Posters

Introduction: Fragility fractures increases re-fracture and mortality risk, especially within two years. Fracture Liaison Services (FLS) aim to prevent secondary fractures by ensuring quality care for patients over 50. This study assesses equity of care in an existing FLS for patients above and below 80 years and evaluates re-fracture and mortality outcomes. Methods: We retrospectively reviewed 2,190 patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS) from January-December 2023 using national FLS Database (FLS-DB) data. After excluding 14 patients with missing data, 2,176 were

Introduction: Older adults with neck of femur (NOF) fractures often fast for prolonged periods, increasing dehydration, delirium risk and peri-operative morbidity. At Chesterfield Royal Hospital, ortho-geriatric department, we implemented Sip Til Send with 150-ml per hour of water Sip Til Send (S2S) pathway and evaluated feasibility, process and safety. Methods Control: subset was taken from 01/03/25-05/05/25. Following this prospective data was collected for all NOF patients put on the S2S pathway from 06/05/25-10/08/25; local contraindications were excluded. Outcomes: Age, American Society

Introduction Delirium affects up to 50% of hospitalised older adults (≥65 years) and is significantly associated with patient morbidity and healthcare burden. The 4AT is a rapid, practical, and cost-effective screening tool for delirium. This project evaluated the effectiveness of 4AT implementation on a care of the elderly ward and assessed strategies to increase its use. Methods All new admissions to a care of the elderly ward over a one-month period were reviewed. Data collected included: suspected delirium, known/suspected cognitive impairment, and completion of initial 4AT screening prior

Prolonged hospital stays for medically fit patients pending discharge destinations are a persistent problem for the national health service, depleting funds and bed availability. Crucially, patients risk hospital-acquired infection, institutionalisation and deconditioning. Discharge destinations for patients with altered need for government-funded social support are decided following submission of a universal referral form (URF), completed by the multidisciplinary team (MDT). Policy states URFs should be submitted 48 hours after a patient is deemed medically fit for discharge (MFFD). We

Introduction: Direct Oral Anticoagulants (DOACs) are increasingly prescribed for atrial fibrillation (AF), and venous thromboembolism (VTE). In geriatric populations, prescribing is complex due to comorbidities, polypharmacy, reduced renal function, and increased bleeding risk. Errors in prescribing or inadequate patient information can lead to adverse outcomes. To address this, a structured DOAC Initiation Form was introduced to standardise prescribing practices, reinforce guideline adherence, and improve patient education. Methods: A multidisciplinary team conducted two Plan-Do-Study-Act

Introduction Anticholinergic medications remain widely prescribed to older adults despite evidence linking cumulative anticholinergic burden (ACB) with delirium, accelerated cognitive decline, falls, longer admissions, and excess mortality. ACB score ≥3 signals heightened risk, yet systematic review is rarely embedded in ward routines. We designed a quality improvement (QI) project using sequential Plan–Do–Study–Act (PDSA) cycles, aiming to show that pragmatic ward-level interventions can deliver measurable clinical benefit by reducing ACB among geriatric inpatients. Method Conducted on a

Background Venous thromboembolism (VTE) is a leading cause of preventable hospital morbidity and mortality. Older adults admitted are at particularly high risk due to immobility, frailty, and comorbidities. NICE guideline NG89 recommends all hospital inpatients undergo a documented VTE risk assessment on admission and reassessment within 24 hours. An initial audit identified incomplete VTE assessments on prescription charts across two geriatric wards in our hospital. Aim To improve the completion rate of VTE risk assessments on two wards from baseline (80–86%) to 100%. Methods Prescription

Introduction: Osteoporosis is a leading cause of morbidity in the elderly, with fragility fractures risking mortality, loss of independence and lengthy hospital stays. Patients admitted to hospital are often frail, with numerous risk factors for osteoporosis. The NOGG (2021) and NICE (CG146) recommend fracture risk assessment using the FRAX score in all women ≥65 years, men ≥75 years, and any adult ≥50 with risk factors such as previous fragility fracture, glucocorticoid use, smoking and high alcohol, low BMI, parental hip fracture, or relevant comorbidities. Despite clear guidance, FRAX

Background: Zoledronic acid (Zol) is used in the prevention and treatment of osteoporotic fractures. Once IV Zol has been administered as an inpatient, discharge documentation and GP communication should be completed. However, this can be inconsistent and can compromise continuity of care. A checklist produced by the HCOP (Health Care of Older People) team aimed to standardise osteoporosis management. In addition to the metrics reviewed in the previous 4 audit cycles, this audit looked at vitamin D correction before Zol. Methods: Data was collected from 55 patients receiving their first dose

Background This project was conducted within the Urology inpatient department at Leicester General Hospital, led by resident doctors under consultant supervision. Introduction ReSPECT forms summarise personalised recommendations for a patient’s care in an emergency setting, outlining their priorities and fears. Incomplete ReSPECT forms risk inappropriate interventions that do not align with patients’ wishes or clinical needs. Locally, the completeness and quality of ReSPECT forms varied, with missing patient preferences or unclear escalation plans, contributing to miscommunication between

Introduction Prescribing for older adults is complex due to frailty, multimorbidity, altered pharmacokinetics, and high risk of adverse drug reactions. Newly graduated doctors write most inpatient prescriptions but often feel underprepared, with error rates up to 10% (Nazar et al., 2015). Simulated prescribing platforms, such as Better Meds, offer a safe, realistic environment to practice. We designed progressive tutorials within geriatrics placement to address prescribing challenges in delirium and polypharmacy. Method Two cohorts of medical students participated: Year 3 (n=20): During the

Abstract Content : Introduction Fragility fractures are common in older adults and carry a high risk of refracture and mortality. Evidence shows that intravenous zoledronic acid can reduce refracture risk by up to one-third, with early initiation proven safe. Yet, real-world practice is often delayed by factors such as vitamin D deficiency, frailty, and system-level gaps. This audit assessed current practice at our centre and evaluated improvements after service changes. Method A retrospective audit was conducted at Heartlands Hospital. Patients aged ≥60 years admitted with fragility fractures

Introduction Sitting out of bed plays a crucial role in preventing deconditioning, muscle wasting, pressure injuries and thrombosis among older inpatients. It also fosters social interaction and cognitive engagement, reducing hospital stay duration and combating 'PJ Paralysis'. Objective To improve the number of older patients sitting out of bed during lunchtime in the COTE ward, thereby supporting their functional recovery and overall well-being. Methods Direct observations were conducted over two consecutive days at baseline and again three weeks after intervention were implemented. Patients

Introduction Older adults have historically been excluded from research, in part due to preconceived notions from researchers, clinicians and patients themselves about research being for younger patients or those with certain medical conditions. These assumptions persist despite “Healthy Ageing” being a priority theme for the National Institute for Health and Care Research and the extensive body of evidence that involvement in research benefits clinical care for older adults. This quality improvement project (QIP) aimed to improve older adults’ understanding of opportunities for research

Introduction Osteoporosis poses a significant health challenge in older adults, especially due to fragility fractures that increase morbidity and mortality. The FRAX tool, designed to estimate a 10-year risk of major osteoporotic and hip fractures, is a key resource for guiding treatment decisions. This audit evaluated how effectively FRAX scoring and primary prevention strategies were being used in a Front Door Frailty ward. Methods: Two retrospective audit cycles were conducted. The first included 51 patients (May–August 2024), and the second 50 patients (January–April 2025), admitted with

Background General Medical Council (GMC) recommends effective departmental inductions to support doctors to transition and work in complex, unfamiliar situations with sick patients. Acute stroke care is time critical, multidisciplinary, multi-specialty clinical work and requires doctors to fully comprehend and be able to perform assessments and interventions correctly and timely. This requires effective and tailored clinical induction. Introduction In our hospital, stroke medicine induction is delivered in large group teaching as part of geriatric medicine and general medicine induction

Introduction A significant proportion of hospital admissions among the elderly are attributed to falls, contributing to morbidity and mortality. NICE guidelines recommend a comprehensive assessment in elderly patients presenting with fall including lying standing blood pressure (LSBP) test, carrying out structured medications review and osteoporosis risk assessment. While a large proportion of patients are reviewed and assessed by frailty team after hospital admission, there are a considerable number of elderly patients with falls admitted to Acute Medical Unit especially during out-of-hours

Introduction: The appropriate use of CT scans is essential for patient safety and effective healthcare delivery. This audit aimed to evaluate whether resident doctors in the NHS are requesting CT scans in line with the Royal College of Radiologists (RCR) guidelines, and to assess the impact of educational interventions on improving compliance. Method: A retrospective audit was conducted in two cycles. Cycle 1 involved reviewing CT scan requests made by resident doctors (up to ST2 level) for patients aged 80+ fin August,2024. The compliance with RCR guidelines was assessed on several criteria

Introduction Blood tests are frequently ordered in geriatric wards, often without clear clinical justification. This can lead to patient discomfort, increased costs, and unnecessary workload on staff and laboratory services. This audit aimed to evaluate the frequency and appropriateness of blood test ordering and reduce unnecessary investigations in geriatric wards. Method We reviewed blood tests ordered over a 2-week period across the four geriatric wards at Leicester Royal Infirmary. Seven commonly requested tests were included: full blood count (FBC), urea and electrolytes (U&E), C-reactive

Introduction: Inappropriate polypharmacy is the use of medications with no evidence-based indication, unmet treatment goals, high risk of adverse drug reactions, or when the patient is unwilling / unable to take treatment as intended. This is particularly concerning in geriatric care, due to increased risk of hospital admissions, adverse drug reactions and significant healthcare costs. To address these risks, clinicians should conduct patient-focused medication reviews. This project aimed to assess and improve polypharmacy reviews at Royal Albert Edward Infirmary (RAEI), with a focus on