Posters

Title: PRN Naloxone Prescription for Patients on Opioids in Gerontology Wards at Orpington Hospital — Quality Improvement Project Team: EN Udoh; F Khan; N Vakilzadehian Introduction: Nearly half of elderly inpatients receive opioids for pain management. Due to co-morbidities and polypharmacy, these patients are at increased risk of opioid toxicity. Naloxone is the established antidote and should be prescribed alongside opioids to manage potential toxicity. Aim: To evaluate adherence to Trust guidelines for Naloxone prescription in gerontology wards. Method: Two spot audits were conducted

Introduction Lumbar spinal stenosis (LSS) is the most common reason for people over 65 to undergo surgery, affecting ~10% of the community-dwelling population. Surgery for lumbar spinal stenosis has a variable outcome. We estimated the association between pre-operative patient demographics, surgical variables and patient-reported outcome measures (PROMs) with a clinically important change (30% change from baseline) in physical function at 6-months in a large, national registry database. Methods We used data from the British Spinal Registry (2013-2023). Anonymised data included demographics

Introduction: The Northern England Evaluation and Lipid Intensification (NEELI) guidelines recommend that for secondary prevention after stroke and transient ischemic attack (TIA), the lipid profile should be checked within 24 hours of admission and atorvastatin 80 mg should be started once daily. If the starting dose was lower than 80 mg, plans should be made for statin uptitration in three months. The aim is to evaluate adherence to NEELI guidelines on checking lipid profile and prescribing statin therapy for optimal secondary prevention after stroke or TIA. Methodology: This is a

Introduction: To synthesise the evidence available on components of reported rehabilitation interventions following pelvic fragility fracture in older adults and describe outcomes measured. Methods: A scoping review reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Scoping Review extension. A systematic search of Cochrane CENTRAL, Embase, MEDLINE and PEDro for studies of rehabilitation among patients 60 years and older with non-pathological pelvic fragility fracture, published up to May 2024. Single case studies were excluded. Screening and study

Introduction The risk of future falls in frail older adults who have fallen once remains high. Therefore, falls harm mitigation strategies are important for falls patients admitted to acute geriatric medicine care. How often Assistive Technology (AT) is offered in this regard is not known. Method A two-part Service Evaluation, Information Governance department approved. 1. Case note audit. Patients admitted to our department with a fall between 1st Sept - 30th Nov 2024. 2. 10 patient questionnaires about AT, completed during admission for a fall (May 2025). Results Audit - 112 returned cases

Introduction: Older people admitted to psychiatric hospitals are a highly vulnerable population, often with multiple comorbidities and complex medication regimens. National data estimates premature mortality of 10–20-years for people with severe mental illness, largely driven by physical health disparities. In older age psychiatry, this risk is compounded by frailty, dementia and polypharmacy. Basic physical health assessment is a cornerstone of safe, high-quality care. For older patients in psychiatric hospitals, this extends beyond routine monitoring for cardiovascular risk, metabolic side

Background ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) forms are used nationally to record advanced care planning (ACP) and resuscitation decisions. The Community Care Beds (CCBs) in Leeds offer inpatient rehabilitation to older patients including a comprehensive geriatric assessment, ACP and a resuscitation discussion which is recorded on a ReSPECT form. Objective To increase the number of patients in CCB beds who have a ReSPECT form in place. Methods The medical notes of patients in 4 CCBs in Leeds on a single day were reviewed for the presence of a ReSPECT form

Introduction: DNACPR documentation is an important component of clinical practice and guides decision making in the event of a cardiac arrest. A thorough documentation reflects the rationale behind the decision and states whether patient and family are aware and in agreement. Incomplete documentation fails to justify the DNACPR decision and demonstrate effective communication. Objective: To increase compliance with the completion of DNACPR documentation ensuring that each form achieves a high standard of completion – defined as at least 80% of the form being completed. Methods: A Plan-Do-Study

Introduction: Older adults with frailty are particularly vulnerable to harm from tight glycaemic control, with hypoglycaemia contributing to falls, cognitive decline, and increased mortality. National (JBDS: Inpatient Care of the Frail Older Adult with Diabetes) and local (Buckinghamshire, Oxfordshire & Berkshire–BOB) guidelines recommend individualising glucose targets according to frailty level, but adherence is inconsistent. This quality improvement project evaluated glycaemic management in inpatients with frailty, aiming to reduce hypoglycaemia and improve target setting in line with

Patients with advanced heart failure (New York Heart Association Class III–IV) frequently experience distressing symptoms including breathlessness, fluid overload, anxiety, and pain. Although national and international guidelines advocate for the use of palliative medications to manage these symptoms, their use remains inconsistent particularly opioids and anxiolytics. This audit aimed to evaluate current prescribing practices for symptom relief in this population and identify areas for clinical improvement. A retrospective audit was conducted on 35 patients with NYHA Class III–IV heart

Introduction Immobility during hospitalisation is a major contributor to muscle loss, deconditioning, functional decline, and prolonged length of stay in older adults. Evidence shows that increased mobility in hospitalised older people is associated with improved health outcomes, reduced functional limitation, and improved quality of life. Hospital-based mobility interventions, such as supervised walking and structured sit-to-stand protocols, help counteract the adverse effects of inactivity and support independence at discharge. Method This quality improvement project was conducted on the

Introduction: The risk of acute oropharyngeal dysphagia is increased in delirium, and is associated with longer hospital admissions, malnutrition, dehydration and sarcopenia. To promote swallow rehabilitation and facilitate recovery from delirium, nasogastric tubes may be trialled for feeding and medication. Methods: This retrospective observational study of senior health wards in a London hospital identified 24 patients with delirium who had a nasogastric tube inserted for acute dysphagia. Data was collected on the swallow rehabilitation (based on recommended IDDSI levels following assessment

Introduction The Frailty Assessment Unit (FAU) at the University Hospital of North Durham opened in April 2025. This is a hospital-based facility aiming to treat frail patients that can be discharged that day, or transferred to a suitable place of care more rapidly than by standard hospital pathways. Patients mainly come from Accident and Emergency or are referred by GPs. FAU have received pharmacist input since June 2025. Data was collected over a two week period to find the number and type of interventions made by the pharmacist. Method Data collection took place over a 2 week period in July

Abstract Content : Background: Delirium is a common but often under-recognized acute condition in hospitalized patients, associated with increased morbidity, length of stay, and healthcare costs. In Ysbyty Ystrad Fawr Hospital’s Medical Assessment Unit (MAU), a retrospective review of patients with a 4AT score ≥4 was done to find out deficiency in the assessment and documentation of delirium, as well as inconsistencies in key aspects of care. Methods: A quality improvement initiative was undertaken to enhance the recognition and management of delirium. A screening and documentation tool, the

BACKGROUND: Dementia is a leading cause of death among people living in care homes. Identifying palliative care needs in individuals with dementia remains challenging, often resulting in frequent hospital admissions and burdensome medical interventions during the final months of life. This review aimed to synthesise existing literature on prognostic tools designed to predict six-month mortality in individuals with dementia residing in care home settings METHODS: This systematic review was registered with PROSPERO (CRD42024623940). A comprehensive search of Embase, CINAHL, PsycINFO, and MEDLINE

Introduction Orthostatic hypotension, a fall in systolic blood pressure of 20mmHg or a diastolic drop of 10mmHg on standing up, is an important risk factor for falls amongst the elderly population. This quality improvement project aimed to improve consistent documentation of lying and standing blood pressure measurements, using sustainable and cost effective interventions. Polypharmacy review was an additional outcome. In this quality improvement project, we assessed the proportion of eligible patients who had lying and standing BP measurement. We made some interventions to improve this rate

Introduction: Purple urine bag syndrome is an uncommon but visually striking finding in catheterised patients, particularly those who are elderly, constipated, or in long-term care. It results from bacterial metabolism of dietary tryptophan, leading to pigment formation within the urinary catheter system. Although often benign, it can be an indicator of underlying infection or evolving sepsis. Case Presentation: A seventy-five-year-old male resident of a nursing home was admitted following concerns of fever, hypotension, and reduced consciousness. On arrival, he had a Glasgow Coma Scale score

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: Older adults undergoing vascular surgery are particularly vulnerable to hospital-acquired infections (HAIs) due to frailty, multi-morbidity, and the high prevalence of emergency interventions. HAIs in this population significantly affect recovery, length of stay, and survival. METHODS We conducted a single-canter retrospective analysis of vascular inpatients aged ≥60 years that developed new HAIs during admission between 1st June 2020 and 31st July 2021. Patients with diabetic foot infections, pre-existing surgical site infections (SSIs), or Clostridium difficile were excluded

Introduction: Phacoemulsification is a widely used cataract surgery technique, particularly in older adults, offering significant improvements in vision and quality of life. As the global population ages, understanding the outcomes and risks of this procedure in elderly individuals becomes increasingly important. This review aims to assess the safety, efficacy, and potential complications of phacoemulsification in older adults. Method: A search was conducted across three databases—PubMed, Scopus, and Cochrane—for studies published between 2020 and 2025. Inclusion criteria were studies focusing