Posters

Introduction We know continence is important to older people but can often be overlooked in clinical practice. Continence can now be selected as a theme for service in the new geriatric medicine curriculum but there is concern that the uptake of this is poor. Our aim was to understand and quantify continence training opportunities and understand current and potential uptake of Continence as a Theme for Service. Method A short online survey was created and resident doctors training in geriatric medicine were invited to complete it from December 2024-April 2025. The survey was included in the

Introduction The transition period for new resident doctors is often overwhelming, requiring rapid adaptation while maintaining safe and effective patient care. The British Medical Association (BMA) advocates new resident doctor for induction. To support this process and improve efficiency, we developed an “Older People’s Handbook”, designed to familiarise new resident doctors with common conditions in geriatric medicine, provide practical guidance on navigating the hospital’s computer systems, and offer clear instructions for completing essential documentation. Method Resident doctors

Co-amoxiclav is a commonly prescribed, semisynthetic, empirical antibiotic. It is metabolised in the liver and eliminated via the kidneys. According to the trust guidelines, patients with severely reduced eGFR should receive a reduced dose of intravenous (IV) co-amoxiclav. This audit was conducted to assess whether IV co-amoxiclav dosing in elderly patients with an eGFR less than 30 ml/min was appropriately reduced in accordance with these guidelines. The standard dose is 1.2 g every 8 hours, but in patients with an eGFR <30, a reduced dose of 1.2 g every 12 hours is recommended. This is to

Introduction: Thorough clinical evaluation is crucial in all specialties, but especially in geriatrics. Frailty, cognitive impairment, and reduced patient cooperation can obscure typical features, making diagnosis more challenging. Musculoskeletal, neurological, and cognitive assessments are particularly important for falls or confusion, where missed diagnoses such as delirium or fractures can worsen outcomes. This audit evaluated the quality of clinical examination during clerking and subsequent senior review on the Geriatric Assessment Unit (GAU), focusing on musculoskeletal, neurological

Introduction Royal College of Emergency Medicine and NHS England define reduction of delays and omissions of critical medication as important strategic objectives. Data from Parkinson’s UK indicate that only 37% of doses of PD medication are delivered on time during hospital stays. The aim of this QI project was to evaluate data from previous 2.5 years and evaluate effectiveness of our improvement work. 2. Method Utilising hospital electronic reporting system, information was obtained on time from Emergency Department (ED) Triage document completion to time that PD medication was prescribed

Background This project at St James’s University Hospital involves resident doctors, advanced care practitioners, and patients on Elderly Care Wards where advance care planning (ACP) is commonly needed. Introduction ACP helps patients express future care preferences but can be challenging to initiate and document. The ReSPECT form standardises the recording of patient wishes, and the Clinical Frailty Score (CFS) predicts mortality risk, particularly if ≥5. This project aims to improve ACP discussions and documentation for patients with CFS ≥5 and to boost doctors’ confidence in leading these

Introduction: Osteoporosis affects approximately 3.5 million individuals in the UK, resulting in over 500,000 fragility fractures annually. An initial fracture significantly increases the risk of subsequent fractures, particularly in very high-risk patients. Current clinical guidelines advocate a "treat-to-target" strategy, recommending anabolic treatment for individuals at very high risk of fracture. The objective of this study was to evaluate biochemical safety, service delivery efficiency, and imminent fracture risk among osteoporosis patients receiving anabolic agents. Methods: We

Introduction: Pelvic fractures are a common fragility fracture, associated with adverse clinical outcome but often under recognised. There is a wide range of incidence 6.9-78.6/100,000/year being reported in the UK. There is a paucity of studies describing incidence and adverse outcomes including mortality and re-fracture risk. The objective of this study is to measure incidence of fragility fracture for the population of Gwent (592,000), compare baseline characteristics with all fragility fractures and measure clinical outcomes of pelvic fractures. Methods: All fragility fracture patients

Introduction: Fracture liaison services (FLS) aim to prevent secondary fractures by promptly identifying patients above 50 years with fragility fractures. The standard recommendation by FLS Database (FLS-DB) is to identify 80% expected fragility fractures, commencing treatment for 50% and monitor 80% at 52 weeks. Methods: A quality improvement methodology based on the model of improvement; Plan-Do-Study-Act (PDSA) cycles was introduced in 2022. The fragility fracture case identification increased from 22.7% (2021) to 41.1% (2022) and 58.4% in 2023, a 149% increase. Process mapping for the

Introduction: Dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis and guiding osteoporosis treatment, particularly when used alongside fracture risk assessment tools such as FRAX. Limited access to DXA scans in some centres, highlighting the need to prioritise their use effectively. The project is aimed to improve DXA access and prompt reporting to meet Fracture Liaison Service Database (FLS-DB) national standards. Methods: This multi-dimensional improvement project began in 2022 using the Model for Improvement. Process mapping identified inefficiencies

Introduction: Fragility fractures are a major cause of morbidity in older adults and are often preceded by falls. Identifying patients at greatest risk of refracture is vital for optimising secondary prevention strategies within Fracture Liaison Service (FLS). This study measures impact of history of single or recurrent (2 or more) falls on the incidence of re-fracture and mortality among patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS). Methods: This study included fragility fracture patients (n= 2,176) reviewed by AB-FLS between January and December 2023. Complete data on

Introduction: Hospital at Home (HAH) is an admission avoidance service where patients receive hospital-level care in their own homes. We conducted a retrospective cohort study to compare patient outcomes in older adults with community-acquired pneumonia (CAP) treated through HAH versus an acute frailty ward in hospital. HAH patients received once daily IV ceftriaxone whereas hospital inpatients were prescribed IV antibiotics as per hospital guidelines. Method: All patients diagnosed with CAP requiring IV antibiotics under HAH and on an acute frailty ward were identified between January and

Introduction: Fear of falling is a common psychological consequence following falls and fragility fractures, contributing to functional decline, reduced quality of life, and increased risk of further falls and fractures. The Fracture Liaison Service (FLS) routinely assesses fall risk to prevent secondary fractures. This study evaluates the quality of falls assessment with respect to psychological impact like fear of falling. In addition, we assessed an association of fear of falling with single or recurrent falls among patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS). Methods

Introduction: Patients over 65 often have multiple comorbidities and complex polypharmacy regimens, many including falls-risk-increasing drugs (FRIDs). Falls are a leading cause of morbidity in this group and are frequently associated with polypharmacy. A quality improvement project on Marjory Warren ward, King’s College Hospital, reviewed FRID prevalence and aimed to de-prescribe them where appropriate. A retrospective review revealed that all patients were on at least one FRID. Using the STOPP-FALL criteria, we systematically identified and reviewed FRIDs during hospital stays to reduce

Introduction: Some institutions have established Perioperative Medicine for Older Persons undergoing Surgery (POPS) services, demonstrating clinical benefits for frail and multimorbid patients over 65 years-old. As part of a national upscale (POPS-SUp), University Hospitals of Leicester geriatricians piloted a vascular-liaison service for those with a clinical frailty score (CFS) of five or more and lower limb pathology. We aimed to improve CFS accuracy by the vascular team and enhance their confidence in identifying and managing geriatric syndromes. Methods: We conducted a mixed-methods

Background: The 2022 revised Geriatric Medicine training curriculum requires trainees to spend more time with a range of healthcare professionals outside their ward placements, including in the community. Contacts and recommendations need to be shared to enable trainees to arrange these placements efficiently. Introduction: Arranging placements was largely ad-hoc and time consuming with communication limited to emails and an informal WhatsApp group. This project aimed to establish a secure space for trainees to share information. Methods: In January 2022, a SharePoint site was created through

Background: Constipation is common in older inpatients due to immobility, illness, dietary changes and dehydration. Poor bowel health can result in pain, faecal impaction, urinary retention and even bowel obstruction. Daily stool chart documentation supports early detection and management, but compliance is often poor. Aim: To improve daily stool chart documentation in a geriatric ward by 10%. Methods: Weekly retrospective reviews of stool charts were undertaken. Compliance was calculated as stool chart entries ÷ total admission days. Interventions were introduced using PDSA methodology: Day 0

Background Postural hypotension, defined as a systolic blood pressure drop of ≥20 mmHg or diastolic drop of ≥10 mmHg within 3 minutes of standing, is common in older hospitalised patients and is a major risk factor for falls, injury and mortality. Management is often complicated by coexisting supine hypertension, for which national guidance is limited. An internal audit (n=28) highlighted low resident doctor confidence in managing these conditions. Our aim was to improve clinician knowledge and confidence through the introduction of a clear guideline and educational materials. Methods A Plan

Introduction: 1 in 2 women over the age of 50 will have an osteoporotic fracture in their lifetime. Romosozumab is approved for the treatment of post-menopausal osteoporosis with very high fracture risk and recent fragility fracture (1). At Leeds Teaching Hospital Trust (LTHT), patients are referred to the Fracture Liaison Service (FLS) via an electronic referral form. One key question on the form is whether the patient might be suitable for anabolic agents, such as Romosozumab. If marked as ‘yes’, the referral is fast-tracked for a quick clinic assessment. This study evaluates identification

Introduction The elderly are susceptible to the adverse effects of anticholinergic drugs. A high anticholinergic burden from their use has been linked to falls, delirium, functional decline and death. NICE guidelines urges review of these drugs in vulnerable elderly with diagnosed or suspected dementia and falls, and have highlighted the use of ACB scoring tools to facilitate our approach. Aim It was observed that ACB assessments were not routinely done in our geriatric wards. We aim to improve compliance with NICE recommendations on ACB assessment in high risk patients and encourage use of a