Opioids in the frailer adult: Are we prescribing them safely?
Barriers and facilitators in care home training implementation: A rapid review to inform rollout of a mealtime care intervention
ISiTO - Improving Sight Therapy for Older-people - A Quality Improvement Project (QIP) at a Tertiary Hospital
Introduction Reduced visual acuity is a frequent contributing factor to admission to an acute hospital for older people yet there is little attention paid to its importance. Vision assessment is meant to be offered to all adults at risk of falling as per Montero-Odasso et al 2022(1). The NHS funds vision assessments in the community for all adults >65 years of age. Aims This project aims to assess current understanding and uptake of vision assessment in the community for patients admitted to a tertiary hospital, and whether targeted information giving can improve uptake of primary care
Grip strength testing to identify sarcopenia in lower limb amputee outpatients: a quality improvement project.
Introduction: The demand for lower limb amputation is growing due to factors including rising rates of diabetes and vascular disease as well as an ageing population. Sarcopenia, the loss of muscle mass and strength associated with ageing, can exacerbate the risk of unfavourable health outcomes and mortality. Consequently, early detection and management of sarcopenia is important in the rehabilitation of older people who have had lower limb amputation. Clinical practice guidelines recommend using grip strength testing to identify probable sarcopenia in high-risk patients during routine care and
Nurse Scientists’ Success: Implementation of Bed-side Fall Injury Attenuation Solutions
Shared educational sessions between UK and Dutch trainees: can boundary-crossing experiences equip us for demographic change?
Background Demographic change poses global challenges, yet healthcare professionals are often trained within a single, siloed system. Boundary-crossing experiences promote innovative thinking by exposing trainees to different external solutions. We evaluated a shared educational session, now in its second year, for UK and Dutch geriatric/elderly care medicine trainees, aiming to equip future healthcare leaders to meet these challenges. Methods A shared, case-based online teaching session for UK and Dutch trainees included brief talks on their respective healthcare systems, followed by breakout
AnchorWell: Maintaining Health Stability - Proactive Care in Extra-Care Facilities: A Quality Improvement Initiative to Reduce Unplanned Healthcare Demand - Pilot
Introduction Urgent community interventions are disproportionately required by residents of independent or extra care living facilities, a small but high-need population. These settings attract individuals seeking more support than available in own homes; Whilst the need initially is often care related this is frequently driven by underlying medical conditions and the ageing process. Unlike nursing or care homes, extra-care living facilities lack enhanced primary care agreements, leaving rising needs unmet. With healthcare shifting from acute to community settings, addressing this gap is
Diagnostic test accuracy of outpatient blood pressure measurement to detect hypertension in older people
Introduction Older people presenting to outpatient (OP) clinics require blood pressure (BP) measurement to consider morbidity contributing to falls and long-term cardiovascular risk. However, BP measurements taken in the outpatient setting (OBPs) may not correlate with BP patterns obtained using ambulatory measurements (ABPMs). ABPM is considered a more accurate method of diagnosing hypertension than OBP in the general population. Using OBPs for clinical decision-making in isolation risks either under or over-diagnosis of hypertension. This study aimed to investigate the diagnostic test
Simulation-Based Training to enhance Medical trainees Communication, Ethical reasoning ,and Teamwork in End-of -Life Care
Simulation-Based Training to enhance Medical trainees Communication, Ethical reasoning ,and Teamwork in End-of -Life Care
Creating a delirium-friendly space: improving environmental factors on a Care of the Elderly ward
Sleep Patterns of Hospitalised Older Adults in an Acute Geriatric Unit
Systematic review of disparities in continuous glucose monitoring prescribing in older adults living with diabetes
Introduction Continuous glucose monitoring (CGM) is transforming diabetes care and its access should not depend on age, ethnicity, or socioeconomic status. Updated NICE guidance in 2022 expanded NHS funding to include people with type 2 diabetes mellitus on insulin who meet certain criteria. Emerging evidence indicates that older adults are significantly less likely to be offered CGM. We aimed to systematically review prescribing of CGM in older age groups compared to younger ones. Methods PROSPERO registration: CRD420251104079 Databases: PubMed, Web of Science Inclusion criteria: studies that
Frailty Progression on General Surgical Waiting Lists: Does POPS Intervention Make a Difference?
Improving the consideration of resuscitation status and electronic upload of Do Not Resuscitate forms in an orthogeriatric ward
Establishing a business case for joint geriatrician and neurology assessments in an outpatient Movement Disorders clinic
Introduction: At our Trust a single Parkinson’s Specialist nurse manages a caseload of around 900 outpatients living with Parkinson’s in conjunction with a team of consultant neurologists. It is estimated around 60% of patients living with Parkinson’s will fall each year and patients living with Parkinson’s are known to be at higher risk of osteoporosis and osteopenia. A proportion of these patients will be living with frailty. In order to reduce harm, manage frailty and reduce unplanned hospital admissions we would suggest a more holistic assessment from a geriatrician may be beneficial for a
Building a Frailty SDEC - The Journey
Introduction The Queen Elizabeth Hospital (QEH), King’s Lynn serves a population of around 331,000 people. There has been exponential growth in the percentage of the population who are aged 65+. The RCP recognises that older people with complex needs would benefit from prompt review by specialist geriatric teams, and the BGS recommends that there is a role for a dedicated geriatrician embedded within assessment units focusing on frail older people. We implemented a number of pilot studies between 2021-2024, however, none provided sustainable excellent care models for frail patients. As such
Establishing a Foslevodopa–Foscarbidopa Service within a geriatric medicine Parkinson’s service
Introduction Our movement disorder service provides care for people living with Parkinson’s across 4 boroughs and 2 acute hospitals. There are predicted to be 1,671 people living with Parkinson’s in our area1. Foslevodopa-foscarbidopa is indicated for the treatment of advanced levodopa-responsive Parkinson’s with severe motor fluctuations when available combinations of medications have not given satisfactory results and apomorphine or deep brain stimulation (DBS) are no longer effective or not appropriate2. Method Our service aims to proactively identify patients who are living with advance
Shadowing Experiences for Care Home Nurses in East Kent
Introduction As part of the NHS England Ageing Well programme, social care nurses from care homes across East Kent were invited to shadow their local acute hospital frailty teams. The aims of the project were to strengthen understanding of the patient journey, enable nurses to identify transferable learning and enhance collaboration across organisational boundaries. Method Participants: Social care nurses from two care homes in East Kent. Format: One-day shadowing placements alongside the Acute Trust Frailty Team. Setting: Hospital frailty units and acute care wards. Feedback: Structured
Remote Falls Medication Review Service: Impact on Falls in Care Homes
Introduction Immedicare, a digitally-enabled, round-the-clock NHS clinical service provides remote support to care homes nationwide, with approximately a quarter of clinical consultations pertaining to falls. Falls in older people are often multifactorial, with medication being a significant modifiable risk factor. In July 2024, Immedicare’s pharmacy team launched a targeted, remote falls medication review service (FMRS) to support residents who had fallen and were prescribed at least one medicine identified as contributing to falls, according to the STOPPFall tool (Seppala et al, A&A, 2021)