Posters

Introduction DNACPR and TEP documentation is a common source of complaints and distress for patients and relatives, particularly when decisions and communications with patients and next of kin (NOK) are poorly recorded. We identified a risk at our hospital: these forms remained paper-based while all other documentation had moved online. We conducted a multi-cycle audit to improve DNACPR/TEP documentation, using the findings to advocate for a transition to online forms, then supported the rollout with education and re-audited to assess impact. Method We audited paper DNACPR forms on care-of

Introduction Comprehensive Geriatric Assessment (CGA) only delivers value if its findings survive the transition from hospital to community, and the discharge summary is the principal vehicle carrying CGA into primary care. In a pre-implementation staff survey (n=14), 86% reported medication changes and rationale frequently missing, and 86% reported incomplete summaries at least occasionally causing extra work or safety concerns. Method We completed a Trust-registered full audit cycle on two geriatric medicine wards at Ealing Hospital against BGS CGA Toolkit, RCP, AoMRC and NICE NG27 standards

Introduction: Older patients admitted with delirium are often sent for a CT head. SIGN 157 says the scan should only be requested if there is new focal neurology, unexplained reduced consciousness, a recent fall, a head injury or anticoagulation. Without one of those, the scan very rarely shows anything that explains the delirium, This may lead to issues such as unnecessary radiation exposure, delay in treatment/diagnosis and cost etc. We wanted to know how often requests recorded a valid reason for the scan. Method: We looked at every CT head requested for patients aged 65 and over with coded

Introduction: The documentation proforma used in the Frailty Same Day Emergency Care (FSDEC) unit includes four ‘routine assessments’ to be completed for all patients. These include Rockwood Clinical Frailty Score (CFS), FRAX/QFracture, lying-standing blood pressure and bladder scan. The purpose of our project was to assess how consistently these assessments are completed, and to understand their impact. Method: We included 100 randomly selected patients referred to FSDEC between August 2025 and April 2026. Data was collected retrospectively from the proforma, including whether assessments

Introduction Frailty increases vulnerability to adverse perioperative outcomes. The Centre for Perioperative Care (CPOC) and British Geriatrics Society (BGS) perioperative guidance advocates identification of frailty alongside multidisciplinary assessment, optimisation and shared decision-making (SDM) throughout the surgical pathway. Accurate frailty recognition is therefore essential. We aimed to improve completion and accuracy of Clinical Frailty Scale (CFS) assessment and evaluate subsequent anaesthetic involvement and SDM. Method We evaluated completion of documented CFS scores at pre

Introduction Delirium affects 20–30% of elderly inpatients and is associated with increased morbidity, mortality and hospital stay. NICE CG103 and the Royal College of Physicians identify visual and hearing impairment as modifiable risk factors of delirium. Routine assessment and optimisation of sensory aids are recommended yet clinical compliance varies. Aims were to assess current practice regarding the accessibility and documentation of vision / hearing aids in elderly inpatients. Our quality improvement goal was to improve compliance with sensory assessment to greater than 80%. Methods A

Introduction Grip strength is associated with disability, frailty and adverse health outcomes in older adults. We explored associations between grip strength and functional impairment among older adults in Ireland and Europe using SHARE data and examined whether these associations differed between Irish participants and the wider European cohort. Method Cross-sectional analysis of adults aged ≥65 years from the Survey of Health, Ageing and Retirement in Europe (SHARE). Logistic regression was used to examine associations between grip strength and impairment in activities of daily living (ADL)

Introduction: Advance care planning (ACP) is a vital aspect of geriatric medicine. Resident doctors often facilitate it through discussion and completion of ReSPECT forms. Quality of documentation can be variable, owing to limited experience, training, or confidence amongst residents¹. This can result in unclear escalation decisions and care that does not reflect patients' wishes. Our project aimed to equip resident doctors with skills for ACP conversations and improve ReSPECT documentation. Method: We designed and delivered an ACP teaching session for resident doctors during their geriatrics

Introduction With the growing older population, too few doctors choose to specialise in geriatric medicine. Research has suggested that both demographic factors (e.g. gender) and educational factors (e.g. exposure to geriatrics) may influence choice of specialty career. We have examined associations between medical school-level exposures, such as teaching quality, over and above individual-level sociodemographic and academic performance measures with applications for higher specialty training in geriatric medicine. Methods We used multi-level regression modelling to test for associations

Introduction Venous thromboembolism is a significant cause of morbidity and mortality following orthopaedic surgery. Older patients with hip fractures represent a particularly vulnerable population. The National Institute for Health and Care Excellence (NICE), British National Formulary (BNF), and local trust guidelines recommend prophylactic post-operative enoxaparin doses with body weight and renal adjustment. This audit aims to assess compliance with these guidelines following hip surgery. Methods A retrospective two-cycle audit was undertaken involving 35 consecutive patients admitted

Introduction: Parkinson’s Disease (PD) is a chronic neurodegenerative condition which rarely changes acutely; however, patients are at increased risk of hospital admission. A previous local study suggested PD patients may have a longer hospital length of stay (LOS), and that PD-specific management standards: correct and timely medication prescribing, could be improved. An initial study in 2024 demonstrated that providing background PD information, medication advice and a basic PD assessment resulted in a reduced LOS. Method PD patients admitted to secondary care received a simple PD

Introduction: Vitamin D levels are routinely tested prior to Zoledronic Acid (ZA) administration in patients <80 years old(YO). Testing remains expensive compared to Vitamin D loading regimens with minimal risk of adverse effects. We performed a quality improvement project reducing the age of Vitamin D Testing (VDT) prior to ZA in a fragility fracture cohort, aiming to reduce cost and time to ZA administration. Methodology: 205 Hip fragility-fracture patients undergoing fixation were retrospectively identified within the Royal Victoria Hospital, Belfast between 01/06/25-31/08/25. Patients

Background: For safe stroke care, comprehensive discharge summary reports are essential. They always can assure promote continuous secondary stroke prevention, facilitate communication between hospital and local community teams, and reduce the chance of possible readmission. In this Quality Improvement Project (QIP), we examined Queen's Hospital's stroke discharge summaries and compared them to the BHRUT local discharge policy and the Royal College of Physicians Stroke Discharge Guidelines (2023). Methods: In these two audit cycles, Cycle 1 done in May 2024 and Cycle 2 in October 2025, we

Introduction Falls affect one third of adults aged over 65 annually and represent the leading cause of emergency hospital admissions in this age group in England. Caffeine is routinely consumed in clinical settings yet is not addressed in current falls prevention guidance. It exerts competing physiological effects relevant to fall risk, improving muscular strength and alertness whilst potentially disrupting postural control. Methods A systematic search of MEDLINE, EMBASE, and PubMed was conducted for all randomised, double-blind, placebo-controlled trials examining effects of acute caffeine

Introduction Neck of femur (NOF) fractures disproportionately affect older patients with complex medical needs and are associated with significant mortality. Many deaths are attributable to comorbidities rather than the fracture alone. NICE recognises that NOF fractures should not be viewed exclusively as surgical problems, but require multidisciplinary management with timely medical and anaesthetic input. We introduced a structured pre-operative multidisciplinary meeting involving trauma and orthopaedic surgeons, geriatricians and anaesthetists (TOGA) to improve shared decision-making, timely

Introduction Advance care planning (ACP) enables patients to consider and communicate their preferences and priorities for future care. A baseline survey of 25 patients and 20 carers attending a community myeloma support group identified an unmet educational need, with approximately one-third expressing a desire for information about what may happen in the future and planning their future wishes. In response, a group-based ACP education workshop was developed. This service evaluation explored participants' previous experiences of ACP, barriers to discussion, and the acceptability and perceived

Introduction The Acute Frailty Team (AFT) in Darlington Memorial Hospital (DMH) assess patients over 65 living with frailty. Some, based on local criteria, are streamed to the Frailty Assessment Unit (FAU), aiming to avoid acute admission. This audit examined whether 4 A's Test (4AT), Early Warning Score (EWS), clinical frailty score (CFS) or presenting complaint (PC) were associated with discharge home, and whether FAU assessment increased this. Methods Data was collected on patients seen by AFT between 1st and 31st May 2026. 161 patients were seen within FAU and 165 outside. 4AT, EWS, CFS

Introduction / Background: Problematic polypharmacy is common in older people and is associated with adverse drug reactions, hospitalisation, and mortality. Hospital admission provides an opportunity to review potentially inappropriate medications; however, deprescribing in acute care is often reactive rather than proactive(1). The British Geriatrics Society (BGS) Pragmatic Prescribing guidance provides condition-specific recommendations to support deprescribing in people living with moderate to severe frailty(2). We aimed to explore how this guidance could be implemented proactively within an

Background: Frail older adults presenting with upper limb fractures are a vulnerable cohort within acute care. Although these injuries are usually managed conservatively, they frequently result in avoidable admissions and prolonged hospital stays. Unlike hip fracture pathways, there is no standardised orthogeriatric model for this group. This project aimed to reduce avoidable admissions and reduce length of stay by integrating early frailty intervention into existing orthopaedic pathways. Methods: Process mapping of the patient journey from Emergency Department (ED) presentation to discharge

Introduction/Background ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) is a national approach documenting recommendations for future and emergency care, including DNACPR. It promotes shared decision-making and personalised care and treatment, particularly relevant with an ageing global population. The Dundee Frailty at Home Team (DF@H) comprises Geriatricians, Advanced Nurse Practitioners, nurses and allied health professionals, providing community-based assessment and management of frail patients equivalent to inpatient care. Aims The project aimed to increase quality