Posters for 2026 Scotland Autumn Meeting

ntroduction : Giant cell arteritis (GCA), also known as Horton’s disease - a large‑vessel vasculitis characterized by granulomatous inflammation of medium and large-sized arteries - is the most common primary systemic vasculitis in adults over the age of 50 [1]. It shows a strong predilection for women, particularly those of Northern European ancestry. The classical presentation includes new‑onset headache, scalp tenderness, jaw claudication and visual disturbance, though the clinical spectrum is heterogeneous and may overlap with other conditions common in older adults [2,3]. Delayed

Background Urinary tract infection (UTI) is frequently diagnosed in hospitalised older people, although non-specific presentations such as delirium, falls and confusion may occur without localising urinary symptoms. This can lead to unnecessary antibiotic exposure, delayed microbiological sampling and missed opportunities for antimicrobial de-escalation. Local problem An initial audit identified inconsistent assessment of urinary symptoms, delayed culture collection, variable adherence to local antimicrobial guidance and incomplete review of microbiology results. The aim was to improve

Introduction Falls are a leading cause of injury, hospital admission and loss of independence among older people. At the start of this project, NICE CG161 recommended comprehensive multifactorial falls assessment for older adults at risk of falls. During the second audit cycle, this guidance was superseded by NICE NG249 (2025). Review of the updated recommendations confirmed that the audit criteria and intervention still aligned with the current guideline. We evaluated documentation of multifactorial falls assessment and the impact of introducing a structured Outpatient Falls Risk Assessment

Introduction Supporting Professional Activity (SPA) time and specialty clinic attendance are essential components of higher specialty training. Despite being allocated within work schedules, protected educational time was frequently interrupted by clinical service demands, limiting curriculum progression and trainee development. We aimed to improve reliable access to protected SPA and specialty clinics for Group 1 specialty registrars through low-cost system interventions. MethodA prospective quality improvement project was undertaken in a district general hospital using two Plan–Do–Study–Act

Background: The Gold Standards Framework (GSF) is a nationally recognised tool used to identify patients approaching the end-of-life and facilitate advances care planning (ACP). Accurate GSF assignment can improve ACP, support preferred place of care and death, and reduce unnecessary admissions. Mortality following hip fracture is currently 6% within one month and varies from 12.1%-35.8 % globally at one year, making accurate prognostication particularly important in orthogeriatric populations. We therefore evaluated the accuracy of GSF assignment in patients aged over 60 years admitted with

Introduction Cauda Equina Syndrome (CES) is a time-critical neurosurgical emergency in which delayed diagnosis may cause irreversible neurological disability. Diagnosis in older adults is challenging because back pain, bladder dysfunction and reduced mobility commonly coexist with age-related comorbidities. This quality improvement initiative evaluated the clinical characteristics of MRI-confirmed CES in older adults and the effect of introducing routine post-void residual (PVR) measurement. Methods A retrospective clinical audit reviewed adults undergoing lumbosacral MRI for suspected CES at

Introduction Revision total hip arthroplasty (rTHA) is increasingly performed in an ageing population, but functional recovery and the need for subsequent revision remain important concerns. This study aimed to evaluate the functional outcomes, re-revision rates and mortality following rTHA in a geriatric population. Methods We retrospectively reviewed 145 revision total hip arthroplasty procedures performed in 138 patients between 2021 and 2025. Patient demographics, indications for revision, re-revision, mortality and postoperative mobility were reviewed. Results A total of 145 revision

Introduction Suspected Transient Ischaemic Attack (TIA) is a common and important reason for Emergency Department (ED) presentation in older adults. Local guidance recommends that patients should undergo CT head imaging, be prescribed aspirin and referred to the TIA clinic. However, a suspected TIA can create diagnostic uncertainty, making clinical decision-making challenging. We evaluated adherence to the local referral pathway to guide service improvement opportunities and identify variation in management according to final diagnosis. Method We conducted a retrospective audit of TIA

Introduction: Medication timing is critical for patients with Parkinson's Disease (PD). The 'Get It on Time" campaign strives to have PD patients receive their medications within 30 minutes of prescribed time. Methods: Using PDSA methodology, a list of current inpatients with PD was populated and their medicines reconciliation (med rec) repeated to check accuracy of admission prescriptions. HEMA records were analysed to ascertain how many doses in the last 3-5 days of admission were given >30 minutes late. We also collected qualitative data from patients via an in-person survey, asking how

Introduction: A Treatment Escalation Plan (TEP) is used to guide the level of appropriate care for patients at risk of deterioration. The aim is to prevent iatrogenic harm by reducing inappropriate investigations and treatments. Benefits of early escalation discussions are well-documented and TEPs are gold standard in the SIGN 167 guideline. Additionally, clarification of care escalation is undeniably beneficial for out-of-hours teams who may unnecessarily investigate and overtreat. The aim of this audit was to 1) identify barriers to TEP decisions on admission to AMU, and 2) increase the

Melatonin biomarkers and delirium in older adults: A systematic review of observational studies Introduction Delirium, a severe clinical syndrome characterised by acute disturbances in attention, awareness and cognition, affects approximately 20–50% of older adults in hospital care. Melatonin, a key regulator of circadian rhythms, has been proposed as a potential biomarker for delirium due to its role in sleep–wake regulation. However, evidence regarding the association between melatonin secretion and delirium remains inconsistent. This systematic review synthesised evidence on the association

Introduction NICE CG103 and SIGN 157 recommend non-pharmacological measures to reduce delirium risk, including visible clocks, day/date orientation, clear signage, and ensuring sensory aids are available and used. This audit assessed compliance with sensory orientation measures on an older adult delirium/dementia ward, then evaluated whether simple ward-based environmental and documentation prompts improved practice. Methods A baseline audit was performed on 14/04/26 on Ward 52, an older adult delirium/dementia ward at Queen Elizabeth University Hospital, Glasgow. Patients aged ≥65 years with

Background: The Clinical Frailty Scale (CFS) is a validated 9-point tool used to assess frailty in older adults, supporting clinical decision-making and care planning. Current guidance recommends CFS assessment at first contact with acute services; however, locally, completion often occurs after review by geriatric teams. This project explored whether a patient/carer-completed CFS questionnaire could facilitate earlier frailty assessment. Aim: To develop a self-completed CFS questionnaire for patients and carers and evaluate its accuracy compared with clinician CFS scores in patients aged over

I ntroduction: Future Care Plans (FCP) enable individuals to express their preferences for future healthcare, promoting person-centred, proactive care and shared decision-making. NHS Greater Glasgow & Clyde recommends that healthcare professionals consider FCP discussions for older people living with one or more long-term conditions who are at increased risk of hospital admission. This quality improvement project aimed to increase FCP completion on Ward 4 and improve documentation of FCPs, Treatment Escalation Plans (TEPs), and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions

Background: Accurate pain assessment is fundamental to effective pain management in older adults. Unrecognised pain is associated with adverse outcomes, including delirium, prolonged hospital stay and reduced quality of life. Although self-report remains the gold standard, some older adults may be unable to reliably report their pain because of cognitive impairment or communication difficulties, making pain more difficult to identify. In these situations, accurate pain assessment depends on healthcare professionals’ knowledge of pain assessment principles and the appropriate use of validated

INTRODUCTION: Older adults living with frailty triaged by the Manchester Triage System (MTS) as low acuity had high admission rates, suggesting under-triage. We tested a Clinical Frailty Scale (CFS)-based modifier to improve MTS accuracy in patients aged ≥65, comparing triage category agreement with clinical outcomes over a three-month period. METHOD: A structured quality improvement approach was used. Baseline data was analysed, triage processes mapped, and a measurement plan developed. The new process was co-designed with Acute Medicine consultants, triage nurses, and consultant

Introduction Signing off investigation results is essential to ensure timely and safe patient care. Missed results contribute to adverse patient outcomes and duplication of work. GGC Healthboard moved to electronic sign off of results in 2021; compliance has been poor. Project Aim: 80% of patients in the older patient's wards will have all results signed off within 48 hours of publication. Method Using PDSA methodology we tested several change ideas over 10 months: Creation of standard operating procedure with clear roles for residents and consultants. Shared via email, SharePoint and posters

Introduction Future care planning (FCP) is indispensable in managing frailty and/or advanced disease, requiring comprehensive discussion of prognosis and treatment options. By articulating what is important to the individual, a personalised future care plan promotes autonomy and dignity. The Recommended Summary Plan for Emergency Care and Treatment (RESPECT) process facilitates FCP and had already been implemented within some areas of our NHS Trust. This quality improvement initiative aimed to promote RESPECT implementation within the hospital at home service to improve FCP for older adults

Introduction: We undertook a two-cycle quality improvement project in a district general hospital to improve completion rates for basic post-fall investigations in patients aged 65 years or older admitted to the General Surgery department for conservative management of head injuries or rib fractures sustained due to a fall. This is a vulnerable group of patients with extensive medical comorbidity and often a medical cause for their fall, yet their care takes place outside a geriatric service. Based on British Geriatrics Society and NICE guidance, we implemented pragmatic educational and

Introduction The management of silver trauma ( patients aged ≥ 65 with traumatic injuries or low-energy falls such as a fall from standing < 2 metres causing life- threatening injuries, resulting in ISS > 15) often suffers from delayed recognition, leading to poor pain control, prolonged lengths of stay and functional decline. This QIP aimed to align local emergency department practices with TARN and RCEM guidelines. Our targets were: Initial pain assessment within 15 minutes, Analgesia administration within 30 minutes, Pain reassessment at 30 minutes after analgesia, Silver trauma assessment