Posters

Introduction Chronic heart failure is a leading cause of hospitalisation in individuals over 65, carrying significant morbidity and mortality, with approximately 50% of patients dying within five years of diagnosis. Despite this, only 40% of patients are under the care of cardiology, a figure projected to decline further. This audit aimed to assess adherence to European Society of Cardiology and NICE guidelines for the investigation and management of heart failure in geriatric inpatients at the Norfolk and Norwich University Hospital. Methods We conducted a closed-loop audit of 100 patients

Introduction: Enhanced Recovery After Surgery (ERAS) protocols have significantly improved outcomes in elective surgery, but their application in emergency settings—particularly for elderly patients—remains limited. Although ERAS guidelines for emergency laparotomy exist, uptake in clinical practice is inconsistent. Data from the National Emergency Laparotomy Audit (NELA) show that patients aged ≥65 experience significantly worse outcomes than younger cohorts, with a 30-day mortality of 15.3% compared to 4.9%, and longer hospital stays (15.2 vs. 11.3 days)1. Our aim was to develop a modified

Introduction & Aims Syncope is a significant cause of morbidity and mortality that is reported to affect up to 20% of adults over 75 years old. We aimed to describe the current Bradford syncope service for older adults. Methods Descriptive statistics were generated using data collected from outpatients discharged from the clinic in September and October 2024. Data were recorded manually using clinic letters and notes. SNOMED CT diagnostic and procedural codes recorded were requested from the Informatics team. Results The study included 46 patients aged 80 years (mean, range 70 to 94), 60% (27)

There is strong evidence in the medical literature that a fracture following a fall, and especially a neck of femur fracture, is one of the most serious events that can happen in an older person’s lifetime. These fractures have been associated with increased morbidity, loss of independence, a high rate of institutionalization, and mortality. Rates of mortality after a year from femoral fractures have been proven to be three to four times higher than the expected in the general population, ranging between 15% to 36%. This emphasizes the importance of developing well-organized care pathways for

Introduction: As neurosurgical procedures are increasingly performed on older patients, there is a growing need to incorporate geriatric care to optimise clinical outcomes. In response, the neurosurgical and geriatric teams at our institution collaborated and launched an in-reach service for elderly patients on neurosurgical wards in January 2025. This project aimed to identify staff perceptions around how the new service could benefit neurosurgical patients and identify areas for improvement. Methods: This qualitative study involved interviewing 15 colleagues across the Neurosurgical multi

Introduction. Discussions about resuscitation provide patients with the opportunity to be involved in highly consequential decisions about the care they receive. Such discussions often occur in response to a clinical deterioration late in the hospital admission or do not happen at all (Parliamentary and Health Service Ombudsman, 2024). This QIP aimed to increase the proportion of care of the elderly (COTE) inpatients at South Tyneside District Hospital with a documented discussion about resuscitation status. Method. Three rounds of data (n=31, n=31 and n=75) were collected at a snapshot in

Introduction Neck of femur (NOF) fractures account for over 60,000 cases in England and are often elderly, with multiple co-morbidities. Post-operative delirium is a frequent complication seen in these patients. With an increasingly frail population, the rates of NOF fractures and associated delirium are projected to increase. Current guidelines state that professionals should actively assess for cognitive impairment upon initial presentation. We aimed to evaluate the compliance of utilising the 4AT tool in post-operative NOF patients, and correlation between post-operative delirium with

Introduction: Falls are a common occurrence in both inpatient and emergency settings with CT head imaging being the gold standard for assessing potential intracranial injuries. However, it was noted that CT scans are often inappropriately requested leading to unnecessary radiation exposure and increased healthcare costs. The aim of the audit was to evaluate adherence to NICE Head Injury Guidelines on CT head[i] scanning after falls in a district hospital. Methods: In the first PDSA cycle, 50 adult patients who attended the ED with a fall were randomly selected. Data was collected

Background: Involvement of Geriatricians in peri-operative assessment acknowledges the altered physiology of frail patients and helps to evaluate realistic outcomes as part of patient-centred shared decision making. This is with the aim of addressing modifiable risk factors, preventing complications, preparing for a realistic recovery and ensuring that treatment options are aligned to what is important to the patient. There is data suggesting improved survival following geriatric peri-operative assessment but little analysis from the patient’s perspective; their thoughts about the shared

Introduction With a growing number of older adults undergoing cardiac surgery, there is increasing emphasis on recovery outcomes beyond morbidity and survival. Many patients prioritise cognition and independence, yet these domains are not routinely assessed. Frailty, multimorbidity and cognitive vulnerability are common in this population, increasing risk of poor longer-term outcomes. However, longitudinal evidence describing cognitive and functional trajectories after surgery remains limited. We characterised cognitive and functional trajectories of older cardiac surgical patients over 5

Abstract Background: The global population of people aged 65 years and over is expected to rise from 761 million in 2021 to 1.6 billion by 2050. Many of these older adults have multiple comorbidities and functional impairments that make them particularly vulnerable during acute hospitalisation. Engagement in meaningful activities can be vital to older people’s care, particularly in acute hospitals. Evidence suggests that such engagement can have a positive impact on the patients’ hospital journeys. To ensure individualised support, it is important to understand the purpose of meaningful

Introduction: Sarcopenia constitutes the progressive loss of muscle mass, strength and function, most commonly in adults ≥60 years old. Associated adverse outcomes include immobility, loss of independence, falls, fractures and increased mortality. Predisposing risk factors include aging, comorbid disease and malnutrition. Malnutrition is common amongst older adults and low protein intake is strongly associated with sarcopenia. Dietary protein intake as a risk factor for sarcopenia and subsequent fracture risk is poorly understood. This systematic review aimed to ascertain the relationship and

Introduction This quality improvement (QI) project aimed to enhance patient experience and safety by reducing fluid fasting times by embedding the recently introduced "Sip til Send" policy in our acute orthopaedic trauma unit. Our concern was that older patients with hip fractures, who are often living with frailty and at high risk of complications, were being kept Nil by Mouth (NBM) for extended periods before operative intervention The "Sip Til Send" policy supports eligible patients in consuming clear fluids (170 mL/hour) until transfer to theatre with a reduction in distress, thirst

Background For patients aged ≥65 awaiting elective hip or knee surgery to be appropriately referred to a Perioperative Care of the Older People Undergoing Surgery (POPS) clinic, an accurate Clinical Frailty Scale (CFS) score is essential. Following the launch of a trial POPS clinic at Royal Surrey Foundation Trust, we compared referral letter CFS scores with those assessed by frailty-trained professionals. 75% of referrals lacked a CFS score, 12.5% differed, and 12.5% matched. To improve scoring accuracy and support appropriate referrals, we developed a CFS Scoring Toolkit, including a patient

Background: TEP’s are a tool used in acute hospital admission to guide appropriate care in the event of deterioration. TEP’s, a gold standard in the SIGN 167 guideline, help ensure that care aligns with the patients’ and families’ wishes. Though all patients should ideally have one on admission, this can be challenging to achieve. Patients with CFS (Clinical Frailty Scale) >5, NEWS >5, DNACPR, or progressive conditions, however, are at higher risk of deterioration and ensuring a valid TEP is in place is vital. Aim: To increase the number of patients in the Orthopaedic ward with a valid TEP in

INTRODUCTION Calcium-sulphate beads (CSB) are bio-absorbable antibiotic carriers which are used to manage surgical site infections as well as fill dead space. Iatrogenic hypercalcaemia from using CSB is a rare but potentially serious adverse effect. METHOD In this case report, we describe a patient who developed symptomatic hypercalcaemia secondary to using CSB during a Girdlestone excision arthroplasty. RESULTS An 86-year-old woman with a recent hip hemiarthroplasty for hip fracture developed a deep wound infection. Despite debridement and washout and prolonged intravenous antibiotics, her

Introduction: The anticholinergic burden (ACB) has been increasingly recognized as a modifiable risk factor that can contribute to falls, cognitive impairment, and frailty in older adults. Reducing ACB through medication review can potentially lower fall risk and ease strain on healthcare systems. This study aims to identify common contributors to ACB in older adults admitted with falls and evaluate whether ACB assessment was documented at hospital admission. Methods: We conducted a retrospective audit of patients aged >75 years admitted with a coded diagnosis of falls to an elderly care unit

A Project on Inpatient Falls: Are We Adequately Addressing Bone Health? Introduction Inpatient falls in older adults frequently lead to fragility fractures, with femoral fractures occurring in up to 82% of cases (RCP, NAIF 2023). These injuries significantly impact long-term morbidity and cost the NHS an estimated £4.4 billion annually (ROS, 2022). Despite tools like FRAX and national guidance (NOGG, 2021; NICE, 2022), bone health assessments remain inconsistently performed in the inpatient setting after a fall. Objectives To evaluate whether inpatients who experienced falls received

Introduction: Frailty is common among older surgical patients and associated with poorer post-operative outcomes. Therefore, identifying at-risk patients for peri-operative optimisation is vital to improve surgical outcomes, yet national audits reveal it remains under-assessed (1). A review of a surgical ward showed that 0% of patients aged over 65 had a Rockwood Clinical Frailty Score (CFS) documented within 48 hours of admission. This QIP aimed to increase timely CFS documentation to 50% by January 2025 and 80% by June 2025 through structured interventions. Method: Following initial

Introduction The POPS (Perioperative medicine for Older People undergoing Surgery) service at Wye Valley NHS Trust has been established since August 2024. During this year, the service has been evolving, and we have been evaluating its impact. This has also involved working with NHS Elect through the POPS-SUp project. As well as the data we have gathered, during the past year there have been many learning points about starting a new service. Method Throughout this year we have used quality improvement methodology to help shape our projects, such as driver diagrams and statistical process