Posters

Introduction: Postural hypotension (PH) is a significant predictor of mortality and is associated with increased risk of falls, functional decline and hospital admission among elderly patients. The National Institute for Health and Care Excellence (NICE) recommends routine assessment of PH in patients presenting with falls alongside a comprehensive review of contributing factors such as medication and hydration. This audit aims to evaluate current practice in the diagnosis and management of PH for patients presenting to Frimley Park Hospital’s Frailty Same Day Emergency Care (SDEC) against

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 Caffeine can adversely affect patient safety by increasing bladder urgency and agitation, raising fall risk, especially among older people. NICE guidance (2019) recommends reducing caffeine intake for individuals with overactive bladder. However, caffeinated drinks often remain the default in healthcare settings. In 2021, University Hospitals of Leicester NHS Trust (UHL) achieved a 30% reduction in toileting-related falls after making decaffeinated hot drinks the standard. In 2023, staff at Northumbria Healthcare NHS Foundation Trust (Northumbria) identified similar concerns. A

Introduction: Hospital Acquired Deconditioning (HAD) describes a patient’s reduction in performance following hospital admission. Medication review and assessment of medication management is a component of Comprehensive Geriatric Assessment. Hospital admission may necessitate the temporary transfer of medication administration to healthcare staff. For some patients, this may result in deterioration in medication management skills that impact discharge planning. This may be avoidable if individuals are supported to maintain these skills in hospital. Method: Two PDSA cycle quality improvement

Introduction Older adults are particularly vulnerable to adverse drug effects from opioids, including constipation, delirium, immobility, and delayed discharge. Despite NICE guidance recommending prophylactic stimulant laxatives with opioid prescriptions, older surgical inpatients frequently receive inadequate bowel care. Prescribing must also consider comorbidities such as renal impairment and cognitive decline. This quality improvement project aimed to optimise opioid and laxative prescribing safety in an elderly surgical population. Methods A two-cycle audit was performed on a long-stay

Introduction: Acute heart failure (HF) is the leading cause of hospital admission in people aged 65 years or older in the UK. Hospital at Home (HAH) is an admission avoidance service for frail older patients with the capabilities of administering intravenous diuretics and carrying out blood test including NT-proBNP. We aimed to audit the diagnosis and management of patients presenting with acute HF to Frimley Health’s HAH services against NICE guidelines (CG187). Methods: A retrospective analysis was carried out for all patients referred to HAH with decompensated HF between January and

Background This QIP was conducted in the Older Person Assessment Unit (OPAU) at Whipps Cross Hospital, acute care unit serving a diverse older adult population in East London. The project was led by resident doctors under consultant supervision. Introduction Falls are a leading cause of admission to the unit, contributing to injury, prolonged hospitalisation, and physiological decline. NICE CG161 provides evidence-based recommendations for risk prevention. Inconsistent documentation and low referral rates for preventative measures contributed to varied care quality and reduced effectiveness in

Introduction:​ Inpatient falls are a significant concern due to their impact on patient safety and outcomes. A standardised approach to reviewing falls can help identify contributing factors and improve care. Despite the recognised importance of fall reviews, inconsistent documentation and inadequate follow-up remain common challenges. This project aims to enhance resident doctors' reviews of patients after an in hospital fall, and improve their confidence and experience in responding to such calls. Ultimately it aims to determine contributing factors, and guide prompt investigation and

Background Cardiovascular complications are one of the most common causes of morbidity and mortality perioperatively during non-cardiac surgery. This risk is significantly increased in those ≥65 and those who are frail. NICE and ESC both recommend that all patients ≥65 have a pre-operative ECG to assess each patient's risk of perioperative cardiovascular complications before any intermediate or high-risk surgery. This study aims to assess the risk of perioperative cardiovascular complications in those ≥65 with abnormal ECGs. Methods We analysed data from patients attending our combined

Abstract: Audit of Cardiac Arrests at Nevill Hall Hospital (October 2022 - February 2025) Introduction This comprehensive audit examined cardiac arrests at Nevill Hall Hospital, part of Aneurin Bevan University Health Board (ABUHB), over a 28-month period. The study investigated relationships between patient frailty, comorbidities, resuscitation appropriateness, and clinical outcomes in a unique step-down hospital setting. Following health board restructuring, Nevill Hall operates without on-site specialties, anaesthetics, or intensive treatment unit facilities, comprising multiple Care of the

Aim This study aimed to assess management pathways and outcomes in sigmoid volvulus (SV). Methods A retrospective review was performed on patients first admitted with SV between 2019 and 2023 within a tertiary-level colorectal service. Demographic, management, and outcome data, including frailty, ASA (American Society of Anaesthesiologists), and National Emergency Laparotomy Audit (NELA) score, were collected. Comparative statistics were used to compare baseline demographics between those operated on and those not and to identify factors associated with survival. Results A total of 72 patients

Introduction: Would you drive a car with a worn tyre? Then why use a walking aid with a worn ferrule? Walking aids are essential tools for supporting and maintaining an individual’s independence, function, and safety. They provide greater stability and balance, promote a safe gait pattern by improving speed and stride evenness, and enhance confidence in mobility. However, it is well known walking aids that are incorrectly fitted or equipped with a worn ferrule can increase the risk of injury and or falls and their associated complications, but there is no evidence to suggest worn out ferrules

Introduction: The Centre for Perioperative Care Guidelines for People Living with Frailty emphasises the need for routine frailty assessment and subsequent Comprehensive Geriatric Assessment (CGA) in older adults within the emergency surgical setting. Medication review and optimisation is an integral part of the CGA. The Scottish Government’s Polypharmacy Guidance provides a 7 steps structure for patient-centred medication reviews. Utilising this structure, our aim was to establish a standardised method for documentation and recording of medication reviews as part of CGAs undertaken by our

Introduction: Inpatient falls are common and serious issue in healthcare, often leading to complications like traumatic brain injuries. Timely and appropriate evaluation using Computed Tomography (CT) scan of the head is crucial for diagnosing and managing those injuries. Clinical guidelines, such as those established by the National Institute for Health and Care and Excellence (NICE) and Royal College of Radiology (RCR) outline when CT head should be performed after a fall to ensure timely intervention and efficient use of resources. However, adherence to this guideline varies, sometimes

Introduction The National Hip Fracture Database (NHFD) 2023 report recommended a care bundle for patients leaving theatre recovery to include anaesthetists’ postoperative instructions regarding blood pressure, fluid management, transfusion and postoperative pain to improve outcomes. This audit evaluates our effectiveness in adhering to these recommendations.​ Methods We retrospectively audited the case notes of 51 hip fracture patients undergoing surgery between June and September 2024 in our trauma centre. Results 76.5% of patients were >80 years, 27.5% were ASA grade 4. One of the 51

Introduction In this retrospective study we examined adverse cardiovascular outcomes in patients under and over 80 years of age. Two cohorts were analysed: those undergoing coronary angiography and those treated for acute coronary syndrome (ACS). The first aim was to asses outcomes in those selected for invasive strategy including elective, urgent, or emergency procedures. The second aim was to compare invasive, excluding staged procedures, versus conservative management in the whole cohort presenting with ACS. Methods Data was retrospectively collected from patients treated at Conquest

Intro: Postoperative delirium (POD) affects 15-50% of older cardiac surgery patients, yet its long-term functional consequences remain poorly characterised. This study examines the association between POD and 5-year trajectories of disability using prospectively collected Barthel Index data. Methods: We analysed 135 patients aged ≥60 undergoing elective CABG±valvular surgery at a UK tertiary centre (2017-2023). POD was identified through daily Postoperative Morbidity Survey (POMS) assessments. Functional status was measured via Barthel Index (0-20) preoperatively and at discharge and at 6

Introduction Diabetes is prevalent (15%) in patients undergoing hip fracture surgery, with inadequate perioperative management linked to poor outcomes. National guidelines recommend surgical prioritisation, medication management, strict glycaemic and electrolyte monitoring, yet adherence remains suboptimal. This audit assessed compliance with the Centre for Peri-Operative Care standards at Ealing Hospital. Method A six-month retrospective audit (Aug 2024 – Jan 2025) reviewed the perioperative care of 26 diabetic patients (28% of 94 total hip fracture cases). Data were collected using online

Introduction: The increasing prevalence of osteoporosis, rising numbers of total hip replacements, and longer life expectancy have contributed to a growing incidence of periprosthetic femoral fractures (PPFFs), particularly in elderly, frail, and comorbid populations. In the UK, the Best Practice Tariff (BPT), introduced in 2010, aimed to improve outcomes in neck of femur (NOF) fractures through timely surgery and orthogeriatric care. For NOF fractures, strong, robust evidence links early surgery with better outcomes. Since 2020, the National Hip Fracture Database (NHFD) has included PPFFs

Introduction A growing evidence base demonstrates that perioperative frailty screening is essential to improve post-operative outcomes, yet it is underutilised in many hospitals. People living with frailty undergoing surgery can be complex and multimorbid with a high risk of complications, and comprehensive geriatric assessment in such cases is invaluable. This study quantifies the impact of initiating a POPS service in Swansea Bay University Health Board, with outcome data over a two-year follow-up period. Method In 2022, a quality improvement project to establish a POPS team was undertaken