Introduction Geriatric medicine requires a unique set of clinical and non-technical skills, including advanced communication skills, multi-disciplinary team management, balancing risks and benefit of treatment in complex multimorbid patients, and a focus on holistic person-centred care. Current simulation courses often focus on acute emergencies but lack the nuance and complexity of geriatric medicine. We describe the development of and feedback from a novel Geriatric Medicine Simulation Course in Wales. Methods The course was designed by a small team of geriatric medicine specialty registrars
Introduction Delirium affects up to 50% of older patients (aged over 65 years) in hospital and is associated with serious consequences including greater morbidity and mortality, longer hospital stays with consequent hospital acquired complications, and an increased likelihood of hospital readmission. Early recognition prompting effective management is critical in improving outcomes for patients with delirium. Methods This QIP was conducted amongst Foundation Year 1 doctors (FY1) working across all wards in a busy district general hospital to improve knowledge of delirium through educational
Background Hip fractures are a common fragility fracture in older people; more than 4,000 patients with a hip fracture in Wales were submitted to the National Hip Fracture Database in 2024. Survival rates have improved in recent years, however while women are twice as likely to sustain a hip fracture than men, the risk of dying is greater for men who sustain a hip fracture. Methods We conducted a retrospective comparison of the demographics, care received and outcomes across sex in patients with hip fracture in Cardiff and Vale University Health Board in 2024. This included pre-existing
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 Sarcopenia, a progressive and generalised skeletal muscle disorder involving the accelerated loss of muscle mass and function, is a significant geriatric syndrome associated with numerous adverse health outcomes, including increased falls, frailty, disability, hospitalisations, and mortality. Despite its high prevalence, particularly in older adults, sarcopenia often remains under diagnosed in routine clinical practice, especially in outpatient settings where early detection and intervention are crucial for preventing progression and improving patient quality of life. Method 1
Abstract Content: Introduction: Emerging and increasing frailty often goes unidentified, and families living with dementia and frailty are missing vital opportunities to receive the right support at the right time. People living with frailty are less able to adapt to stress factors such as acute illness, injury, or changes in their environment, personal or social circumstances, leading to adverse health outcomes and an earlier loss of independence. Method: We have developed a unique and innovative National frailty Consultant Admiral Nurse service to address this concern. This service was
Introduction: The older population are more likely to suffer from chronic diseases, requiring more frequent hospital admissions, therefore, in University Hospital of Wales there is a dedicated Older Persons Acute Medical Unit (OPAMU). The OPAMU, opened in 2023, admits frail patients directly from the Emergency (ED) and Acute Medicine (AM) Departments for comprehensive geriatric assessment before discharge or onward hospital stay. Main objective: To understand how our patients felt throughout different steps of their journey to the OPAMU. Secondary objective: To assess how the patient
Introduction Advance care planning (ACP) is a patient-centred discussion involving the patient, family, and healthcare professional to ensure future care aligns with patient wishes. In Wales, this includes two recognised documents for those with capacity, and a best interests form for those without, completed by a Lasting Power of Attorney or IMCA. ACPs in the elderly population have been shown to enhance quality of life, communication, and reduce unwanted hospital admissions. This project aimed to improve ACP completion in primary care. Method Forty-one residents, who were registered to Roath
Background Pop-Up Digital assessments utilising screening tools such as the 4AT could been seen as a method to improve early diagnosis. The aim of this project is to improve the use of the 4AT through a redesigned pop-up Delirium Assessment, and to see whether its use would improve following raising awareness though ‘Dementia Action Week’. Methods Thirty patients' medical records from emergency admissions containing the medical coding criteria ‘Confusion’, ‘Delirium’, and ‘Dementia’ were included for each cycle. Patients under 65, and those admitted for less than 24 hours were excluded. The
Title: Improving Bone Health in Patients with Parkinson’s Disease: A Retrospective Study in a DGH Background: Parkinson’s disease (PD) is a neurodegenerative disorder primarily affecting movement, but its impact on bone health is often overlooked. Over 40% of individuals with PD experience recurrent falls, with more than a two-fold increased risk of hip fractures and nearly double the risk of non-vertebral fractures—largely influenced by mobility impairments, vitamin D deficiency, and long-term effects of medication. The aim of this study was to evaluate local compliance with bone health
Introduction Patients with Parkinson’s Disease (PD) are at an increased risk of developing osteoporosis. Vertebral fractures (VFs) are the commonest type of osteoporotic fracture and are frequently underdiagnosed, up to 70% going unreported. Individuals with VFs are at a significantly higher risk of experiencing subsequent fractures (relative risk increase of 2.8 for hip fractures and 5.4 for additional VFs). The presence of VFs are often not formally reported. VFs are also associated with an eightfold increase in morbidity. These complications could result in reduced independence and