Posters

Introduction Fragility fractures are associated with increased morbidity and mortality. Early identification of patients at risk is essential for prevention. Bone health assessment tools are recommended in current clinical guidelines for those at risk. Despite this, baseline audit data showed that only 3% of patients admitted to a geriatric ward following a fall had a bone health assessment completed within 72 hours of admission. This project aimed to increase the completion rate of bone health assessments to over 90%. Methods A series of targeted interventions were implemented over four

Introduction: Visual impairment is a key yet often neglected risk factor for falls in older adults. National guidance recommends that vision be assessed routinely as part of a multifactorial falls risk evaluation. This audit aimed to evaluate whether vision was appropriately assessed and documented in patients admitted with falls at Croydon University Hospital. Methods: A retrospective audit was conducted on patients admitted under the acute medical take following a fall between the 1st-12th of February 2025. Patient records were reviewed for documentation of vision assessment, history of

Background: Falls in frail older adults can cause prolonged hospital stays, raising the risk of further falls, infections, and decline. This case shows how delayed discharge and complex care planning can worsen outcomes in this group. Case Presentation An 86-year-old male with Alzheimer’s dementia, chronic kidney disease, and peripheral vascular disease sustained an unwitnessed fall at home while taking medication. He was found to have an avulsion fracture of the right anterior superior iliac spine (ASIS) with soft tissue changes and was managed conservatively under orthopaedics. His three

Introduction: Polypharmacy—commonly defined as the use of five or more medications—is highly prevalent among older adults and is associated with increased risks of adverse drug events, falls, cognitive impairment, hospital admissions, and reduced quality of life. Inappropriate polypharmacy, where medications provide limited benefit or cause harm, represents a significant patient safety concern. Structured medication reviews (SMRs), supported by validated deprescribing tools such as STOPP/START and Beers Criteria, are essential for identifying and addressing potentially inappropriate

Background: Urinary incontinence is common among older hospital inpatients and is associated with functional decline, skin damage, and delayed discharge. While guidelines recommend structured assessment and conservative management, continence care often remains reactive and inconsistent. This review uses behavioural science theory to explore the barriers and facilitators to implementing improvements in continence care for older people in acute hospital settings. Methods: A search strategy, across MEDLINE, EMBASE and EMCARE encompassed peer-reviewed literature from 2015–2025 using terms related

Introduction In older adults, the inability to rise independently after a fall increases the risk of long-lies and associated complications. Up to 65% of individuals attended by ambulance crews post-fall are assisted up without requiring further medical intervention. This study investigated the effectiveness of Floor-Rise Training (FRT) in improving floor-rise ability and reducing fear of falling in community-dwelling older adults. Method This pilot cluster-randomised controlled trial was conducted within five existing Otago exercise classes. Sixty-one participants aged ≥65 years were enrolled

Background Stairs are a serious safety hazard for older adults, with stair falls being the leading cause of accidental death [1,2]. Mechanistic, proof-of-principle, research has examined the development of interventions to improve staircase safety. The aims of this systematic review are to synthesise and evaluate stair fall interventions and identify those showing effectiveness and to establish a pathway to implementation for these interventions. Methods Five databases were searched for interventions seeking to reduce risk or occurrence of falls on stairs. Quality of the studies was assessed

Introduction: Inpatient falls are a common cause of harm in hospitalised older adults. National guidance from the 2024 National Audit of Inpatient Falls (NAIF) and Royal College of Physicians (RCP) outlines standards for timely and structured post-falls care. This quality improvement project aimed to assess local adherence to these standards and to implement a guideline to support safer, more consistent inpatient falls management. Method: A retrospective audit reviewed all inpatient falls reported via the Datix system in May 2024. Falls in clinical areas requiring medical review were included

Introduction: Approximately half of individuals aged 80 years and older experience at least one fall per year, costing the NHS an estimated £2 billion annually. Visual impairment is a recognised potentially modifiable risk factor for falls and their resulting consequences including injuries and hospitalisation. Despite this, visual assessment is often overlooked by clinicians when managing these patients, potentially due to the absence of standardised guidelines. Method: A first-cycle clinical audit was undertaken in an acute Geriatric Medicine ward between January 2025 and March 2025

Introduction Patients with Parkinson’s Disease (PD) are at an increased risk of developing osteoporosis. Vertebral fractures (VFs) are the commonest type of osteoporotic fracture and are frequently underdiagnosed, up to 70% going unreported. Individuals with VFs are at a significantly higher risk of experiencing subsequent fractures (relative risk increase of 2.8 for hip fractures and 5.4 for additional VFs). The presence of VFs are often not formally reported. VFs are also associated with an eightfold increase in morbidity. These complications could result in reduced independence and

Introduction Annually, around 130,000 people in Wales are reported to have at least one fall incident. Existing evidence suggests that Mental Health inpatient units, on average exhibit higher incidence of fragility fracture than acute hospital wards which could be contributed by medication such as antipsychotics and anti-depressants. Consequently, a quality Improvement project was formulated to evaluate fragility fracture risk among Elderly inpatient Mental Health unit and to analyse their adherence of treatment to the National Standards. Method Patients admitted to old age psychiatry ward at

Introduction Bone health declines with age, with almost 3 million people in the UK living with osteoporosis. Osteoporosis is a common condition affecting older people where bone density is reduced, increasing the risk of fragility fractures. Most patients are diagnosed following a fracture, and only then prescribed bone protection. Older people have an increased falls risk due to muscle weakness, impaired vision and balance, pain, postural hypotension and medications; increased falls frequency correlates to increased fracture incidence. We aimed to evaluate whether bone health was routinely

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