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Displaying 201 - 220 of 1550
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M. Rahman (1), D. Khan (1)
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Introduction: Parkinson's disease is a progressive neurological degeneration of certain cells (called dopaminergic cells) within a specific part of the brain (substantia nigra). (1) Withholding PD medication or a prolonged delay in administering PD medication can lead to an increase in care needs and increases the risk of neuroleptic malignant type syndromes, which can be fatal. (2). Method: Prospective data was collected amongst doctors of different grades working in the Trust using Google forms. Results: Baseline data was collected in January 2025. 88.9% responders managed PD patients in

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K Wong1; S Aslam1; R Mizoguchi1
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Delirium – Getting the Basics Right on a Busy Care of the Elderly Ward Introduction: Delirium is a disorder of attention and cognition that is commonly encountered on Care Of the Elderly wards. It is associated with a significantly increased risk of morbidity and mortality, both during and after hospital stays. Best practice guidance from NICE (National Institute for Health and Care Excellence) outlines standards for screening and preventing delirium. Where possible, appropriate preventative measures should be implemented to address underlying causes such as pain, hypoxia, constipation, and
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1. MR Sarfraz; 2. I Mushtaq; 3. A Ali; 4. Anwar S; 5. F Ikram; 6. MF Hemida; 4. S Ajaz
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Introduction: Falls are a leading cause of death in older adults, with hypertension (HTN) potentially increasing this risk. However, trends in fall-related mortality with co-existing HTN remain understudied. We hypothesize an increasing trend in fall-related mortality among older adults with HTN, with disparities by sex, region, and place of death. Methods: A retrospective analysis of adults ≥65 years was conducted using CDC WONDER (1999–2023). Age-adjusted mortality rates (AAMRs) per 100,000 were stratified by sex, region, and place of death. Trends were assessed using annual and average

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Z NADEEM1
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Introduction The cumulative effect of medications with anticholinergic properties is known as anticholinergic burden (ACB). Adverse effects of anticholinergic drugs include increased risk of cognitive impairment, dementia, falls, and mortality among older people. Despite its serious implications for quality of life of older people, deprescribing to reduce anticholinergic burden is not guided by a single standardised guideline. Hence, practice remains variable. The aim of this service evaluation was to assess how effectively deprescribing is undertaken on Healthcare of Older People (HCOP) wards
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A.NIEMCZUK
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Introduction Elderly patients are prone to developing delirium, with this risk being heightened by admission to hospital. In Sunderland hospital all patients are screened on admission by the frailty team, but we suspected cases were being missed later in admission. NICE advocates that delirium is screened and appropriately investigated during a patient's admission. To aid detection, RADAR, a bedside delirium screening tool is completed with each set of observations. RADAR is an effective screening tool, with three to four RADAR screenings per day, RADAR has a 73% sensitivity and a 67%
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ZY Lau1, C Silbiger1
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Introduction It is estimated that the prevalence of cervical spine (c-spine) fractures following low impact falls in those over 65 is around 3.4%. These debilitating injuries carry a 12% 3-month mortality rate and a high morbidity rate. The gold standard investigation for suspected c-spine fractures is a c-spine computed tomography (CT). However, c-spine X-rays (XR) are often requested instead. As a department treating over 1000 falls a year, we suspected CT c-spines were being under-requested. Specifically, this QI project (QIP) aimed to ensure the cervical spine is being assessed with the
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Jaya Singh Kshatri 1,2 , Soumya Ranjan Sahu1, Supriya Darshini Behera1, Daisy J.A. Janssen3, Susan D. Shenkin2, Sanghamitra Pati1
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Background: Comprehensive Geriatric Assessment (CGA) is a cornerstone of geriatric care, but is challenging to implement in low- and middle-income countries (LMICs) due to scale, workforce limitations and the absence of culturally appropriate tools. Community Health Workers (CHWs) play a critical role in rural India, yet they lack a suitable screening instrument to identify older adults who require further and detailed CGA. Objectives: To develop and validate the Elderly Health Status Assessment and Screening (EHSAS) tool—a concise, culturally adapted, and multidimensional screening tool for

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F Hallam-Bowles 1,2; A Kilby 3; AL Gordon 4,5; S Timmons 1; PA Logan 1,6; L Rees 7; W Lawry 8; CHAFFINCH stakeholder group; K Robinson 1
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Introduction Co-production approaches are increasingly used in research. However, they are not often evaluated in care home settings. The study aimed to explore how co-production occurred in a series of workshops around falls management in care homes. Methods Sixteen stakeholders (care home residents and relatives, care home staff, health and social care professionals) participating in co-production workshops in a systematic action research study were invited to take part in a qualitative evaluation. The workshops were developing a model for delivering falls training in care homes across
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Vasvi Sadhwani1, Xuan Ning Lai1, Wen Min Ng2, Akif Gani1
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Introduction Magnesium is essential for regulating cardiovascular, neuromuscular and respiratory functions. Hypomagnesemia in older adults is often overlooked and insufficiently managed. Inadequate monitoring and correction of hypomagnesemia may leave old and frail patients more vulnerable to acute cognitive decline which in some cases can be preventable. This study assessed the current management of hypomagnesaemia in older adults admitted to the geriatric wards of an NHS Trust and its association with acute cognitive decline. Methods A retrospective review of old and frail patients admitted
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A Jacob1; U Patel1; G Trafford2; L Jones1; J.N Omomila1; M Makarchuk1.
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Introduction Catheter insertion is an invasive procedure associated with significant morbidity, including urinary tract infections (UTIs), prolonged hospital stays and patient discomfort. UTI is the commonest hospital-acquired infection, accounting for 19% of cases. We conducted a clinical audit to assess patients who had a catheter during their hospital stay, focusing on the indications for catheterization and the incidence of UTIs. Based on the findings of the first audit, we introduced guidelines for out-of-hours catheter insertion and inpatient Trial Without Catheter (TWOC) protocols
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A Rajgopal1, W W Chin2, J Dudley3
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Introduction As the UK population ages, the demand for effective geriatric care continues to grow. Discussions amongst resident doctors highlighted that they often feel underprepared in managing older adults with frailty and multiple comorbidities. This quality improvement project aimed to improve confidence in managing complex geriatric topics through an online teaching programme, The Comprehensive Geriatric Lecture Series, targeted towards final-year medical students and foundation doctors. Topics covered included Stroke, Mind, Falls, Medications, Frailty, Orthogeriatrics, and Matters Most

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N Khairi1; R Behranwala2; M Carr1
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Introduction: Hospital admission exposes older adults to harms, including delirium, acute kidney injury (AKI), and mortality. Hospital at Home (HAH) services allow treatment of acute illnesses, such as infection with IV antibiotics in the home setting. Methods: We retrospectively compared patients managed in the community under HAH with those admitted to an acute frailty ward. Over a twelve-month period, we identified older adults with urinary tract infection requiring IV antibiotics. HAH patients received daily IV ceftriaxone, while inpatients were treated according to hospital guidelines and
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A AQEEL1, A MUHAMMAD Shoaib2
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Introduction: A fast track discharge is considered when someone has a life-limiting illness, and their condition appears to be rapidly deteriorating. The Fast Track Pathway aims to provide patients with access to NHS continuing Healthcare as quickly as possible with minimum delay. Given the nature of the needs, this time period should not usually exceed 48 hours from receipt of the completed Fast Track Pathway Tool. ICBs should ensure that they have commissioned sufficient capacity in the care system to ensure that delays in the delivery of care packages are minimal. If this discharge is
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Daniel Tsui
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Introduction Effective communication about medication changes during hospitalisation is critical for patient understanding, satisfaction, and adherence. This service evaluation examined how older patients and their carers perceive healthcare professionals’ communication around medication changes during inpatient care. Methods A qualitative study was conducted using semi-structured interviews with 10 participants (6 older inpatients, 4 carers) across four geriatric wards. Thematic analysis was applied. Sampling was guided by information power, with data saturation achieved after 10 interviews
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OC Cobb1; H Moe Aung2; L White2
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Introduction: Hearing aids often appear broken and whether due to the battery or earwax simple fixes can allow patients to hear. This project aimed to improve hearing impaired patients' experience and healthcare by providing support for hearing aids across Elderly Medicine wards in a large teaching hospital in Leeds. Method: A survey evaluated the proportion of patients with non-functional hearing aids, with qualitative questions to evaluate the impact. The first intervention was a toolkit showing how to check if a hearing aid worked, how to fix common issues, to go alongside spare batteries
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SD Shenkin1,2; S Powell3; FGruber3; E Cadger3; A Chong3; S MacDonald4; E MacDowell5; C Henderson6; R Hogg6; A Anand1,3; P Linksted3
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Introduction: Individuals’ health data is routinely recorded in electronic health records in primary and secondary care. Care homes collect extensive data about residents, and many now use electronic care planning systems. Linked data could be useful in care homes, healthcare and administration, to highlight change in condition, or trends in needs. This project aimed to link individual-level data held in care homes with health data, and co-design dashboards to display this to care homes. Methods: In the DataLoch Trusted Research Environment, in partnership with NHS Lothian, the University of

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VJW Koh1,2; BE Harbinson2; JP Ansah1,3; AWM Chan1,2; DB Matchar1,4
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Introduction Hip fractures in older adults often lead to prolonged disability and reduced quality of life. While baseline physical health is a known predictor of recovery following hip fracture, the underlying causal mechanisms remain poorly understood. There is growing interest in the influence psychosocial factors – for example, psychological resilience – have on recovery. This study examines the relationship between baseline psychological resilience and 12-month recovery of functional outcomes following hip fracture surgery in older patients. Methods A 12-month, multi-centre pilot cohort
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Elizabeth Seccombe1, Fionnuala Johnston2
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Introduction: A multidisciplinary team (MDT) clinic was introduced at Sunderland Hospital for patients with Parkinson’s disease (PD) in 2019, leading to a reduction in hospital attendance rates. The MDT clinic enables PD patients to consult with a geriatrician, a specialist pharmacist for PD, and a physiotherapist, allowing for an early assessment of mobility and side effects from PD medications. We wished to evaluate and then improve patient experience at the MDT Parkinson’s clinic. Method/ results: We evaluated patient experience by surveying 28 patients who attended the MDT Parkinson’s

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Susmita Nath1, Bryony Elliott2
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Introduction: There is limited evidence regarding the optimal anaesthetic choice for neck of femur (NOF) surgery, particularly in comparing general anaesthesia (GA) versus regional anaesthesia (spinal). While some cohort studies suggest that regional anaesthesia may offer superior post-operative outcomes, including reduced delirium and shorter recovery times, the lack of clear guidelines leaves uncertainty about the best anaesthetic approach for improved patient outcomes. Methods: This audit aimed to assess the impact of GA versus spinal anaesthesia on patient outcomes in NOF surgery. A cohort
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Robert Winfield
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Introduction: Direct-acting oral anticoagulants (DOACs) have seen a recent increase in numbers prescribed, due to effective prevention of strokes and embolic events in non-valvular atrial fibrillation. Despite increasing use, expansive dosing criteria and strict monitoring guidelines, inappropriate doses of DOACs are being prescribed in the community. Recent studies predicted that 15%-20% of elderly patients with AF were receiving inappropriate DOAC doses, with most underdosed. Patients are thus at risk of increased bleeding if overdosed or thrombotic events if underdosed. Method: 85 patients
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