Posters

Patients with a hip fracture should start rehabilitation no later than the day after their operation (NICE Quality Statement). Only 69% of patients with a hip fracture were mobilised day one post operation in 2025 in North Tees Hospital putting it in the lowest performing quartile in the United Kingdom. Delayed mobilisation is shown to increase the risk of post-operative complications and increased lengths of hospital stay. The aim of this audit was to identify the percentage of patients mobilised day one and key barriers to mobilisation which could be addressed to reduce post operative

Cardiology in Older Persons: Identifying Opportunities to Prevent Deconditioning Through Early Multidisciplinary Rehabilitation Introduction: Older adults admitted under cardiology are at increased risk of frailty, functional decline and hospital-associated deconditioning. Acute illness, invasive procedures, complications and prolonged hospitalisation can further reduce mobility and independence. We undertook an audit of patients admitted under the Cardiology in Older Persons (COPs) pathway to identify opportunities for earlier rehabilitation and functional support. Method: A retrospective

Background: Patients with a learning disability (LD) are classified as vulnerable. This group of patients are reported to have a significantly younger median age of death (61 years), and receive poorer quality acute care. The Royal College of Physicians (RCP) acute care toolkit (2022) was developed to support doctors in prioritising specific aspects of care in hospital for these individuals. The national hip fracture database (NHFD) includes patients with a hip fracture over the age of 60 years old, meaning those with a LD who develop frailty younger are excluded. Our aim is to assess whether

Introduction Patients with advanced dementia admitted to surgical wards may experience pain that goes unrecognised due to communication barriers. The PAINAD (Pain Assessment in Advanced Dementia) tool, recommended for non-verbal pain assessment, was rarely or never used. This concern was identified through clinical observation and a retrospective review of surgical dementia patients. This audit sought to assess current use of PAINAD, evaluate adherence to local recommendations, and implement changes to improve pain assessment and outcomes. 2. Method A retrospective review was conducted using

Introduction: The expansion of acute frailty services is essential to meet the needs of our ageing population. According to the UK Office for National Statistics 2021 census, over one-sixth of the population (18.6%, or 11.1 million people) were aged 65 and over, with this proportion expected to rise to 25% within the next 20 years. Acute Frailty Team (AFT) was introduced in Newcastle in December 2024, aiming to create a streamlined pathway to avoid unnecessary admission and improving supportive discharges, the first frailty team in North-east England. The second audit cycle shows a decrease in

Introduction Delirium is a common and significant, but often underidentified cause of morbidity and mortality in older inpatients. Screening improves detection, management, patient outcomes, length of stay and readmission rates. NICE recommends the 4AT as the optimal screening tool for its accuracy, accessibility, and simplicity. The Trust’s protocol mandates 4AT assessment on clerking for all patients aged 65+. This project's primary aim was to audit 4AT screening on admission in the Geriatrics department. Secondary aims assessed documentation clarity: whether high 4AT scores (≥4) triggered

Introduction Prolonged bed rest in older hospitalised patients can contribute to deconditioning and loss of functional independence. Mealtimes provide a practical opportunity to encourage mobilisation. This quality improvement project assessed whether education and prompting could improve sitting out for lunch among older inpatients. Methods Ten inpatients aged ≥65 years on a rehabilitation/geriatric ward were observed over three consecutive days. Patients were assessed for their ability and clinical suitability to sit out for lunch. Where appropriate, patients who remained in bed were

Introduction: Developmental idiopathic scoliosis (DIS) is a lifelong musculoskeletal condition, despite decades of research, aetiology remains unconfirmed with theories that implicate genetic predisposition, asymmetric neuromuscular activity, biomechanical loading asymmetry, CNS maturational delay, and hormonal factors. Management is threshold-driven observation under 25 degrees, and from 25 to 40 degrees having brace wearing as optimal treatment, and beyond 40 degrees requiring surgery, leaving no active treatment tier between bracing and surgery. Methods: Clinical observations from a

Introduction: Urinary incontinence further exacerbated by prostate diseases are detrimental to quality of life and functional independence, Real-time Ultrasound (RTUS) provides an objective and non-invasive Pelvic Floor Muscle (PFM) retraining for continence management with older men. RTUS guided PFM rehabilitation in an older male patient with urinary incontinence secondary to prostatic enlargement provides baseline PFM function. Methods: Mandatory fluid fasting with only maximal 250 ml of H2O consumption to expand the bladder as required for transabdominal RTUS imaging. A male prostate

Introduction: Chronic heart failure (HF) is highly prevalent in older adults, in whom frailty is common and associated with poorer outcomes. Despite advances in guideline-directed medical therapy, concerns regarding tolerability and polypharmacy contribute to under-utilisation in frail patients. This study aimed to map existing evidence on how frailty is incorporated into HF interventional trials. Method: A scoping review was conducted of Medline, Ovid Embase, Cochrane CENTRAL, and ClinicalTrials.gov for HF interventional studies published up to August 2025 where frailty was assessed using a

Introduction: Opioid medications are associated with significant side effects in older people, including constipation, falls, delirium, and reduced bone health which can lead to loss of independence and hospital readmission. NICE guidelines encourage appropriate opioid deprescribing and review. This Quality Improvement Project aimed to improve the provision of education and a weaning plan for patients with opioids prescribed at discharge, following an acute hospital admission. Method: To achieve this, we provided education of opioid deprescribing to doctors and pharmacists across the Acute

Introduction Delirium is associated with significant morbidity, prolonged hospitalisation and adverse outcomes. Assessment of delirium risk factors and potential causes within 24 hours of admission was inconsistent on our acute frailty unit. Staff feedback identified limited confidence, unclear ownership of screening, variable access to screening tools and inconsistent assessment of pain and nutrition as key barriers. Method A quality improvement project assessed compliance with comprehensive delirium assessment within 24 hours of admission. Documentation was reviewed for 15 patients per cycle

Background: Delirium is a common complication of hospitalisation in older adults and is associated with increased mortality, prolonged hospital stay and functional decline. Although routine screening using the 4AT is recommended, delirium assessment and documentation remain inconsistent. Baseline auditing identified poor ward-based 4AT completion, with assessments predominantly undertaken by medical staff despite the multidisciplinary nature of geriatric care. Aim: To improve multidisciplinary recognition, assessment and documentation of delirium by increasing staff knowledge, confidence and

Background: Delirium is a common complication of hospitalisation in older adults and is associated with increased mortality, prolonged hospital stay and functional decline. Although routine screening using the 4AT is recommended, delirium assessment and documentation remain inconsistent. Baseline auditing identified poor ward-based 4AT completion, with assessments predominantly undertaken by medical staff despite the multidisciplinary nature of geriatric care. Aim: To improve multidisciplinary recognition, assessment and documentation of delirium by increasing staff knowledge, confidence and

Introduction Invasive and conservative medical management strategies are widely used in the treatment of Non-ST-segment Elevation Myocardial Infarction (NSTEMI). Multiple studies have demonstrated no significant long term survival benefit of invasive management in patients aged ≥75 years old presenting with NSTEMI compared to conservative management. Therefore, the optimal management strategy in this age group remains uncertain. Purpose To investigate the 2-year major adverse cardiovascular events (MACE) as the primary outcome in patients aged ≥75 years old presenting with NSTEMI and managed

Introduction: The expansion of acute frailty services is essential to meet the needs of our ageing population. According to the UK Office for National Statistics 2021 census, over one-sixth of the population (18.6%, or 11.1 million people) were aged 65 and over, with this proportion expected to rise to 25% within the next 20 years. Acute Frailty Team (AFT) was introduced in Newcastle in December 2024, aiming to create a streamlined pathway to avoid unnecessary admission and improving supportive discharges, the first frailty team in North-east England. The second audit cycle shows a decrease in

Background: Peripheral intravenous cannulas (PIVCs) carry significant risks of phlebitis and hospital-acquired bacteraemia, particularly in elderly patients. Royal Berkshire Hospital trust policy CG321 recommends daily review, VIP (visual infusion phlebitis) scoring, and removal within 72 hours unless extended to 96 hours with documented senior justification. This QIP aimed to improve PIVC documentation, review, and timely removal across two acute geriatric wards. Methods: Baseline data were collected on Ward A (general geriatrics, n=8) and Ward B (orthogeriatrics, n=11) in March 2026, with a

Introduction Clear identification of the responsible consultant is essential for safe inpatient care. This quality improvement project used two PDSA cycles to improve patient awareness of their named consultant on a medical ward, achieving a sustained improvement through improved bedside signage and standardised ward-round introductions. Informal feedback from patients and ward staff suggested that many inpatients were unaware of who their named consultant was, leading to confusion and difficulty escalating concerns. Method My quality improvement project used ‘Plan Do Study Act’ (PDSA)

Patients with hip fracture should start rehabilitation no later than the day after their operation (NICE Quality Statement). Only 69% of patients with a hip fracture were mobilised day one post operation in 2025 in North Tees Hospital putting it in the lowest performing quartile in the United Kingdom. Delayed mobilisation is shown to increase the risk of post operative complications such as pulmonary embolism and lower respiratory tract infections along with increasing lengths of hospital stay associated with increased risk of morbidity and mortality within the geriatric population. The aim of

Introduction As the incidence of cancer in adults aged ≥65 years continues to rise, so does the complexity of management. Comprehensive Geriatric Assessment (CGA)-led interventions have demonstrated a reduction in treatment-related complications and unplanned hospital admissions, support appropriate treatment decision-making and improve quality of life. We evaluated the implementation of CGA through a new Oncogeriatric clinic in optimising older adults undergoing assessment for surgery and/or chemotherapy with colorectal or hepatobiliary malignancy. Methods We conducted a retrospective audit