Posters

Background: Delirium is a frequent and serious complication in older trauma patients, affecting an estimated 20–60%, particularly after fractures, spinal injuries, and prolonged immobilization. It typically arises from a combination of factors, including the acute effects of injury, pain, polypharmacy, infection, constipation, urinary retention, and physiological stress layered onto existing comorbidities and reduced cognitive reserve. Despite its impact, delirium is often under-recognised in busy ward settings, where hypoactive presentations are easily mistaken for fatigue, low mood, or

Introduction Computed tomography (CT) of the brain plays a crucial role in identifying pathologies responsible for acute confusion and reductions in Glasgow Coma Score (GCS). The quality of radiological request forms is essential to both radiographers and radiologists, with inadequate detail leading to avoidable delays and a reduction in diagnostic accuracy. This Quality Improvement Project (QIP) aims to improve the quality of CT brain requests submitted to investigate acute confusion and reduced GCS between December 2025 and February 2026, from the Care of the Elderly (COTE) wards and the

Introduction Delirium is a common but serious complication in older surgical patients, associated with increased morbidity and mortality, prolonged length of stay and poorer long-term outcomes. NICE guidance recommends all patients are observed daily for signs of delirium and promotes a multidisciplinary approach to prevention and management. The diagnosis and documentation of delirium is important for coding, handover of care and for helping patients and families understand their symptoms.  Methods  Clinical notes of patients aged ≥65 discharged from general surgery in January 2025 (n = 38)

Introduction  Delirium is a common but serious complication in older surgical patients, associated with increased morbidity and mortality, prolonged length of stay and poorer long-term outcomes. NICE guidance recommends all patients are observed daily for signs of delirium and promotes a multidisciplinary approach to prevention and management. The diagnosis and documentation of delirium is important for coding, handover of care and for helping patients and families understand their symptoms.  Methods  Clinical notes of patients aged ≥65 discharged from general surgery in January 2025 (n = 38)

Background Understanding a patient’s usual cognition and communication needs is central to preventing delirium. The ‘Get to Know Me’ booklet is intended to capture this information early in admission and support personalised care. Locally, use of the booklet was inconsistent, and foundation doctors reported they were often unaware it existed, unsure where it was kept, and unclear whose role it was to supply it. This project aimed to improve awareness, confidence and use through a focused teaching intervention. Methods Foundation doctors completed a baseline questionnaire assessing awareness

Introduction: Dysphagia is common in older people and is associated with aspiration and respiratory complications, particularly in those with cervical spine fractures1. A pilot study (2021) led to standards of care (SOP), developed with SLT team, for staff training to initiate early bedside dysphagia screening to mitigate respiratory complications and improve outcomes. Aim: To evaluate whether bedside dysphagia screening in older patients admitted with cervical spine fractures can mitigate aspiration and respiratory complications. Method: A retrospective cohort study using electronic records

With an ageing population, the number of older people attending emergency departments with head injuries is increasing. 2023 NICE guidelines advise to consider a CT scan for these patients who have sustained a head injury and have no other indication for a CT head scan but are on anticoagulation treatment or antiplatelet treatment. However, there are time, financial and personal costs of hospital conveyance to facilitate scanning to both individuals and the wider system. Method Across two UK, South coast hospitals, retrospective review of requests for CT brains from 1964 patients over 80years

Background Skull base osteomyelitis (SBO) is an uncommon but life-threatening complication of necrotising otitis externa, typically affecting older adults with diabetes. Presentation is often non-specific, and diagnosis is frequently delayed. Case An 84-year-old man with type 1 diabetes, vascular comorbidity and advanced frailty presented with a fall preceded by dizziness on standing. He reported a 6-month history of recurrent falls and severe postural light-headedness. For 3 months, he had persistent right-sided otalgia and offensive otorrhoea treated in primary care with repeated courses of

St Mary’s is a central MTC and receives approximately 340 ‘Major Trauma Calls’ per month. Rib fractures (RF) are often seen in major trauma, frequently feature in high-acuity mechanisms of injury, and are known to cause extensive pain and distress. St Mary’s RF SOP directs trauma teams to utilise a 24/7 ‘invasive’ analgesic pathway (advance regional nerve blocks/epidurals/PCA’s) as part of a multimodal analgesic approach to acute pain. The RF SOP defines invasive pathways indicated if a patient’s rib fracture severity score ‘STUMBL’ is >16. Our team completed a retrospective cohort data

Introduction: Sleep disturbances are common in individuals living with dementia, especially those living with Lewy Body Dementia (LBD) and Parkinson’s Disease (PD). These disturbances are associated with increased depressive symptoms among carers and can precipitate transition to care homes. DREAMS:START (Dementia RElAted Manual for Sleep; STrAtegies for RelaTives) is a clinically effective intervention for sleep disturbance in all-cause dementias. However, the experiences of supporting individuals living with LBD or PD and sleep disturbance remains unexplored. Therefore, this study sought to

Aim: To create a clinical culture of “Think Trauma” with all 65+yr olds presenting following unplanned attendances to the ground from any height for any reason. A good trauma assessment should be possible regardless of the first contact clinicians admitting specialty or grade. Overall improving initial assessment, management of and reduction in missed injuries in these older trauma patients. Method: Formed a senior multispecialty team to identify an educational plan. Based on narrative feedback from other trauma courses, a low-fidelity simulation-led course was created. Aimed at more junior

Introduction The Oxford and Reading Cognitive Health After Recovery from acute illness and Delirium- Prospective Study (ORCHARD-PS) aims to investigate the pathophysiology of delirium and future dementia risk after acute illness (Gan JM, Elderton L, Vijayakumar Sheela M, et al. BMJ Open, 2025 Jun 13;15(6):e102028). We determined baseline delirium occurrence, delirium subtype and associations with cognition and frailty in an interim analysis. Methods Acute medical patients aged 65 years and older without terminal illness, advanced dementia or nursing home residence were enrolled after consent

Introduction Falls are a leading cause of hospital admission in the elderly frail population. Current NICE guidance specifically recommends CT imaging as primary investigation of choice for detecting a clinically important brain injury (CIBI) in patients over age 65, with LOC/amnesia, or on anticoagulation who have sustained a head injury (HI). Aim To consider appropriateness of NICE guidance for CT head imaging for patients living with frailty, who present with HI following a fall from standing height. Method Clinical audit of 329 patients, Clinical Frailty Score 4-8, presenting with HI

Introduction Injurious falls are common, especially amongst adults older than 65. World and UK guidance recommend adopting a multifactorial approach to falls prevention, and there are tools that can support practitioners to address multiple falls risks. Many of these risks can be addressed through simple, practical actions (e.g., removing trip hazards, checking suitability of footwear). Social prescribing practitioners (SPPs) provide patients with non-clinical practical and emotional support in the community and are well-positioned to prevent falls. To our knowledge, no effective, evidence

Introduction There are numerous risk factors for falling in older adults, and world and UK guidance advocate adopting a multifactorial approach to falls prevention. Many falls risks can be addressed through actions for which clinical training is not required (e.g., removing trip hazards or providing advice about footwear). Patients’ access to falls prevention could be improved by supporting non-clinicians to use a standardised approach to identify risks and preventative actions. We aimed to identify risks and actions described in the published literature that could be incorporated into a novel

Introduction Older patients are at a higher risk of suffering injuries that are classed as major trauma (MT), due to a variety of factors. Injuries to the orofacial region present unique challenges in their management, necessitating a balance between functional and aesthetic demands. Despite these challenges, few studies to date have considered how a facial injury may impact outcomes in the older population. We describe a 10-year review at a major trauma centre (MTC) of older patients, who present with facial injuries alongside MT. Methods Data for patients over 65 years old who attended our

Introduction Atypical parkinsonian syndromes (APS), progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and corticobasal degeneration syndrome (CBS), are relatively rare and clinically heterogeneous. This can result in misdiagnosis, usually for idiopathic Parkinson’s disease. Recent cohort studies indicate characterising NPS could facilitate earlier and more accurate APS diagnosis. We audited NPS and associated management in a specialist APS clinic population. Methods Electronic patient records were reviewed for 97 ‘active’ patients attending the Oxford University Hospitals APS

Introduction Inpatient falls among older adults living with dementia are a significant patient safety challenge in acute hospital settings. Disorientation in unfamiliar environments and variable staff confidence in mobilisation contribute to avoidable harm, distress, and increased healthcare costs. This quality improvement project aimed to test the feasibility and early impact of a dementia-friendly environmental and training intervention on an acute elderly care ward. Method A quality improvement pilot was conducted on Hardy Ward, an acute elderly care ward within a large NHS Trust. Using a

Introduction: The 2023 National Institute for Health and Care Excellence (NICE) guidelines advocate consideration of a Computer Tomography (CT) scan in people taking anticoagulants with sustained head injury regardless of other risk factors. In practice, this is typically implemented as a mandatory indication for imaging. We reviewed ED attendances of those aged over 65 on anticoagulation who underwent a CT following head injury, to identify factors that could indicate a higher or lower risk of radiological evidence of acute traumatic brain injury (TBI). Methods: ED attendances between July

Introduction Subaxial cervical spine fractures in older adults are increasingly common and often occur in the context of frailty, multimorbidity, and low-energy trauma. Despite this, outcome data to guide optimal management are limited. We aimed to describe early morbidity and mortality and identify factors associated with poor outcomes in older patients with these injuries. Method We conducted a retrospective cohort study of consecutive patients aged 65 years and over admitted to our Major Trauma Centre with subaxial cervical spine fractures. Data collected included demographics, pre-injury