Posters

Introduction Acute heart failure (AHF) is a life-threatening condition that frequently necessitates emergency hospital admission. Intravenous (IV) diuretics, particularly furosemide, are vital in initial management, with early administration shown to improve outcomes. Despite guideline recommendations, delays or deviations in prescribing practices are common. This quality improvement project aimed to assess compliance with European Society of Cardiology (ESC) guidelines regarding the timely administration of IV furosemide in patients with AHF. Method A retrospective audit was undertaken at

Introduction Pain is a common yet under-recognised and debilitating symptom among elderly patients, particularly with dementia, cognitive impairment, or communication barriers. Inadequate assessment can result in adverse outcomes, including reduced mobility, falls, and prolonged hospitalisation. This Quality Improvement Project aims to improve compliance with pain assessment and documentation on acute and frailty geriatric wards. At our hospital, a gap in systematic pain assessment was identified, hence we sought to address this by implementing standardized protocols, enhancing timely

Introduction Parkinson’s disease (PD) is the second most common neurodegenerative condition globally. Its cardinal motor signs are bradykinesia, rest tremor, rigidity, and postural instability. The motor symptoms of PD often lead to dependence on others to perform daily activities. Globally, the incidence of PD is rising. However, for countries in sub-Saharan-Africa such as Tanzania, research on the motor aspects of PD and the associated disability is sparse. The primary aim of this study was to determine the motor symptoms, and burden of motor symptoms, in newly diagnosed people with

INTRODUCTION The increasing prevalence of frailty in the ageing UK population poses significant challenges for healthcare systems, particularly in emergency departments (EDs). Frailty is a leading factor in hospital readmissions among individuals over 65 years old. This project aims to analyze readmissions of frail patients within 7 and 30 days of ED discharge following comprehensive geriatric assessments (CGAs). METHOD This retrospective audit aimed to identify 7 day and 30 day readmissions of patients discharged by the Frailty Emergency Service (FES) at Leicester Royal Infirmary over a six

Background: Sarcopenia, a prevalent geriatric syndrome with multifactorial origins, is strongly influenced by malnutrition alongside immobility and chronic illness and contributes substantially to falls, disability, and mortality. The SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls) questionnaire is widely used to screen for probable sarcopenia; however, the conventional cut-off of ≥4 has yielded insufficient sensitivity across studies. Objective: To evaluate how SARC-F scores correspond to muscle strength and physical performance tests endorsed by the

Background Cumulative deficit frailty indices from randomised controlled trials (RCT) are increasingly used to assess whether trial findings are applicable to people living with frailty. The aim of this study was to examine the range and type of deficits included in these frailty indices and compare these to those from cohort studies. Methods We identified RCTs assessing treatment effect modification using the cumulative deficit frailty index, as well as cohort studies assessing mortality risk associated with frailty, from recent systematic reviews. We extracted the deficits included in the

Aims This study assesses national trends and, sociodemographic and clinical factors associated with polypharmacy and potentially in appropriate prescribing among people with type 2 diabetes in Scotland from 2012 to 2022. Methods Retrospective cohort study using nationwide data from the Scottish Care Information – Diabetes database. Individuals aged ≥40 years with type 2 diabetes were included. Medication counts were based on unique medications dispensed per calendar year. Potentially inappropriate medications were based on the 2023 Beers criteria and applied to people aged over 65 years. A

Background Randomised controlled trials are often criticised for excluding older people with multiple long-term conditions. This study used individual participant data (IPD) for 25 trials of sodium glucose co-transporter-2 inhibitors (SGLT2i) to compare baseline characteristics, comorbidities, and event rates between trial participants and community SGLT2i-treated people. Methods Trials were identified through a systematic review with subsequent application for IPD. Community SGLT2i-treated people in routine care were identified from SAIL databank. For each trial, we applied the eligibility

Introduction Iron deficiency anaemia (IDA) is one of the most common reasons for referral to day-case settings, reflecting its significant contribution to global morbidity and disease burden. In 2017/2018, over 100,000 treatments were delivered nationally at a cost of £465 million – averaging £449/ case. Locally in South London, a single trust treats 50-60 patients monthly. In the general population , anemia is defined as a haemoglobin <130g/L in men and <120 g/L in non-pregnant women, in association with a serum ferritin<30 mg/L (in the absence of inflammation).The diagnostic criteria differs

Introduction: Anticholinergic medications are widely prescribed to manage pain, urinary incontinence, allergies. Patients with high frailty scores are more susceptible to anticholinergic adverse effects such as falls, cognitive impairment, urinary retention. The Anticholinergic Burden Score (ACB) is a tool used to quantify the cumulative anticholinergic effect of patients' medications. A score of 3 or more is associated with an increased risk of mortality and worse cognitive function. This quality improvement project aims to quantify and reduce ACB scores of patients admitted to the Acute

Introduction: Venous thromboembolism (VTE) is a common complication in post-stroke patients, with an incidence of approximately 17%. Pulmonary embolism accounts for 25–50% of reported VTE-related deaths. Pharmacological prophylaxis with low-molecular-weight heparin (LMWH) is contraindicated within the first 30 days following stroke due to the risk of haemorrhagic transformation and clot instability. As an alternative, mechanical prophylaxis using intermittent pneumatic compression (IPC) has demonstrated efficacy in reducing VTE incidence and improving survival outcomes. Evidence from the CLOTS

Introduction: In October 2023, the electronic patient record system Epic® was introduced across two London NHS Foundation Trusts — King's College Hospital (KCH) and Guy's & St Thomas' (GSTT). This replaced legacy documentation processes, including the Comprehensive Geriatric Assessment (CGA). At KCH, a CGA template widely used by the multidisciplinary team was lost, leading to inconsistent CGA documentation, poor communication of outcomes at discharge, and reduced data usability. This quality improvement project aimed to standardise CGA documentation and communication across care settings

Introduction Older people living in Nursing Homes (NH) are often admitted to Acute Hospitals (AH) toward their end-of-life (EOL) due to the limited capacity to manage exacerbations and symptoms within NHs. The EAGLEcare (Enhancing Advance care planning, Geriatric and End-of-Life care in NHs in the East) Programme was set up to improve in-NH care and to reduce avoidable AH admissions and their unintended consequences. Methods A system of proactive case-finding for residents with specific and general indicators of advanced life-limiting illnesses was developed in collaboration with NH partners

Introduction: Emergency laparotomy is associated with high risk of mortality and morbidity. NELA best practice tariff identifies Geriatrician input as a key performance indicator for all patients over 80 years of age and those who are over 65 and living with frailty. Evidence suggests geriatrician-led comprehensive geriatric assessment (CGA) may improve post-operative outcomes, but only 8% received one between 2019-2020 in our Trust (national average 27%). The aim of this project was to create a standardised referral system between general surgeons and ageing and complex medicine (ACM) team

Introduction Pain is a major concern in cognitively impaired patients. Communication challenges contribute to poor recognition and undertreatment, negatively impacting prognosis and quality of life. The National Dementia Audit highlighted that structured pain assessment for people with dementia admitted to hospitals remains a significant area for improvement. The PAINAD (Pain Assessment in Advanced Dementia) scale aids in structured pain recognition through objective assessment. We implemented a quality improvement project aiming to improve PAINAD utilisation in inpatient geriatric wards

Background The NHS 10 year plan outlines the ambition to shift care from a Hospital centric model, to integrated community based systems, but little is known about how to implement this change. The integrated frailty crisis multidisciplinary team working across acute and community settings were motivated to improve services but lacked the confidence/knowledge to lead quality improvement (QI). A whole pathway QI practitioner development programme was established with projects aligned to the overarching system strategy to embed the change. Methods A structured training and coaching programme was

Introduction Indwelling urinary catheters are commonly used in hospitalised adults. Measuring bags, while necessary for fluid monitoring in specific cases, are often used by default without clear indication. This can restrict mobility, affect dignity, and contribute to functional decline in patients with preserved mobility. This project aimed to evaluate the usage of urine collection systems and their impact on patient well-being and improve the usage of less restrictive leg bags where appropriate. Methods QIP was conducted on medical wards at two hospital sites. Cycle 1 (Jan–Feb 2024)

Introduction Out-of-hours (OOH) services provide emergency primary care outside normal GP hours, serving patients with higher health needs. Delirium affects 25% of hospitalised older adults, causes distress to patients and carers, and leads to poor outcomes. However, little is known about delirium presentations and prevalence in OOH services. We aimed to investigate delirium occurrence and management using case records from an OOH service in South-West England. Methods The OPEN database contains 33,345 consultations of patients ≥65 attending the OOH service between April 2019–March 2020. We

Title: Therapists’ perspectives on a new Structured Tailored approach to Rehabilitation AfTer HIp FragilitY Fracture – the Stratify Feasibility Randomised Controlled Trial. Background: The stratify feasibility randomised controlled trial explored a risk-stratified rehabilitation intervention, where patients with hip fracture were categorised as low, medium, or high risk of poor outcome and received tailored interventions accordingly. This qualitative study aimed to understand therapists’ views on the acceptability of the approach, as well as barriers and facilitators to its implementation, to

Introduction: Delirium is a common and serious presentation in older inpatients, associated with increased risk of mortality and long term cognitive impairment. Drugs with anticholinergic properties (DAPs)have been linked to poorer cognitive outcomes, and anticholinergic burden may contribute to the development of delirium. This study explores whether higher Anticholinergic Burden Scale (ACB) scores are associated with delirium in older inpatients referred to Old Age Liaison Psychiatry (OALP) at Nottingham University Hospitals (NUH). Method: All inpatients aged 65 or older referred to OALP at