Improving Patient Safety: Assessment and Rationalisation of Urinary Catheterisation Practices in Hospitalised Adults
Introduction Indwelling urinary catheterisation is common in hospitalised adults but is associated with catheter‑associated urinary tract infection, prolonged hospital stay, deconditioning and discomfort when not optimally indicated or reviewed. A two‑cycle quality improvement project in Morriston Hospital aimed to evaluate and improve the appropriateness, documentation and ongoing review of urinary catheter use to enhance patient safety. Method Two retrospective audit cycles were undertaken on adult inpatients with indwelling urinary catheters, using clinical notes and catheter bundles as
Should the Clinical Frailty Score (CFS) be used to guide decision-making among Intensive Care Unit (ICU) inpatients?
Prevalence of Frailty Among Adult Inpatients at a Teaching Hospital in the Kurdistan Region of Iraq
Increasing number of deaths attributed to frailty of old age over the last 7 years
Introduction In many older adults, frailty is due to underlying co-morbidities rather than just due ageing. Frailty was rarely mentioned in the death certificates until the Royal College of Pathologists revised the causes of death list in 2020 which suggests two terms: Frailty syndrome which should be quantified with comorbidities and Frailty of old age if the deceased was above 80. The aim of this study was to identify the trend in deaths coded as Frailty of old age in England and Wales over the last 7 years. Methods We extracted data from the Office for National Statistics. Since ICD
Systematic review of the effectiveness of social prescribing for older adults living with frailty or multimorbidity
Introduction Social prescribing is a widely implemented tool used to support unmet non-medical needs in the community. This systematic review aimed to summarise the impact of social prescribing on a population of older adults living with frailty and/or multimorbidity. Methods This review was conducted in line with PRISMA guidelines for systematic review. Searches were completed across MEDLINE, EMBASE and PsychInfo. Social prescribing was defined as co-ordinated multi-component individualised community-based referrals via a link worker. Studies of adults age 65+ or predominantly older adults
Deprescribing in Frailty (DiF) project; Phase 1 – Scoping the issue
Introduction Deprescribing in older people living with frailty is an evidence-based, structured, patient-centred process aimed at reducing or stopping medications where potential harms outweigh benefits. Evidence suggests that deprescribing is safe and feasible, reduces number of potentially inappropriate medications (PIMs) in older people, without increasing adverse outcomes and leads to modest clinically meaningful benefits. Identifying PIMs is a critical step in deprescribing and Phase1 of this project aims to proactively identify and understand the size of inappropriate polypharmacy in
Patient Perspectives on Medicines and Their Impact on Frailty and Falls: A Qualitative Study
Introduction Frailty and falls are significant concerns for older adults, leading to reduced independence and increased healthcare needs. Medicines, particularly polypharmacy, can contribute to frailty and falls yet patient awareness of these risks remains unclear. Patient engagement is essential to inform strategies that improve knowledge and reduce the risk of medicines related harm. Methods Participants were identified by the local NHS patient engagement team and invited to participate in focus groups. Semi-structured interview templates were designed by the study team. Sessions were
Evaluation of Computed Tomography Head scan reporting on Brain Frailty Markers in an Acute Medical Cohort
Integrating CGA principles and acute clinical assessment into pharmacist-led care home service: A Feasibility Study
Introduction Falls, hospital admissions, and reduced quality of life (QoL) are common among care home residents with dementia. Polypharmacy increases these risks, particularly in those with frailty. Current models of care often lack structured medication review and pharmacist-led reviews rarely include clinical assessment. We assessed the feasibility of a prescribing pharmacist with advanced clinical skills delivering holistic structured medication review alongside acute clinical care in a care home setting. Methods Single-group before-and-after feasibility study in a Glasgow care home
Does the drive to a net-zero NHS affect General Practice access for our vulnerable patients? A systematised narrative review
Introduction The National Health Service (NHS) aims to achieve net-zero emissions by 2045. Telehealth is a potential low-carbon alternative within general practice which might help to achieve this. Despite environmental benefits, concerns remain regarding the impact on vulnerable groups who may face digital exclusion. This systematised narrative review examines how telehealth, as part of decarbonisation efforts, influences access to general practice among vulnerable populations. Methods A systematic search of Medline, Embase and Scopus was conducted using PRISMA guidelines. Eligibility
Metabolic Bone Treatment Service Overhaul: A Quality Improvement Approach
Introduction The Assessment and Rehabilitation Day Unit (ARDU) at Aintree Hospital is responsible for the safe and timely administration of treatments for osteoporosis. In the last 5 years patient numbers have increased significantly, leading to an overwhelmed service resulting in long overdue waiting lists and a burnt-out team. A Quality Improvement (QI) project was initiated to stabilise the service and reduce the overdue waiting list by 50% by October 2025. Method Using a clinical microsystem approach, the team developed a driver diagram and measurement strategy to identify priority areas
Improving Oral Care Delivery and Staff Confidence on Geriatric Medicine Wards: A Quality Improvement Project
Can a Self‑Assessment Tool Identify Unmet Therapy and Pharmacy Needs in Older Adults With Frailty on an Ambulatory Unit?
Lying Standing Blood Pressure Measurement following Hip Fracture
Background: Frail patients are at risk of post-operative orthostatic hypotension. Measuring lying and standing blood pressure (LSBP) is a key part of comprehensive post-operative geriatric assessment. Method: Three cycles of data were collected from the National Hip Fracture Database on patients with neck of femur fractures at Leeds General Infirmary. Each cycle was discussed at local governance meetings, followed by implementation of novel interventions. First, information on LSBP was added to online induction resources. Then, a poster was distributed, and finally, an email template was
Using the Self Assessment for Frailty in the Emergency Department Tool (SAFE-T) in urgent and emergency care
Leveraging the Electronic Health Record to Deliver High Fidelity Comprehensive Geriatric Assessment in the Emergency Setting
Introduction Comprehensive Geriatric Assessment (CGA) in the emergency department can reduce length-of-stay and prevent functional decline in older adults. However, CGA is a complex intervention requiring multi-disciplinary input and appropriate resource investment, making it challenging to deliver for ‘front-door’ frailty services. We hypothesised that improved utilisation of existing functionality within the electronic health record (EHR) could enhance delivery of high fidelity CGA in the emergency setting. Methods Quality improvement methodology was employed to evaluate a standardised
Comparing paramedic and geriatrician Clinical Frailty Scale scores: a baseline evaluation to improve frailty pathway allocation
Introduction Accurate prehospital frailty scoring allows direct admission to older persons' assessment units (OPAU), enabling early comprehensive geriatric assessment (CGA) and reducing unnecessary hospital admissions. The Welsh Ambulance Service Trust (WAST) uses the Clinical Frailty Scale (CFS) to guide pathway decisions, and patients scoring ≥5 may be eligible for direct OPAU admission. We compared paramedic CFS scores with those derived from in-hospital CGA, and surveyed paramedics about their training needs. Method We undertook a single-point data collection across OPAU and acute