My posters
Displaying 61 - 80 of 1064
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Introduction: It is important to identify delirium on admission as delirium increases patient mortality and also is linked to an increased length of hospital admission (1). Delirium is identified through a scoring system such as 4AT (2) and should be done on all patients over 65, with new confusion, or reduced mobility (3) as per NICE guidelines. The aim of the QIP is therefore to bring the department in line with NICE guidelines and increase the number of patients in the over 65 cohort having a cognitive assessment, and in particular looking at those with confusion and falls as these can be
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Introduction The UCNH model is being implemented across Sussex to reduce ED pressures. Based at the Polegate Make Ready Centre, the UCNH launched in mid-November 2024 to provide alternative pathways for 999 callers. The UCNH operates as a multidisciplinary team of up to eight clinicians, including an Urgent Community Response Trainee Advanced Care Practitioner and a Consultant in Frailty, two Advanced Paramedic Practitioners, two Computer-Aided Dispatch drivers, and two remote consultation paramedics. Method The team triages calls, manages acute cases, and works collaboratively with ambulance
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Introduction: Polypharmacy, multimorbidity, and frailty are closely interlinked. The STOPPFrail (Screening Tool of Older Person’s Prescriptions) criteria offer a structured approach to identifying potentially inappropriate medications (PIMs) in very frail older adults with limited life expectancy. This study evaluates the application of these criteria before and after admission to a specialist geriatric ward in a tertiary care hospital. Methodology: Medications were assessed against the STOPPFrail (Version 2) criteria before and after admission. Patients aged ≥65 years were included if they
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Introduction Malaysia is transitioning from an ageing to an aged nation. According to the Department of Statistics Malaysia (DOSM), 7.4% of Malaysia's population was aged 65 years or older in 2023, projected to exceed 15% by 2030. Frailty is increasingly prevalent, affecting 11% of adults aged 50–59 years and escalating to 51% among those aged 90 years or older, based on global data. A local pilot study in March 2024 in general medical wards highlighted common frailty-related issues, including deconditioning (36%), delirium (17%), and a 12-month readmission rate of 46%. Objectives To introduce
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Introduction Early access to specialist care is recognised to be beneficial for older adults living with frailty. Decision-making around assessing function and mobility to facilitate safe discharge can be challenging for staff in an Emergency Department environment. This can result in patients being admitted to await specialist review. The aim of this test of change was to explore the role and contribution of a Specialist Frailty Allied Health Professional (AHP) within the ED and to evaluate the impact on the care of patients living with frailty. Methods For a 12-month period, the ED has had a
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Neck of Femur Fractures (NOFF) - Educational QIP on Medication Management to Reduce Avoidable Hypotension and Acute Kidney Injury (AKI) Introduction Hip fractures prevalence increases with age. Patients aged ≥80 years have high morbidity and mortality risk following a hip fracture (hazard ratio for men [HR] 7.95, 95% CI 6.13-10.30 and HR women 5.75, 95% CI 4.94-6.67, respectively). Intraoperative hypotension is a risk factor for Acute Kidney Injury (AKI) after Neck of Femur Fracture (NOFF) surgery. The National NCEPOD AKI Report found a third of AKI is predictable and avoidable. Sodium-Glucose
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Introduction: Older people living with frailty are core users of health and social care. Services attuned to their needs afford better outcomes, help avoid harm and improve the experience for people living with frailty and their carers. These services may also help with flow and capacity. The Glasgow Royal Infirmary (GRI) Team aimed to advance services in order to enhance the quality and provision of care for older people with frailty. Methods: As part of the Health Improvement Scotland Focus on Frailty Programme, the GRI Team developed processes for early identification of people living with
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Title: An overview of the Dementia UK Consultant Admiral Nurse service supporting families affected by frailty and dementia Authors: K Lyons1. Provenances: 1. Dementia UK Introduction: Emerging and increasing frailty often goes unidentified, and families living with dementia and frailty are missing vital opportunities to receive the right support at the right time. People living with frailty are less able to adapt to stress factors such as acute illness, injury, or changes in their environment, personal or social circumstances, leading to adverse health outcomes and an earlier loss of
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Introduction: World Guidelines for Falls Prevention & Management for Older Adults[1] recommends medication review as part of multifactorial risk assessment for those at high risk of falling. Use of Falls Risk Increasing Drugs (FRIDs) [2], polypharmacy and anticholinergic burden are known to increase risk of falls in older people [3]. This prospective observational study was conducted to assess if polypharmacy, prescription of FRIDs and anticholinergic burden [4] improve after hospitalisation with a fall. Method: Data gathered from electronic medication records once necessary ethical approvals
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Introduction . DVT is a common complication post stroke. Clinically evident DVT can occur in 2-10% after an acute stroke. DVT can develop as early as Day 2 after acute stroke; Risk peaks between Days 2 and 7. Untreated proximal DVT has a 6-15% mortality risk. Intermittent pneumatic compression (IPC) of the legs is recommended to reduce the risk of DVT in non-ambulatory stroke patients. Methods Criteria = All new stroke admissions to Stroke ward should have IPC applied by the time they were seen by the consultant on the post-take ward round – Unless contraindicated. Initial Audit = 100
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Background: The Gold Standard Framework (GSF) was first introduced to General Practice in 2000. It is recognised a third of hospital inpatients may be in their last year of life and over the past 25 years there has been evidence to show the GSF reduces hospitalisation and allows more people to live and die in their preferred place of care. Teams undertaking GSF find admissions and lengths of stay are significantly reduced. Our inpatient ward did not have processes to identify those appropriate for the GSF therefore a process to identify and code patients for the community to follow up on
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Aim: We aimed to improve the assessment, documentation, and management of inpatient falls by introducing a memorable CARE poster and promoting the use of a digital falls proforma for both nurses and doctors. This initiative aims to standardize practices and enhance patient safety. Method: Cycle 1: Initial data revealed poor documentation of falls, with missing elements such as Clinical Frailty Scale (CFS) scoring, medication review, pain management, and lying/standing blood pressure (LSBP) measurement. These critical aspects were incorporated into the CARE poster. Cycle 2: The CARE poster and
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Introduction: With an aging population of major trauma patients admitted to the Southwest Major Trauma Centre, a dedicated team of medics, nurses, and therapists launched a pilot aimed at enhancing the care of frail major trauma patients in a Major Trauma Centre (MTC). This initiative - the Frailty and Trauma Liaison Team (FTLT), focuses on ensuring continuity and quality of care for this vulnerable population in major trauma. Methods: It targeted the completion of comprehensive geriatric assessments (CGA) within 72 hours for patients with a Clinical Frailty Scale (CFS) score greater than 4
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Introduction According to the GMC’s Good Medical Practice, medical professionals have a responsibility to be considerate and compassionate to those close to a patient through giving support and information. For those lacking capacity, clinicians can assume that patients would want those close to them to be kept up to date with their condition. NHS digital data last year showed that 17.1% of written complaints are linked with communication. The primary aim of this project was to increase the percentage of surgical patients aged 65 or over receiving a next of kin (NOK) update. The secondary aim
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Introduction: Frailty is a growing concern, particularly for older adults attending Emergency Departments (EDs). Frailty accounts for 5-10% of all ED visits and up to 30% of acute admissions1. The NHS mandates that hospitals with Type 1 EDs provide a minimum of 70 hours of Acute Frailty Services per week to address this challenge1. At Salford Royal Foundation Trust (SRFT), a Frailty Same Day Emergency Care (SDEC) service was introduced to deliver rapid assessment and care for frail older adults, aiming to reduce hospital admissions and improve patient outcomes2. This service operates five days
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Introduction: Care home residents are often multi-morbid with both physical and cognitive impairments. An average care home resident takes 7.2 medications per day. Older people are more likely to experience adverse effects from polypharmacy due to pharmacokinetic and pharmacodynamic changes associated with age. Polypharmacy and anti-cholinergic burden (ACB) not only increase the risk of adverse drug reactions but also can increase the number of falls, hospital admissions and mortality. Method: Retrospective analysis in October 2024 of all patients at a residential home who had an initial
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INTRODUCTION: We now face an increasing challenge of managing type 1 diabetes (T1DM) in older people. 3% of patients with T1DM are over 80 years old - a number that is set to rise over the coming decades. Diabetes is a risk factor for frailty, and advanced age comes with a higher incidence and severity of comorbidities affecting patients’ ability to manage their treatments, such as arthritis or dementia. A recent systematic search in England highlighted the scarcity of data surrounding this, finding no articles specifically researching frailty in older adults with T1DM. CASE STUDY: ●90-year
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Introduction Despite the UK’s increasing life expectancy, and increase in the older population, there is an overwhelming lack of Geriatricians in the UK; as of 2022, there is only 1 consultant Geriatrician per 8,031 individuals over the age of 65 (BGS, 2023). To meet the complex care needs of this population, there must be a focus on increasing the interest that doctors have towards Geriatric Medicine, with the overall aim being to recruit more doctors into the speciality. Methodology The aim of this review was to investigate what factors medical students perceive as barriers to pursuing a
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Introduction: There are approximately 549,000 new fragility fractures each year in the UK and the prevalence of both osteoporosis and risk of falling increases with age. Care home residents are three times more likely to fall and have a 3- to 4-fold higher incidence of fractures than people of the same age living in the community. These older, frailer and multimorbid patients often have the highest fracture risk and therefore the most to gain from anti-osteoporosis treatments to reduce this risk. Method: Retrospective audit of residents who were reviewed by the newly started Enhanced Health in
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