Posters

Introduction Advanced care planning (ACP) conversations are very important in the geriatric department due to the frailty and co-morbidities of patients managed. The purpose of this audit was to establish if staff on the ageing and health wards were having these discussions and any barriers and facilitators to this. Method 1.A snap shot audit of DNACPR and ReSPECT forms in the ageing and health wards in Forth Valley Royal Hospital. 2. A Questionnaire regarding familiarity, use, facilitators and barriers in completion of ReSPECT forms sent to medical staff on ageing and health wards. The data

Introduction: Bowel charts can help detect changes in bowel habit, especially in patients with complex medical needs or limited communication abilities. Early recognition of constipation may prevent delirium, whereas recognising diarrhoea can prevent breakdown/infection of sores. SSKIN bundles, containing insufficient data on stool type/size, are sometimes used alongside bowel charts, leading to discrepancies. We aimed to improve accuracy of bowel charts over a 3-month period. Method: 10 patients from the Department of Medicine for the Elderly ward were randomly selected weekly for 6 weeks

Introduction: Urinary tract infections (UTIs) are the second most common community-acquired infection and the leading cause of hospital infections in individuals over 65 years. UTI treatment is a major driver of antibiotic resistance (AMR), with E. coli being the primary pathogen causing this in the UK. Further, asymptomatic bacteremia is common in over 65s and does not lead to increased morbidity. However, unnecessary antibiotic exposure increases the risk of harm, including AMR and C.difficile infection, contributing to the rising AMR-related mortality. Method: This study aimed to assess

Introduction: The cornerstone of catheter-associated urinary tract infection (CAUTI) prevention is avoiding unnecessary indwelling urinary catheter (IUC) insertion [1]. As part of a long-term project to reduce the number of catheters, the most common inserted device used across MOE wards in our hospital, we recently undertook a project to improve planning (does it need to stay, can we remove it?) and the reliability of information reconciliation around their use. Methods: We designed a data collection tool, analysing key aspects of IUC care, measured our performance at least twice-yearly using

Introduction Peri-operative care of the Older Person undergoing Surgery (POPS) is an evidence-based multi-disciplinary intervention known to improve care and outcomes in older patients undergoing surgery. A POPS service has now been established in the Southwest Scotland Vascular Network (SSVN); to the best of our knowledge, the first of its kind nationally. We report our early experience. Methods SSVN opted to fund one whole time equivalent geriatrician using a vacant consultant surgeon salary. This has permitted the daily input of expert geriatricians for all patients over 60 in our service

Introduction: Anticholinergic medications have been associated with an increased risk of cognitive impairment, falls, and higher all-cause mortality. Falls, delirium, and dementia are common presentations leading to admissions of older patients. Therefore, there is an emphasis on reducing the anticholinergic burden (ACB) in the elderly. This study investigated if the burden changed between the points of admission and being an inpatient. Methods: A retrospective cross-sectional audit was conducted on geriatric inpatients (≥85 years or ≥75 years if diagnosed with Parkinson’s disease as per local

Introduction: The UK’s ageing population presents growing challenges for health and social care.1 Age-related impairments in mobility, strength, cognition, and endurance contribute to the development of frailty and decreased physical activity in older adults.2 Despite the World Health Organization’s recommendations for regular physical activity among older adults, participation remains low due to physical, psychological, and social barriers.3 This study is aimed to explore these barriers and understand older adults’ preferences regarding physical activity to inform the co-development of

Introduction Patients with frailty at Tiree Medical Practice (TMP) are identified and managed by a Multi-Disciplinary Team. That team also provide out of hours and emergency care on the island meaning quick access to patient information is essential. The aim of this project was to improve frailty record keeping at TMP. It was intended that by 30 April 2025, a full Frailty Record (FR) would be held for at least 90% of patients identified as having frailty. The process of determining the parameters of the FR was dynamic but the final definition was an entry containing: Identifying details

Quality Improvement Project : Enhancing Stroke Unit Ward Round Documentations in a Large District Hospital Author Name - T Han; R Ehsan; A T Moe; K S Tun; D Ramsey Provenance - Princess Royal University Hospital Background This improvement project was undertaken within the Stroke Unit (SU) at Princess Royal University Hospital under King’s College Hospital NHS Foundation Trust. The multidisciplinary stroke team includes consultants, registrars, junior doctors, nurses, and therapists. Patients are typically admitted from the Hyperacute Stroke Unit (HASU) following initial stabilisation and

Introduction Collateral history is a cornerstone of geriatric inpatient care, informing decisions on diagnosis, discharge planning, and long-term support. Older adults often present with cognitive impairment, frailty, or limited communication capacity, making accurate history-taking essential. A baseline audit of 30 inpatients showed only 10% had all ten domains of collateral history documented. In 46% of cases, collateral history was taken more than once. Documentation was often inconsistent across notes from different professionals, hindering holistic understanding. Based on our baseline

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia, particularly among older patients. Its presence in patients undergoing hip fracture surgery can complicate perioperative management and is associated with increased morbidity. Evaluating both pre-existing and new-onset AF in this population can guide more targeted interventions, vigilance and improve patient outcomes. Objective: To analyze the prevalence of pre-existing AF and the incidence of new-onset perioperative AF among older patients undergoing surgery for hip fractures. Method: A retrospective analysis of patients

Background This audit was conducted on a Care of the Elderly (COTE) ward in a district hospital focusing on males over 65 years of age who developed acute urinary retention (AUR) during their admission. Introduction AUR is a common emergency in males that is responsible for 30,000 hospital admissions a year. The suboptimal management of AUR can lead to failed TWOC, recurrence of AUR, as well as an increased risk of urinary tract infections and multiple hospitalizations. The aims of this audit were to review management of AUR on a COTE ward over a 3 month period and compared this against NICE

Introduction  Advance Care Planning (ACP) should be discussed with patients in the last 12-months of life. Clinical frailty scale (CFS) ≥7 correlates with a 1-year mortality of ≥50%. Optional Electronic Patient Record (EPR) ACP documentation was introduced in 2020, enabling routine data collection on ACP which showed an increase in ACP conversations documented over time. We aimed to establish if this was representative of the number of ACP conversations happening, applying the findings to configuration of a new EPR planned for October 2024.   Methods  Retrospective paper notes review of 38

Introduction: Sarcopenia, the age-related loss of muscle mass and strength, is a major contributor to frailty, falls, and functional decline in older adults, significantly increasing the risk of hospitalisations and mortality. While vitamin D is well known for its role in bone health, its potential benefit for skeletal muscle remains under investigation. This review critically evaluates the role of vitamin D supplementation in improving muscle health and function in older adults without vitamin D deficiency. Methods: A literature search across multiple databases identified 591 English-language

Introduction Inappropriate polypharmacy in complex, multimorbid, and frail older adults increases risks of adverse events, hospital admissions, and nonadherence. Polypharmacy review is an important part of Comprehensive Geriatric Assessment (CGA) with national guidance emphasising the goal being harm reduction rather than deprescribing. This audit evaluated the impact of polypharmacy review within the Dundee Enhanced Care at Home Team (DECAHT) geriatrician caseload. Method A retrospective audit of the 25 most recent patient discharges under DECAHT-geriatrician care (July–August 2024) was

Background: Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use. Older adults are at higher risk of antibiotic associated complications, especially C. diff infection. Methods: Baseline data were collected from the hospital's electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance

"Assessment and Analgesia Prescription for Acute Pain in Older Adults Presenting to the Acute Frailty Unit" M Aslam; A Ajmal; J Selwyn; Ageing and Health; Forth Valley Royal Hospital Introduction: Pain in older adults is a common yet frequently under-recognised and undertreated issue. Age-related physiological changes, cognitive decline, and communication barriers make accurate pain assessment challenging. Despite its subjectivity, patients self-report remains the most reliable measure of pain. A multidisciplinary, person-centred approach—guided by both qualitative and quantitative methods—is

Introduction Hip fractures are a leading cause of morbidity and mortality in frail older adults, with 70,000–75,000 cases annually in the UK. Osteoporosis is a major contributor, and those with one hip fracture face a 2–3 fold risk of recurrence. Intravenous (IV) zoledronic acid reduces future fractures and improves outcomes. Scottish standards recommend a loading dose of vitamin D within 7 days and IV zoledronic acid within 30 days unless contraindicated, along with referral to the local bone health pathway. Zoledronic acid is also cost-effective, costing under £1,000 compared to over £14,000

Introduction Working on Tameside Geriatric medicine wards in the past year, we came across several patients who had a DNACPR form, their families/NOK were not aware and they lacked mental capacity themselves to understand. Some had capacity but it wasn't discussed with them which was shocking. We believe that a decision to with-hold life saving treatment is huge and there should be more conversation and documentation surrounding it. Method We collected data from the 2 specialized Geriatric Medicine wards using a data collection tool to see how many patients had DNACPR decisions discussed with

Introduction Dementia is marked by progressive cognitive decline and frequent neuropsychiatric symptoms, which heavily impact patients and caregivers. Antipsychotic use in dementia requires careful risk-benefit analysis due to risks like sedation, falls, extrapyramidal side effects, and increased cerebrovascular events. Recent studies show a threefold rise in stroke risk with certain antipsychotics. Methods A retrospective review of dementia patients prescribed antipsychotics for non-cognitive symptoms assessed documentation quality. Key points included comprehensive assessments, trials of non