare services. There is however an insufficient number of geriatricians to meet this need. Most older adults will therefore continue to receive their medical care from doctors without specialised geriatric medicine training. It is important therefore that all doctors possess fundamental gerontological competencies. Which specific competencies and how they might best be integrated into medical education remain unclear. Our aim was to summarise the literature on the geriatric medical competencies

Introduction The number of older adults accessing the healthcare service far exceeds the available geriatric specialist services. It is recognised that for the foreseeable future most hospital inpatient contacts with older adults will be completed by doctors not specifically trained in Geriatric Medicine. To ensure the provision of adequate healthcare, it is imperative that all hospital doctors are trained in the minimum Geriatric Medicine competencies. Allowing for the broad, complex, and multidisciplinary nature of Geriatric Medicine, we conducted a group concept mapping (GCM) study to

Introduction Monitored dosage systems (MDS) encompass a wide range of devices to help management of medication. This research uses poison centre data to explore risks associated with their use. Method A search of accidental overdose enquiries to the UK National Poisons Information Service (NPIS) between 1/01/2017-31/12/22, classified as “therapeutic error/medical error” involving patients aged 65 or over was performed. Enquiries involving an MDS were identified. Data were analysed using descriptive statistics and chi-square test. Results There were 394 enquiries concerning 393 patients and

Introduction: There is growing awareness of the harms caused by racial abuse and discrimination from patients towards healthcare professionals, including anecdotal reports of patients ‘requesting a white doctor’ (Kline, BMJ Opinion, 2020); yet there is limited understanding of the impact in Geriatric settings. We conducted a survey in an inpatient Older Persons Service (OPS) on the prevalence, impact and actions taken in response to patient racism towards staff. Methods: A cross-sectional survey (Total N=47; Black and Minority Ethnic (BME) staff: N=32; White staff: N=15) of staff experiences

Introduction: The Centre for Perioperative Care recommends the assessment and documentation of delirium using a validated tool such as the 4-AT in older people undergoing surgery. Aim: This quality improvement project (QIP) aimed to improve the assessment and documentation of delirium in patients aged 65 and above following vascular surgery in a tertiary centre. Methods: Patients aged ≥65 years who had undergone vascular surgery were identified and data was collected with access to the electronic patient record system. Analysis was carried out using Microsoft Excel and SPSS. Following baseline

Introduction There is limited understanding of long-term delirium care after discharge from hospital for older people. A realist approach was used to investigate the contextual factors and mechanisms of care that influence recovery from delirium. Realist evaluation is fundamentally theory-driven. A preliminary programme theory was used as the foundation for theory testing and refinement, in order to develop the RecoverED intervention. Method Realist interviewing techniques were used to obtain real-world and lived experiences of delirium recovery and service use in the community for theory