Posters

There is a 35-week waiting time to be seen in a gastroenterology clinic for investigations such as UGI endoscopy and colonoscopy for a condition such as low Hb, weight loss, dysphagia and so on. Most of the time without adequate initial workup and ruling out iron-deficient anaemia and differentials as per the British Gastroenterology Society. The hospital is witnessing an exponential influx of patients, reflecting in long waiting times to accommodate clinic patients. The current established low Hb referral pathway via GP to gastroenterologists does not consider the co-morbidities and frailty

A 75-year-old male presented with chronic fatigue and gradually worsening generalised muscle weakness over three years. He was treated by his GP for two months for a suspected case of polymyalgia rheumatica with a two-month course of steroids, which resulted in no significant improvement. His medical history included post-COVID syndrome and mixed anxiety and depressive disorder. He lives at home with his wife and requires assistance to navigate stairs, using a walking stick for mobility. On examination, he exhibited grade 4/5 muscle weakness in both proximal and distal muscles. Blood tests

Introduction: Inpatient falls are a common problem, and it is important that newly qualified doctors feel confident in conducting competent assessments of patients after they fall. This project seeks to assess the confidence levels of final year Manchester Medical School (MMS) students surrounding the topic of inpatient falls assessments, as well as to determine whether another resource from MMS regarding this topic would be beneficial. Method: A survey was conducted and disseminated amongst final year students at MMS through email and social media, with questions designed to address the

Background: Falls are common presenting complaints in older adults, particularly those aged 65 and above, with prevalence increasing with age. The risk of falls is multifactorial, and polypharmacy, defined as the use of five or more medications, is one of the significant modifiable risk factors. Inappropriate medication use, which occurs in 30-50% of cases in the elderly, exacerbates this risk. Objective: This audit aimed to assess the impact of polypharmacy on fall risk among elderly patients and evaluate the effectiveness of medication reconciliation in reducing this risk. The study was

Introduction: Inadequate patient selection for transfer to community hospitals disrupts care continuity and compromises patient safety and outcomes. The SBAR communication tool presents a promising solution to address this challenge. This study investigated the impact of SBAR on quality of care and patient outcomes. Methods: Retrospective study involving patients admitted to Samuel Johnson and Sir Robert Peel Community Hospitals from October to November 2023. Data regarding the completion of the SBAR forms, accepted and rejected patients and reasons for rejection, and repatriation numbers were

Background Loneliness is increasingly impacting older people in the UK and associated with poor health. The “Campaign to end loneliness” estimates that 1.2 million people are lonely. Age UK states that 2 million people will be lonely by 2026. For half of people aged >65, their main source of company is TV or pets. Our objectives are to identify the prevalence of loneliness in the population presenting to Leighton Frailty Unit, develop a social prescribing tool to reduce this and highlight community services. Methods During September 2023- February 2024 we gathered baseline data on loneliness

Drugs that have anti-cholinergic affects are known to have side effects such as urinary retention and constipation. In older people these drugs can also contribute to cognitive decline and loss of functional capacity leading to older patients being at risk of increased falls. Taking multiple medications with anti-cholinergic affects create a higher anti-cholinergic burden. Hilmer and Gnjidic (2022). Drugs that have anti-cholinergic affects block acetylcholine receptors (muscles do not receive neurotransmitter and therefore not functioning properly), Brown (2019). Some of these drugs are

Background Delirium is an acute impairment of attention and cognition, precipitated by physiological stressors (Wilson et al., Nature Reviews, Disease Primers, 2020, 6(1)), associated with adverse outcomes (Huraizi et al., Journal of Clinical Medicine, 2023, 12(16), p. 5346) and often under-diagnosed in hospital (Lochlainn, Frewen and Bryant, Age And Ageing, 2018, 47(suppl_5), pp. v1–v12). Integrating early assessment into clinical practice is vital (Hopper et al., Geriatric Medicine GIRFT, 2021). This project assessed compliance with delirium guidelines from the National Institute for Health

Introduction: Inpatient falls present a significant safety concern in NHS hospitals, with approximately 247,000 inpatient falls per year in England alone (Healthcare Quality Improvement Partnership (2023), National Audit of Inpatient Falls 2022). The actions following an inpatient fall have potential to influence clinical outcomes and patient safety. This quality improvement project aimed to enhance patient safety by improving the accuracy of post-fall review documentation and increase awareness of the Trust's post-fall protocol. Methods: Data collection involved reviewing electronic notes of

Introduction: Femoral fragility fractures (FFFs) are a significant healthcare concern, with the incidence predicted to rise to 100,000 annually in the UK by 2033. Current secondary preventative strategies focus on the patient’s physical state – overlooking Hospital-associated Deconditioning (HAD), the decline in patient wellbeing post-admission. To prevent HAD, a ‘Games Area’ (GA) was introduced in December 2023 as a service improvement. This study evaluates the GA’s effectiveness in preventing HAD, by assessing patient satisfaction. Method: We evaluated all patients aged 65yrs or more during

Introduction and Background- Bowel obstruction poses a considerable medical dilemma, demanding swift identification and intervention due to its propensity for severe complications. This challenge is exacerbated in elderly individuals who may be frail and less amenable to surgical interventions. Alvimopan, a peripherally acting μ-opioid receptor antagonist renowned for its pro-kinetic effects on the bowel, has shown promise in clinical trials. Nevertheless, despite its efficacy, it remains underutilised in many clinical hospital settings. Thus, our systemic review aims to underscore the

Introduction Recent trials like ASCEND, ASPREE, and ARRIVE emphasise the limited efficacy of aspirin in primary cardiovascular prevention and its associated increased bleeding risk, particularly in the elderly. Consequently, the Screening Tool of Older Persons’ Prescriptions (STOPP) criteria does not recommend aspirin treatment for primary cardiovascular prevention in any case. This study aimed to determine the prevalence of inappropriate aspirin use among elderly patients admitted within our department and our ability to correctly identify and discontinue its use. Methods Patients aged over

Introduction With an increasing ageing population, more people are now living with multiple comorbidities and on polypharmacy. Medicines prescribed appropriately provide huge benefits; but inappropriate prescribing without safe optimisation can cause significant harm. Method We assessed current practices of reviewing and optimising medications in Elderly Care at Maidstone Hospital. 44 Patients were selected randomly from three elderly care wards. We retrospectively evaluated if medications for these patients were reviewed and optimised using the START-STOPP tool at clerking, post take and

Introduction Geriatric medicine is inherently complex and requires multi-disciplinary integration. Simulation-based training has been recognised by the Joint Royal Colleges of Physicians’ Training Board and the Royal College of Nursing as a method to enhance learning and improve patient outcomes. This project aimed to develop a multi-professional simulation programme within care of the elderly to mimic the multi-professional clinical practice that takes place on geriatric hospital wards. Methods A total of ten half-day simulation sessions have been run across two sites in two years. The

Introduction The British Geriatrics Society advocates for the development of local protocols to address frailty (1). A Cochrane Review on the use of Comprehensive Geriatric Assessment (CGA) resulted in higher survival rates at 3 months and fewer admissions to nursing homes at one year following hospital admission (2). Key components of CGA, including Treatment Escalation Plans (TEPs), Universal Care Plans (UCPs), Clinical Frailty Scores (CFS), and Abbreviated Mental Test (AMT) play pivotal roles in identifying frailty, establishing timely end-of-life care plans, preventing future inappropriate

Introduction - The British Thoracic Society Guidelines 2017 recommends oxygen delivery to achieve target oxygen saturation range between 94% and 98% of the majority of medically unwell adult patients, and 88% to 92% in patients at risk of hypercapnic respiratory failure. Oxygen is a drug which should be prescribed for patient’s just like any other medication and is often over-looked. For some older people oxygen treatment can impair mobility, increase deconditioning and the risk of falls. We conducted a re-audit and PDSA cycle expanding from one ward (Eashing) to all three geriatrics wards

The World Health Organisation lists antibiotic resistance as one of the biggest threats to global health [1]. We contribute to this as clinicians, through errors such as delayed review of prescriptions or prescribing against local trust guidelines. We have carried out a quality improvement project to improve antibiotic prescriptions on a geriatric ward at Croydon University Hospital. We carried out a fortnightly cross-sectional analysis of the antibiotic prescriptions on a geriatric ward. This included looking at the antibiotic prescribed, indication, duration, route of administration and

Introduction: Frailty Hotline Service (FHS) was set up initially in January 2021 to provide 24/7 advice and guidance to care home medical staff within the Mid & South Essex Health and Care Partnership footprint as a part of covid response. This was expanded to support GPs, Urgent Care Response Team (UCRT), community hospitals, hospices etc and later established as Community Frailty Hotline Service (FHS) with an aim for hospital avoidance and provide support to frailer older patients in their own places. Later, a Frailty Virtual Ward (FVW) was established to complement FHS within the MSE HCP

Introduction Physical and cognitive decline at an older age is preceded by changes that accumulate over time until they become clinically evident difficulties. These changes, frequently overlooked by patients and health professionals, may respond better than fully established conditions to strategies designed to prevent disabilities and dependence in later life. The objective of this study was twofold: to provide further support for the need to screen for early functional changes in older adults and to look for an early association between decline in mobility and cognition. Methods A cross

Introduction: More than 50% of patients undergoing emergency general surgery are > 65 years. The Emergency Laparotomy and Frailty (ELF) study showed strong associations between frailty (CFS ≥ 5) and increased mortality, risks of complications, and length of hospital stay. Methods: For nearly 10 years, we have had geriatric liaison input for general surgery and colorectal patients in a tertiary teaching centre. This has transformed into a fully embedded service involving consultant geriatrician, registrars and senior house offices, providing 3-day a week medical input. NELA best practice tariff