Posters

Introduction: Anticholinergic medications work by blocking neurotransmitter acetylcholine and may be used in variety of clinical settings. Older adults are more susceptible to harm from these treatments due to age-related physiological changes and higher prevalence of polypharmacy. Publications such as Pragmatic Prescribing Guide from the British Geriatric Society encourage review with the aim of reducing anticholinergic burden (ACB) in moderate and severe frailty. Despite evidence indicating cognitive and dementia risk, delirium, falls, fractures, functional decline, constipation, dry mouth

Introduction Over 65 million people worldwide are estimated to have Long Covid following SARS-CoV-2 infection. UK population data flags under-recognition of symptoms in older people as a potential issue. Given known frailty prevalence in this age group, a meaningful proportion of those affected are likely to be living with frailty. Long Covid is a complex multisystem condition of symptoms which persist/emerge three months after initial infection and is associated with over 200 reported symptoms. Many of these have similarities with frailty including fatigue, breathlessness, cognitive

Introduction Treatment Escalation Plans (TEPs) and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions are important components of person-centred care, particularly for people with complex and potentially deteriorating illness. The Pan-London Universal Care Plan (UCP) is a shared digital care plan supporting communication of patients' wishes, preferences and treatment escalation decisions across health and care settings. At Whittington Health NHS Trust, baseline audit identified gaps between escalation decisions documented during hospital admission and their availability on the UCP

Introduction A pilot audit of older adults admitted to hospital and receiving a comprehensive geriatric assessment found that 73% of patients who received a therapy assessment had experienced functional decline requiring increased support. All patients in this group also presented with delirium. Despite this, delirium screening was not routinely included in therapy assessments for older adults. This quality improvement project aimed to increase delirium assessment by therapists and reduce associated deconditioning among older adults admitted to hospital. Method A single PDSA cycle was carried

Introduction: Timely administration of intravenous Zoledronic Acid (ZA) following Neck of femur (NOF) fracture reduces subsequent fracture risk by up to 35% and is recommended by national guidance. Local policy recommends ZA administration between Days 5-8 post-operatively, following a minimum of 4 days of Vitamin D loading. Delays occur due to late counselling, decision-making and treatment coordination. Aim: To identify delays in ZA administration in eligible NOF patients and implement strategies to improve pathway efficiency. Methods: A quality improvement project was conducted at a

Acute decompensated heart failure (ADHF) is a common cause of hospital admission, particularly among older adults. The 2023 ESC guideline recommends that patients with known heart failure receiving outpatient diuretics are prescribed 1–2 times their usual oral diuretic dose intravenously on admission. Patients receiving intravenous diuretics should undergo daily monitoring including weight, renal function/electrolytes and fluid balance. This re-audit aimed to assess compliance with these guidelines and improve management of acute DHF in Sunderland Royal Hospital. Clinical records of 25

Introduction: Vertebral fragility fractures are a key indicator of underlying osteoporosis and strongly predict future fractures. However, they are frequently overlooked, particularly when asymptomatic or identified incidentally on imaging, resulting in missed opportunities for secondary fracture prevention. Methods: A quality improvement project was implemented across four frailty wards. Interventions included an educational poster on vertebral fracture management distributed electronically and displayed on wards, alongside clinical note stickers prompting osteoporosis assessment following

Abstract Author Name : K Tun1; L Scarlett1; E Fender2; M Murphy1; J Gerrard3; S Mbale2; M Gardener2; K Asavisanu1; L Kitchen1; S Lightbody1; S Sikder1 ; A Gowland1; J Scholes2; E Alduaij1; E Alaraik1; N Alanazi1; R Alhoqail1,8; A Bevan7; S Siva4; J Whitney5; R Dallmeyer4; G Walker1; T Kalsi1,6 Abstract Provenance : 1Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust 2Integrated Care Transformation Team, Guy’s and St Thomas’ NHS Foundation Trust 3Age UK Lambeth 4Quay Health Solutions 5Kings College Hospital 6CARICE, Faculty of Life Sciences & Medicine, King’s College

Introduction Delirium is common and frequently under-recognised in older hospital inpatients. The 4AT and Confusion Assessment Method (CAM) are widely used bedside assessments, but their comparative accuracy against an independent reference standard is not clearly summarised. We compared their accuracy in older inpatients. Methods Rapid review. PubMed was searched in English for the previous 10 years using ("4AT" OR "4 A's test") AND ("confusion assessment method" OR CAM) AND delirium AND (accuracy OR sensitivity OR specificity), yielding 32 records. Eligibility required accuracy data for both

Introduction: Delirium affects 20–30% of older inpatients and independently increases mortality, length of stay and long-term cognitive decline. However, it is frequently missed when diagnostic attention is shifted entirely to a primary acute illness or when confounded by baseline cognitive impairment. NICE guidelines recommend routine 4AT screening of older patients on acute admission (audit standard ≥90%). We audited 4AT completion in patients aged ≥65 on an acute medical unit (AMU) and examined which presentations were least likely to be screened. Method: A two-cycle audit was performed

Introduction Intravenous zoledronate (IV Zol) is an established first‑line therapy after fragility hip fracture, and its use has risen markedly within our trauma service. The orthogeriatric team identified concerns regarding patients’ understanding of secondary fracture prevention and noted cases where patients were inappropriately prescribed oral alendronate in primary care despite already receiving IV Zol. Our project goals were to empower patients, ensure safer prescribing, and improve our communication with primary care colleagues. Methodology We conducted a two-cycle quality improvement

Abstract Content : Background The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process promotes personalised emergency care planning and shared decision-making for patients at risk of clinical deterioration. High-quality documentation is essential to ensure appropriate escalation decisions and patient-centred care. This audit evaluated compliance with Resuscitation Council UK (RCUK) standards for ReSPECT documentation in an Acute Medical Unit (AMU). Methods A retrospective audit of 50 consecutive patients admitted to the AMU between 1–15 April 2026 was undertaken

Background Within the Ageing and Complex Medicine (ACM) Directorate at Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, learning points from Datix incident reports are not routinely shared with frontline clinicians, when classified as “no harm”. This increases risk of the recurrence of errors. Therefore, we aimed to routinely share a "Learning from Incidents" newsletter with all resident doctors in ACM so they could reflect on key learning points from Datix reports. We aimed to transform Datix reporting from a reactive process into a proactive resource for clinicians

Introduction: The Government's Neighbourhood Health Framework identifies frailty as a priority for Integrated Neighbourhood Teams (INTs). People aged over 75 years with moderate-to-severe frailty represent only 3–5% of the population but account for over one-quarter of non-elective hospital admissions. Delivering proactive neighbourhood-based frailty care requires a workforce skilled in early frailty identification and personalised care assessment. We developed a multidisciplinary education programme to build capability among Holistic Needs Assessors, a new role supporting proactive frailty

Introduction: In an acute setting, timely echocardiograms are essential to guide early specialist management of heart failure. National Institute for Health and Care Excellence (NICE) guidelines stipulate a prompt single NT-proBNP measurement and recommend performing transthoracic echocardiography (TTE) within 48 hours of admission in patients with new heart failure with raised naturetic peptide levels. This audit aims to evaluate the timeliness of TTE to assess if they are in-line with national guidelines. Methods: An initial baseline audit was conducted to assess current adherence to

Introduction Accurate mortality documentation is essential for safe communication with primary care and learning from deaths. At KCH, inconsistent death documentation following inpatient deaths on Gerontology wards was identified with incorrect information being communicated to GPs indicating the patients were still alive. Aim To identify barriers within the electronic documentation pathway and increase the proportion of correctly completed discharge summaries following inpatient deaths. Methods Using the Plan- Do-Study- Act methodology, we reviewed 206 deaths from September 2025 to May 2026

Introduction Around 400,000 people live in care homes in England and Wales. This population is expected to grow significantly in the next decade, due to a population living longer with complex multimorbidity. However, little is known about the extent of preventable harms or deaths in care homes, which was identified as a key research priority in the 2022 NHS Patient Safety Strategy. Methods We undertook a national observational study of Prevention of Future Death (PFD) reports, issued by coroners in England and Wales. The Preventable Deaths Tracker ( https://preventabledeathstracker.net/) was

Background Thirty-day readmissions in older adults are commonly attributed to frailty and multimorbidity. However, early readmissions may reflect unresolved acute illness or deficiencies in transitional care rather than baseline vulnerability. Distinguishing early from later readmissions may help identify modifiable system-level factors. Thus, we aimed to determine predictors of early (<7-day) versus later (7–30-day) 30-day readmissions in general medical patients. Methods We conducted a retrospective cohort study of adult general medical inpatients admitted between January–June 2023 and

From Recognition to Conversation: Improving Advance Care Planning for Older People Living with Frailty in Acute Care Settings Background Older people living with frailty have unpredictable illness trajectories, making recognition of the final year of life challenging. Advance care planning (ACP) may be delayed despite recognition of frailty and deterioration during acute admissions. We evaluated the timing of prognosis and end-of-life (EOL) discussions and clinicians’ confidence in initiating them. Methods Records of 100 patients who died across three older people’s wards between December 2024

Introduction People living with frailty are vulnerable to the detrimental effects of prolonged Emergency Department stays and ‘Corridor care’. Therapeutic interventions aimed at preventing deconditioning, falls and delirium are challenging to deliver in the Emergency Department. Method During a period of increased and sustained demand we trialled a Frailty Mobility Support Worker attached to the Acute Frailty Team at the RUH, Bath. They worked alongside nursing staff in the Emergency Department as well the Acute Frailty MDT to deliver targeted interventions to support nutrition, hydration