Posters for 2025 Scotland Autumn Meeting

Abstract Content : Background: Delirium is a common but often under-recognized acute condition in hospitalized patients, associated with increased morbidity, length of stay, and healthcare costs. In Ysbyty Ystrad Fawr Hospital’s Medical Assessment Unit (MAU), a retrospective review of patients with a 4AT score ≥4 was done to find out deficiency in the assessment and documentation of delirium, as well as inconsistencies in key aspects of care. Methods: A quality improvement initiative was undertaken to enhance the recognition and management of delirium. A screening and documentation tool, the

BACKGROUND: Dementia is a leading cause of death among people living in care homes. Identifying palliative care needs in individuals with dementia remains challenging, often resulting in frequent hospital admissions and burdensome medical interventions during the final months of life. This review aimed to synthesise existing literature on prognostic tools designed to predict six-month mortality in individuals with dementia residing in care home settings METHODS: This systematic review was registered with PROSPERO (CRD42024623940). A comprehensive search of Embase, CINAHL, PsycINFO, and MEDLINE

Introduction Orthostatic hypotension, a fall in systolic blood pressure of 20mmHg or a diastolic drop of 10mmHg on standing up, is an important risk factor for falls amongst the elderly population. This quality improvement project aimed to improve consistent documentation of lying and standing blood pressure measurements, using sustainable and cost effective interventions. Polypharmacy review was an additional outcome. In this quality improvement project, we assessed the proportion of eligible patients who had lying and standing BP measurement. We made some interventions to improve this rate

Introduction: Purple urine bag syndrome is an uncommon but visually striking finding in catheterised patients, particularly those who are elderly, constipated, or in long-term care. It results from bacterial metabolism of dietary tryptophan, leading to pigment formation within the urinary catheter system. Although often benign, it can be an indicator of underlying infection or evolving sepsis. Case Presentation: A seventy-five-year-old male resident of a nursing home was admitted following concerns of fever, hypotension, and reduced consciousness. On arrival, he had a Glasgow Coma Scale score

Introduction Inpatient falls remain a major healthcare challenge, with an average rate of 6.6 per 1,000 occupied bed-days in NHS England and Wales hospitals. Prevention of falls during hospital stay based on identifying and managing the modifiable risks are challenging. Multifactorial falls risk assessment and prevention action plan (MFRA FPAP) is a proforma booklet adopted by ABUHB. Methodology The initial QIP (2022–2024) revealed incomplete and poor-quality MFRA. Falls champions were introduced for a period of time, it showed an improvement, but was not sustained. Due to a rise in in-patient

Introduction: Older adults undergoing vascular surgery are particularly vulnerable to hospital-acquired infections (HAIs) due to frailty, multi-morbidity, and the high prevalence of emergency interventions. HAIs in this population significantly affect recovery, length of stay, and survival. METHODS We conducted a single-canter retrospective analysis of vascular inpatients aged ≥60 years that developed new HAIs during admission between 1st June 2020 and 31st July 2021. Patients with diabetic foot infections, pre-existing surgical site infections (SSIs), or Clostridium difficile were excluded

Objectives: The review explores existing evidence to assess the care and support available to address climate change's health impact on the vulnerable communities dwelling older adults. Method: The review followed Arksey and O'Malley's framework for scoping reviews, and we searched 5 major databases: Web of Science, CINAHL, Scopus, PubMed, and EBSCOhost. All articles focused on older adults and climate change published in English were included without any restrictions on study design. A total of 29 studies met the criteria for review out of the initial 568 related articles. The final selected

Introduction: Timely completion of the Medical Certificate of Cause of Death (MCCD) is essential for legal reasons, to support grieving families, and to allow funeral arrangements to be made. On the acute geriatric ward, delays in tasks related to patient death and poor documentation were observed. It was hypothesised this was related to unclear responsibilities, lack of continuity in following up Procurator Fiscal (PF) referrals, and variable confidence in certifying death. Method: This quality improvement (QI) project was conducted from November 2024 to April 2025. Baseline data identified

Introduction Advanced care planning (ACP) conversations are very important in the geriatric department due to the frailty and co-morbidities of patients managed. The purpose of this audit was to establish if staff on the ageing and health wards were having these discussions and any barriers and facilitators to this. Method 1.A snap shot audit of DNACPR and ReSPECT forms in the ageing and health wards in Forth Valley Royal Hospital. 2. A Questionnaire regarding familiarity, use, facilitators and barriers in completion of ReSPECT forms sent to medical staff on ageing and health wards. The data

Introduction: Bowel charts can help detect changes in bowel habit, especially in patients with complex medical needs or limited communication abilities. Early recognition of constipation may prevent delirium, whereas recognising diarrhoea can prevent breakdown/infection of sores. SSKIN bundles, containing insufficient data on stool type/size, are sometimes used alongside bowel charts, leading to discrepancies. We aimed to improve accuracy of bowel charts over a 3-month period. Method: 10 patients from the Department of Medicine for the Elderly ward were randomly selected weekly for 6 weeks

Introduction: Urinary tract infections (UTIs) are the second most common community-acquired infection and the leading cause of hospital infections in individuals over 65 years. UTI treatment is a major driver of antibiotic resistance (AMR), with E. coli being the primary pathogen causing this in the UK. Further, asymptomatic bacteremia is common in over 65s and does not lead to increased morbidity. However, unnecessary antibiotic exposure increases the risk of harm, including AMR and C.difficile infection, contributing to the rising AMR-related mortality. Method: This study aimed to assess

Introduction: The cornerstone of catheter-associated urinary tract infection (CAUTI) prevention is avoiding unnecessary indwelling urinary catheter (IUC) insertion [1]. As part of a long-term project to reduce the number of catheters, the most common inserted device used across MOE wards in our hospital, we recently undertook a project to improve planning (does it need to stay, can we remove it?) and the reliability of information reconciliation around their use. Methods: We designed a data collection tool, analysing key aspects of IUC care, measured our performance at least twice-yearly using

Introduction Peri-operative care of the Older Person undergoing Surgery (POPS) is an evidence-based multi-disciplinary intervention known to improve care and outcomes in older patients undergoing surgery. A POPS service has now been established in the Southwest Scotland Vascular Network (SSVN); to the best of our knowledge, the first of its kind nationally. We report our early experience. Methods SSVN opted to fund one whole time equivalent geriatrician using a vacant consultant surgeon salary. This has permitted the daily input of expert geriatricians for all patients over 60 in our service

Introduction: Anticholinergic medications have been associated with an increased risk of cognitive impairment, falls, and higher all-cause mortality. Falls, delirium, and dementia are common presentations leading to admissions of older patients. Therefore, there is an emphasis on reducing the anticholinergic burden (ACB) in the elderly. This study investigated if the burden changed between the points of admission and being an inpatient. Methods: A retrospective cross-sectional audit was conducted on geriatric inpatients (≥85 years or ≥75 years if diagnosed with Parkinson’s disease as per local

Introduction: The UK’s ageing population presents growing challenges for health and social care.1 Age-related impairments in mobility, strength, cognition, and endurance contribute to the development of frailty and decreased physical activity in older adults.2 Despite the World Health Organization’s recommendations for regular physical activity among older adults, participation remains low due to physical, psychological, and social barriers.3 This study is aimed to explore these barriers and understand older adults’ preferences regarding physical activity to inform the co-development of

Introduction Patients with frailty at Tiree Medical Practice (TMP) are identified and managed by a Multi-Disciplinary Team. That team also provide out of hours and emergency care on the island meaning quick access to patient information is essential. The aim of this project was to improve frailty record keeping at TMP. It was intended that by 30 April 2025, a full Frailty Record (FR) would be held for at least 90% of patients identified as having frailty. The process of determining the parameters of the FR was dynamic but the final definition was an entry containing: Identifying details

Quality Improvement Project : Enhancing Stroke Unit Ward Round Documentations in a Large District Hospital Author Name - T Han; R Ehsan; A T Moe; K S Tun; D Ramsey Provenance - Princess Royal University Hospital Background This improvement project was undertaken within the Stroke Unit (SU) at Princess Royal University Hospital under King’s College Hospital NHS Foundation Trust. The multidisciplinary stroke team includes consultants, registrars, junior doctors, nurses, and therapists. Patients are typically admitted from the Hyperacute Stroke Unit (HASU) following initial stabilisation and

Introduction Collateral history is a cornerstone of geriatric inpatient care, informing decisions on diagnosis, discharge planning, and long-term support. Older adults often present with cognitive impairment, frailty, or limited communication capacity, making accurate history-taking essential. A baseline audit of 30 inpatients showed only 10% had all ten domains of collateral history documented. In 46% of cases, collateral history was taken more than once. Documentation was often inconsistent across notes from different professionals, hindering holistic understanding. Based on our baseline

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia, particularly among older patients. Its presence in patients undergoing hip fracture surgery can complicate perioperative management and is associated with increased morbidity. Evaluating both pre-existing and new-onset AF in this population can guide more targeted interventions, vigilance and improve patient outcomes. Objective: To analyze the prevalence of pre-existing AF and the incidence of new-onset perioperative AF among older patients undergoing surgery for hip fractures. Method: A retrospective analysis of patients

Introduction  Advance Care Planning (ACP) should be discussed with patients in the last 12-months of life. Clinical frailty scale (CFS) ≥7 correlates with a 1-year mortality of ≥50%. Optional Electronic Patient Record (EPR) ACP documentation was introduced in 2020, enabling routine data collection on ACP which showed an increase in ACP conversations documented over time. We aimed to establish if this was representative of the number of ACP conversations happening, applying the findings to configuration of a new EPR planned for October 2024.   Methods  Retrospective paper notes review of 38