Posters

Introduction: This quality improvement project (QIP) was conducted in a busy Emergency Department (ED) in South Wales (Grange University Hospital (GUH)), as part of efforts to improve safety for older patients. Our ultimate goal is to reduce unnecessary re-admissions, as hospital stays can cause rapid deconditioning in older patients. Patients aged over 65 account for 25% of ED attendances (Emergency Care Data Set, 2024). It is well documented for this subset of patients that good handover is crucial to improving overall standards of care, and continuity of care into the community. Standard

Background Frailty is a poor prognostic indicator following cardiopulmonary resuscitation (CPR). Discussions about Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions are often contentious. While existing research focuses on patients’ and relatives’ perspectives, there is a lack of in-depth studies exploring clinicians' experiences of DNACPR discussions. This study aims to explore how clinicians' personal and professional beliefs and experiences influence their approach to DNACPR conversations with frail, older adults. Methods Ninety clinicians from primary and secondary care

Title: Ageing with Confidence; A QI project on Urinary Incontinence Assessment Introduction: UI is a common yet underdiagnosed geriatric problem with a UK prevalence of >20% in individuals aged over 65. Despite its high prevalence, UI often remains untreated negatively impacting the quality of life. Objectives: This project aimed to raise awareness and improve patient outcomes by introducing a standardised urinary incontinence (UI) assessment proforma to aid early recognition and management of UI among elderly patients admitted to the COTE ward in a district general hospital. Methods: A

Introduction: The UK and global life expectancy is increasing, but life years lived in ill health is also increasing. Disease burden, and health and social care service use is highest in older age. Prevention, treatment and management of conditions of older age (e.g. frailty and multi-morbidity) is a research priority. Efficient trials need to better recruit and retain older participants to produce robust and generalisable evidence for our aging population. Synthesised qualitative and quantitative evidence regarding trial retention does not generally include the oldest and frail in society

Background: National and local standards in acute frailty recommend a seven-day service, with front-door assessment and a dedicated frailty area. Many acute frailty teams struggle to maintain a dedicated space as they are vulnerable to becoming inpatient areas when bed pressures increase. The Acute Older Persons Unit (AOPU) at Guys and St Thomas' has faced similar challenges and is based on the Acute Admissions Ward and the Emergency Department. This project assessed whether a dedicated Acute Frailty SDEC (F-SDEC) space increased the number of patients seen and the number of same-day

Introduction Adverse drug events (ADEs) in older adults contribute to preventable harm, hospitalisation, and health inequalities. While age-related physiological changes affecting drug safety are recognised, less attention is given to how sociodemographic and structural factors such as ethnicity and deprivation jointly shape vulnerability to ADEs. This limits the development of equitable medication safety strategies. This review examines how intersectional risks are conceptualised and analysed in ADE research to inform more inclusive approaches to medication safety. Method A scoping review was

Introduction The Comprehensive Geriatric Assessment (CGA) is the gold standard for managing frailty in older adults, with strong support in the literature. However, gaps remain in the evaluation of electronic CGA's (eCGA's) and standardised implementation. The Frailty Intervention Team at Sandwell and West Birmingham delivers multidisciplinary care via CGA, but prior to intervention, assessments were often incomplete, with baseline compliance at just 23%. This was largely due to the absence of a user-friendly, embedded electronic solution. Method A root cause analysis identified key barriers

Introduction Osteoporosis is systematic skeletal disorder causing low bone mass, which increases pre-disposition to fractures. In older adults, fragility fractures are usually the first presentation of this. National Osteoporosis Guidelines Group (NOGG) have published evidenced-based guidelines for identifying and managing bone health in the over 50’s, however compliance can be variable. Methods An EMIS search was conducted of patients at the Surrey practice which identified 46 patients over 50 years old (25 of which were over 70 years old) who had been coded as having had a fragility fracture

Introduction: Fragility fractures can have a profound impact on older adults’ quality of life. Optimising bone health by checking vitamin D level, FRAX score, and actioning outcomes provides a cost-effective strategy for reducing the incidence of these fractures. Our aim therefore is to promote awareness and undertaking of bone health assessments in the Older Persons Unit (OPU) Methods: This was a pre-post cross-sectional study. Data was collected from 212 patient records over two separate days, one month apart. Patients admitted to the OPU at St Thomas’ Hospital were included and data was

Introduction: The older population are more likely to suffer from chronic diseases, requiring more frequent hospital admissions, therefore, in University Hospital of Wales there is a dedicated Older Persons Acute Medical Unit (OPAMU). The OPAMU, opened in 2023, admits frail patients directly from the Emergency (ED) and Acute Medicine (AM) Departments for comprehensive geriatric assessment before discharge or onward hospital stay. Main objective: To understand how our patients felt throughout different steps of their journey to the OPAMU. Secondary objective: To assess how the patient

Introduction Clinicians covering six older people’s medicine wards reported feeling burdened by requests for weekend review of patients without clear indications, reducing time for patient care. We aimed to standardise the process to streamline reviews, freeing up clinicians to deliver optimal care. Methods We developed a new electronic weekend handover process using existing capabilities within our electronic patient record. The COM-B behaviour change method was used with a focus group of clinicians including PAs, residents and consultants to identify targets to change behaviour. Fifteen

Introduction: Involvement of Geriatricians in peri-operative assessment acknowledges the altered physiology of frail patients and helps to evaluate realistic outcomes as part of patient-centred shared decision making. This is with the aim of addressing modifiable risk factors, preventing complications, preparing for a realistic recovery and ensuring that treatment options are aligned to what is important to the patient. There is data suggesting improved survival following geriatric peri-operative assessment but little analysis from the patient’s perspective; their thoughts about the shared

Introduction: Dementia and hearing conditions are both major public health concerns. Most people living with dementia also live with hearing conditions (e.g., hearing loss, vestibular disorders, hyperacusis). Furthermore, evidence suggests that hearing loss is a risk factor for the development of dementia. There is a critical need for research to explain the association between dementia and hearing conditions and to optimise assessments and interventions for this co-morbidity. This James Lind Alliance Priority Setting Partnership (JLA PSP) aimed to identify unanswered research questions about

Introduction: Deconditioning, the progressive loss of physical and functional capacity during hospital admission, is a well-recognized but often under-addressed risk factor for poor patient outcomes. It can lead to increased dependency, delayed discharge, and higher rates of hospital-associated complications. Despite its importance, barriers such as invasive lines, limited staff awareness, and entrenched ward routines often prevent patients from engaging in early mobilization. Objective: Our quality improvement project sought to evaluate whether small and simple, multidisciplinary

Introduction Fragility fractures are a frequent presentation to the acute medical take. Defined as a fracture following a fall from standing height or less[1], they represent up to 10% of acute admissions. Despite this, we identified no standardised protocol for commencing bone protection in our unit. Our project aimed to improve the management of bone health in this cohort. Methods Data was collected across an 18-week audit cycle, with 6 weeks of baseline data collected prior to any interventions. Patients with radiologically proven fractures sustained from standing height or less were

Introduction: Osteoporosis affects approximately 3.5 million individuals in the UK, with prevalence increasing with age—particularly among women over 75. Hip fractures carry a one-year mortality rate of nearly 33%, underscoring the importance of primary prevention over reactive treatment. However, many elderly patients do not proactively engage with their GP regarding bone health. Objective: This audit aimed to Identify elderly inpatients at elevated risk of osteoporotic fragility fractures using the FRAX tool Communicate these findings to their GPs to support early intervention. Methodology

Introduction Delirium is common in older inpatients and associated with cognitive decline, underlying dementia, and mortality. NICE recommends that current or resolved delirium diagnosis is communicated to general practitioners (GPs) upon discharge. A 2021–22 quality improvement project at Lister Hospital improved the delirium assessments consistently to over 95% across the Trust. However, this study found that only 25% of delirium cases were documented in discharge letters. This gap poses significant risks to patient safety, as unresolved delirium may be overlooked, and underlying dementia

Introduction Delirium is common in older inpatients and associated with cognitive decline, underlying dementia, and mortality. NICE recommends that current or resolved delirium diagnoses are communicated to general practitioners (GPs) upon discharge. A 2021–22 quality improvement project at Lister Hospital improved the delirium assessments consistently to over 95% across the Trust. However, this study found that only 25% of delirium cases were documented in discharge letters. This gap poses significant risks to patient safety, as unresolved delirium may be overlooked, and underlying dementia

Introduction: Inappropriate polypharmacy is the use of medications with no evidence-based indication, unmet treatment goals, high risk of adverse drug reactions, or when the patient is unwilling / unable to take treatment as intended. This is particularly concerning in geriatric care, due to increased risk of hospital admissions, adverse drug reactions and significant healthcare costs. To address these risks, clinicians should conduct patient-focused medication reviews. This project aimed to assess and improve polypharmacy reviews at Royal Albert Edward Infirmary (RAEI), with a focus on

Introduction Dementia is an increasing global health problem. Picture description tasks are a useful tool to assess semantic-based language deficits, which can occur during later stages of dementia. There is a paucity of research regarding culturally appropriate picture description tasks within sub-Saharan Africa. Aim Develop a culturally adapted picture description task and scoring method and evaluate its feasibility as a cognitive measure in two rural communities in the Hai district of Kilimanjaro, Tanzania. Methods An adaptation of a widely used picture description task was developed using