Posters

The Surgical Frailty Journey – An Education Programme to Enhance Surgeon Confidence in Managing Frail Patients Introduction: Consultant surgeons of the future will need to manage patients with increasing levels of complexity and comorbidity as the population ages. National Emergency Laparotomy Audit (NELA) data highlights that patients over 70 constitute over 50% of emergency laparotomies, with frailty being a key determinant of outcomes 1. Previous surgical curricula have included recognition and management of frailty 2. Updated versions have deviated from such specifics, and surgical

Introduction: Falls in older adults are a common presentation to A&E. As per a report, over 1300 people experienced femoral fracture following a fall in 2021. Falls can be multifactorial, and evaluating this is important. A patient with a new inpatient fall can develop complications like fractures and prolonged hospital stay, leading to higher morbidity and mortality. We noticed that patients admitted with different illnesses develop new inpatient falls in the wards. Hence, we decided to conduct a QI project to review the condition and the circumstances surrounding the falls as an inpatient

Introduction Heart failure with reduced ejection fraction (HFrEF) remains an important topic within geriatric populations due to its high prevalence. The European Society of Cardiology (ESC) recommends the four pillars, namely ARNI/ACE inhibitors/ARB, beta-blockers, mineralocorticoid receptor antagonists (MRA) and SGLT2 inhibitors. Frailty and co-morbidities often complicates management, yet the benefit is substantial, with an estimated 73% relative risk reduction in mortality. This project evaluated compliance to the four pillars on hospital discharge, following interventions including

Introduction Orthostatic hypotension, a fall in blood pressure (systolic drop of 20mmHg, diastolic drop of 10mmHg) on standing up from lying or sitting position, is an important risk factor for fall among elderly population. In this quality improvement project, we assess the proportion of eligible patients who had lying and standing BP measurement. We made some interventions to improve this rate and reassess the proportion of patients who had their lying and standing pressure done afterwards. Method This is a prospective quality improvement project that recruited patients older than 65 years

Background: Falls are common among older people and are associated with serious sequelae, including hip fractures, physical injury, institutionalisation, and death. Data from the National Hip Fracture Database and the Trauma Audit and Research Network (TARN) reveal a significant financial liability for the NHS, driven largely by prolonged hospital stays. NICE guidelines recommend that all patients aged 65 and over should be routinely asked about any falls in the past 12 months during healthcare interactions. This practice is not consistently implemented during surgical admissions. Methods: A

Introduction: Continence optimisation, investigation and management is an essential part of any CGA 1, and its importance in Geriatric Medicine is reflected in the Higher Specialty Curriculum 2. Despite this, training in continence care is inadequate with limited opportunities to develop expertise and practical skills. As a result, few HSTs pursue Continence as a Theme for Service or feel equipped to lead on continence care post-CCT. Fragmented service provision by Urology, Gynaecology and Geriatric services undermines a holistic approach required when caring for the complexities of a frail

Background Constipation is a common yet under-recognised issue in older hospitalised adults, often driven by reduced mobility, inadequate hydration, poor dietary intake, and polypharmacy. It contributes to significant complications, including discomfort, delirium, and avoidable escalation to pharmacological interventions. Despite national guidelines, bowel care remains inconsistently addressed in routine practice. This project aimed to evaluate current inpatient constipation management and promote guideline-aligned, holistic care for older people. Methods A hospital-based quality improvement

Introduction: Polypharmacy and inappropriate prescribing are responsible for a significant number of inimical events in elderly patients, including falls and adverse drug reactions. Given the ageing population in the UK, it is now more essential than ever to ensure medication burden is addressed and potentially inappropriate prescribing is reduced. The START/STOPP criteria for prescribing is a validated, evolving criteria that guides appropriate pharmacotherapy for elderly patients, with the aim of supporting safe prescribing. In this project, our objective was a 20% reduction in inappropriate

Introduction LGMD populations have an increased fracture risk. LGMD populations also have a lower muscle mass and therefore abnormal serum creatinine levels, making it more difficult to assess renal function via conventional means, potentially leading to delays in care. Serum Cystatin-C, produced by all nucleated cells, is an alternative way to assess renal function in these patients. Clinical Case A 46-year-old woman with LGMD presented to hospital after a sudden fall from standing to the floor. X-ray imaging confirmed an extracapsular left NOF# and she was operated on the next day with a

The Iliaca Fascia block (IFB) is a crucial regional anaesthetic technique primarily used for providing analgesia in Femoral Fractures. The block targets the femoral, lateral femoral cutaneous, and obturator nerves by depositing local anaesthetic beneath the Fascia Iliaca. The British Orthopaedic Association Standards for Trauma (BOAST) guidelines for management of neck of femur fractures recommend "offering immediate and regular analgesia on presentation” Our Primary aim was to assess whether the block has been completed. If not completed; was a rationale/contraindication appropriately

Introduction: Hospital-acquired deconditioning is a major contributor to inpatient falls, with evidence showing that immobility imposed to prevent falls can paradoxically increase fall risk. In response, the 2024 National Audit of Inpatient Falls (NAIF) advocates a shift from falls prevention to promoting safe activity through a structured Multifactorial Assessment to Optimise Safe Activity (MASA), encompassing six domains: vision, lying and standing blood pressure (LSBP), medication review, delirium, mobility, and continence. Method: A two-cycle quality improvement project was conducted on

Title: The Complexity of Missed Fractures and Postural Instability in an Elderly Fall Patient: A Case Study Introduction: Falls in the elderly population are a significant cause of morbidity and mortality, often leading to fractures, reduced mobility, and decreased quality of life. Diagnosing fractures can be challenging, particularly in frail or cognitively impaired individuals who may not report or recognize pain, or when the fracture is subtle on initial radiographs. Missed fractures, combined with postural instability, present unique challenges for clinicians, requiring a multi-faceted

Background: Hip fractures represent a significant global health burden, leading to substantial morbidity, mortality, and healthcare costs. Delays in surgical intervention are consistently linked to poorer patient outcomes. This audit aimed to evaluate and enhance hip fracture management at Southampton General Hospital (SGH) through targeted quality improvement initiatives. Methods: An interventional clinical audit was conducted at SGH, a Major Trauma Centre, comparing a pre-intervention period (December 2023 – March 2024; n=272 patients) with a post-intervention period (September 2024 –

Background "Dignity in death" (DiD) refers to avoiding suffering at the end-of-life by meeting individuals' physical, emotional, and spiritual needs compassionately and respectfully. This includes upholding autonomy, preserving individuality, and fostering open discussions about death while aligning care with the person’s values. Holistic care prioritises comfort and dignity, treating death with understanding rather than fear (Ignacio et al., 2016). However, little is known about how care home staff perceive "dignity in death," despite extensive research on hospital and hospice staff (Hemati

Background "Dignity in death" (DiD) refers to avoiding suffering at the end-of-life by meeting individuals' physical, emotional, and spiritual needs compassionately and respectfully. This includes upholding autonomy, preserving individuality, and fostering open discussions about death while aligning care with the person’s values. Holistic care prioritises comfort and dignity, treating death with understanding rather than fear (Ignacio et al., 2016). However, little is known about how care home staff perceive "dignity in death," despite extensive research on hospital and hospice staff (Hemati

Background: Hip fractures represent a significant global health burden, leading to substantial morbidity, mortality, and healthcare costs. Delays in surgical intervention are consistently linked to poorer patient outcomes. This audit aimed to evaluate and enhance hip fracture management at Southampton General Hospital (SGH) through targeted quality improvement initiatives. Methods: An interventional clinical audit was conducted at SGH, a Major Trauma Centre, comparing a pre-intervention period (December 2023 – March 2024; n=272 patients) with a post-intervention period (September 2024 –

DNAR QIP abstract Introduction: Advanced Care Planning (ACP) involves making decisions about future care, including resuscitation. When resuscitation is deemed not in a patient’s best interest, a Do Not Attempt Resuscitation (DNAR) order is made to prevent harm. NHS England recommends that ACP decisions be shareable as this improves efficiency of repeated discussions and ensures patients’ wishes are respected. In Wales there is no consistently used ACP documents which increases risk of unwanted management as well as inconsistency in the ACP documentation. Methods: This study aimed to improve

Introduction: Polypharmacy is a highly prevalent challenge in geriatric care, particularly concerning patients with cardiovascular conditions. The STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) and START (Screening Tool to Alert to Right Treatment) criteria are recognized tools designed to optimize medication regimens in older adults by identifying potential omissions and potentially inappropriate prescriptions. This project aimed to evaluate and improve adherence to the STOPP/START criteria for cardiovascular and coagulation medications among older people

Introduction As the population ages, more older adults with moderate to severe frailty are undergoing invasive cardiac interventions. Despite its prognostic significance, frailty is not incorporated into conventional cardiac risk scores. Best practice requires assessment of baseline function, care needs, and polypharmacy to inform intervention suitability, ceiling of care decisions, and discharge planning. The Clinical Frailty Scale (CFS) is a validated tool (1) for summarising frailty based on clinical judgement. Accurate social history documentation is essential and endorsed by both European

Background: Frailty is a growing public health issue due to the aging population. Early recognition and awareness are key in preventing deterioration and promoting independence. A leaflet was created to: Encourage conversation about frailty. Highlight the importance of lifestyle interventions and discharge planning. Include local contact numbers and community support services. Support early detection, reduce avoidable hospital admissions, and promote healthier aging at home. Aims: Assess the effectiveness of the leaflet in improving patient and carer awareness. Support recognition and