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Improving Patient Safety: Assessment and Rationalisation of Urinary Catheterisation Practices in Hospitalised Adults

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H Y Sanda; M Danish; A Slowinski; A Hamed; S Shah; P Igic, T Maddock
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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

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Should the Clinical Frailty Score (CFS) be used to guide decision-making among Intensive Care Unit (ICU) inpatients?

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Dr H-M JAMES; Professor A JOHANSEN; Dr B JONES
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Abstract ID - 4412 Abstract title - Should the Clinical Frailty Score (CFS) be used to guide decision-making among Intensive Care Unit (ICU) inpatients? Abstract Author Name - Dr H-M JAMES; Professor A JOHANSEN; Dr B JONES Abstract Provenance - Cardiff and Vale University Health Board, Intensive Care Unit Should the Clinical Frailty Score (CFS) be used to guide decision-making among Intensive Care Unit (ICU) inpatients? Background When deciding on the appropriateness of ICU admission an understanding of patients’ prior dependency is just one issue to be considered, alongside their medical
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Prevalence of Frailty Among Adult Inpatients at a Teaching Hospital in the Kurdistan Region of Iraq

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D Ezzat1; R A Kamal2; M A Abdullah2; M F Abdulrazaq2; T N Shawis2
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Introduction Frailty is a clinical syndrome characterised by reduced physiological reserve associated with poor hospital outcomes. Limited epidemiological data exists in Middle Eastern populations, specifically the Kurdistan Region of Iraq. This study aimed to determine frailty prevalence and predictive factors among inpatients in Rizgary Hospital, Erbil, addressing a regional evidence gap. Method A cross-sectional observational study was conducted of 162 inpatients (mean age: 72.4±8.7 (82 male, 80 female)), at Rizgary Hospital between December 2024 and March 2025. Frailty was assessed using
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Increasing number of deaths attributed to frailty of old age over the last 7 years

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P Chatterjee1 ; V Adhiyaman2
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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

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Systematic review of the effectiveness of social prescribing for older adults living with frailty or multimorbidity

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N J Bracewell1,2, J K Taylor3,4, K G E Kala5, A Weatherburn1
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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

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Deprescribing in Frailty (DiF) project; Phase 1 – Scoping the issue

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Kyaw Soe Tun1; Lelly Oboh2; Sarah Swabey1; Grace Walker1
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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

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Patient Perspectives on Medicines and Their Impact on Frailty and Falls: A Qualitative Study

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L Black1; J Crawford2; J Lock1; E Thompson2; J Stirton2; P Forsyth3; C Smyth2; G McCafferty2; A Harkins2; C McDonald2; L Halcrow4; L Dorrian5
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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

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Evaluation of Computed Tomography Head scan reporting on Brain Frailty Markers in an Acute Medical Cohort

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A Yu1; J Gan2; S T Pendlebury2,3
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Introduction Computed tomography head (CTH) scans are commonly used in the acute medical setting to detect acute intracranial pathology. CTH scan information on cerebrovascular burden and atrophy, key markers of brain frailty, could also be used to identify patients at risk of cognitive decline. In an observational study, we assessed reporting brain frailty markers in routinely acquired scans. Method Anonymised reports of CTH scans performed during or <1-year of index admission were retrieved on consecutive acute medicine patients aged >65 years admitted over six 8-week periods (2010-2018)
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Integrating CGA principles and acute clinical assessment into pharmacist-led care home service: A Feasibility Study

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L Black1; Dr R Lowrie1; J Crawford2.
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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

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Does the drive to a net-zero NHS affect General Practice access for our vulnerable patients? A systematised narrative review

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Sanah Hussain1, Georgia Paddington1
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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

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Metabolic Bone Treatment Service Overhaul: A Quality Improvement Approach

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A Alcock1; C Gibson1; S Halliwell2; G Noblet1; M Sheridan1; M Wright1
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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

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Improving Oral Care Delivery and Staff Confidence on Geriatric Medicine Wards: A Quality Improvement Project

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Ff Evans1*; J Keast1,2*; T Hughes1; D Allen1; M Upcott1
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Introduction Poor oral health is associated with increased rates of hospital-acquired infections and prolonged hospital stays (1), with aspiration a major contributor of preventable morbidity and mortality (2). Recent evidence suggests that 60-80% of older inpatients have unmet oral care needs, whilst only 38% of nursing staff have had formal oral care training. An audit conducted by the SALT team at the University Hospital of Wales identified widespread poor oral hygiene and a need to upskill staff in this area. This QIP aimed to improve patient oral care, and staff confidence in oral care
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Can a Self‑Assessment Tool Identify Unmet Therapy and Pharmacy Needs in Older Adults With Frailty on an Ambulatory Unit?

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H Symcox1; R Li1; B Greensitt1; M Fry1; N Noble1; M A Williams1,2
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Introduction Unmet needs of those living with frailty significantly contribute to hospital admissions. The Ambulatory Assessment Unit (AAU) is a high-turnover, same-day emergency care unit with 40% of patients aged ≥65. Aligned with the 10 Year Health Plan shift from sickness to prevention, this Quality Improvement (QI) project aimed to better identify patients in AAU with unmet therapy and pharmacy needs using the Edmonton Frail Scale Acute Care (EFS-AC). Methods The project received Trust governance approval (ULYSSES No.9934). Existing practice of referring to physiotherapy/pharmacy
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Lying Standing Blood Pressure Measurement following Hip Fracture

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K Howick 1; A Kenda 1;M White 1
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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

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Using the Self Assessment for Frailty in the Emergency Department Tool (SAFE-T) in urgent and emergency care

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Dr B Arun1; J Pasley2; S Williams2; Dr S Wells1; Dr S Lewis1
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Abstract The Self-Assessment of Frailty in the Emergency Department Tool (SAFE-T), in keeping with the clinical frailly scale (CFS), has been developed as a self-assessment questionnaire. The tool is designed for completion by patients and/or their carers on arrival to urgent care, enabling more efficient and consistent CFS assessment by clinical staff. This is version 3 of the tool, developed via PDSA cycles and co-produced with patients and the MDT. Method SAFE-T questionnaires were distributed among a convenience sample of patients over 65 years of age in the ED and acute medicine unit
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Leveraging the Electronic Health Record to Deliver High Fidelity Comprehensive Geriatric Assessment in the Emergency Setting

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Garry Mallett1, Faida Al-Maiyah1, Clover Donohue1, Imogen Jury1, Rohan Sharma1, James Maguire1, Grace Walker1
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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

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Comparing paramedic and geriatrician Clinical Frailty Scale scores: a baseline evaluation to improve frailty pathway allocation

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Amy Noble1 Alexandra Burgess1
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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

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Inadequate Footwear in Older Medical Inpatients: An Overlooked Target for Falls Prevention and Mobility Promotion

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V Matuschka1; S Casey2; R Hutton2; M Rashid2; C Mason2; D Fitzpatrick3
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Introduction Inpatient falls are among the most common and preventable adverse events in acute hospitals. Appropriate footwear is a simple, low-cost intervention that may reduce falls and deconditioning. This study evaluated footwear worn by older medical inpatients and explored associations between footwear adequacy, falls, mobility and cognition. Methods We conducted a cross-sectional review of a sample of patients aged ≥65 yrs on general medical wards, excluding those in critical care, clinically unstable or end of life. Demographics, reason for admission, mobility, cognitive impairment
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Transforming Weekend Flow: The Impact of a 7-Day Acute Frailty Service on Older Patients

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A Urquhart1; J Acharya1; A Manzoor2; A Lingeswaran2; A Aranda-Martinez2; K Yeong2; P Enwere2; C Chikusu2; R Williams2; R Lisk1
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Introduction The UK population is ageing, resulting in increasing numbers of older patients being admitted to hospital. At St Peter’s Hospital, Summary Acute Medicine Indicator Table (SAMIT) data show that frail patients aged over 75 have an average length of stay of 10.5 days. This group is particularly vulnerable to hospital-acquired harms, including infection, falls, and delirium, making early assessment and discharge a key priority. Method This quality improvement project utilised Plan–Do–Study–Act (PDSA) cycles to assess discharge rates for patients aged over 75 admitted via the acute
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Music based interventions to reduce agitation in nursing home residents diagnosed with dementia- a systematic review

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H Clay
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Background: Agitation is a distressing symptom of dementia. Some research suggests that engaging in music can reduce this symptom. This review synthesises recent evidence on this. Methods: A search was conducted of Pubmed articles in the last 10 years. A two-stage screening of the titles and abstracts was conducted. A narrative synthesis was performed due to heterogeneity of methods. Results: The search yielded 24 papers of which 15 were excluded. These studies were either randomised controlled trials or before-after studies. They all had an objective scale used to assess agitation as an
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