Posters

Background Perioperative services must adapt to the needs of an increasingly older surgical population. Perioperative medicine for Older People undergoing Surgery (POPS) services integrate geriatric medicine teams into surgical pathways to provide quality and cost-effective medical care. This project aims to examine value-based outcomes (clinical and financial impact) of embedding a POPS service at a district general hospital. Methods Following a period of implementation on an acute Trauma and Orthopaedic (T&O) ward, a two-week pilot was undertaken. All emergency fragility fracture admissions

Wipes are a practical solution for cleansing skin and widely used in children, neonates, and in geriatric care. Some wipes contain compounds may cause dryness, itching, irritation, and inflammation. This abstract looks at the efficacy of wipes that do not contain multiple unnecessary added ingredients.

Introduction: Early identification and management of all contributory factors is vital in the management of delirium. Delay in investigation can lead to morbidity, mortality, longer length of stay or inappropriate discharge from hospital. We carried out a Quality Improvement project looking to ensure all patients with delirium had appropriate blood tests taken in the Emergency Department (ED). Methods: For the first cycle, 25 patients > 65 years admitted through ED in December 2022 and January 2023 with delirium were identified based on medical clerking and post take ward round diagnosis

At University Hospital Monklands, a district general hospital in Lanarkshire, an ED in-reach pilot was set up to deliver the best possible outcomes for frail older adults by proactively reducing unscheduled admissions, thereby reducing the time they spend in the hospital. Aim To reduce unscheduled admissions for patients with a clinical frailty score (CFS) ≥ 6, admitted to ED between 8am – 3pm, Monday to Friday, by 50%. Method An ED Frailty MDT was formed, comprising of Acute Care of the Elderly (ACE) nurses/ Advanced Nurse Practitioners (ANP) and Consultant Geriatricians. Patients ≥ 65 years

Introduction Falls are a common cause of morbidity and mortality in frail patients, with visual impairment doubling the risk of falls. NICE advises a multifactorial approach to identify risk factors to be treated, improved and managed. This includes sensory/visual assessment, which is poorly done in practice. The aim is for 50% of relevant patients admitted with fractures following falls to have a vision assessment within 5 days of admission. Methods A modified RCP ‘Look out! Bedside vision check for falls prevention’ aid for healthcare professionals was utilised. Patients excluded were those

Introduction: BGS reports in its 'Case for more Geriatricians' that the number of people age over 85 is set to double by 2045. As well as Geriatric specific policies in the Ageing Well programme of the NHS Longterm Workforce Plan there are plans to expand the number of allied health professionals including Physician Associates (PA). We set out to improve PA students knowledge of and confidence in managing geriatric patients with a bespoke teaching programme culminating in a novel bleep simulation. Methods: We identified the students needs with a preliminary survey and then created a teaching

Introduction: Traumatic Brain Injury (TBI) is the most common fall-related injury among adults 65 and older, despite the high incidence there is a paucity of research to guide management of older adult TBI . Simple passive remote home monitoring systems can be used to unobtrusively track markers of health and function in older adults and enhance clinical decision making in community-based care models, such as ‘hospital at home’. There are few studies to-date examining healthcare practitioners (HCPs) views on this technology. We aimed to explore HCPs insights on how to best develop the

INTRODUCTION Medical graduates should be capable of providing good quality care for older adults who present with multi-morbidity, frailty and challenging long-term conditions, as recommended by the GMC’s “Outcomes for Graduates” guidance. Simulation-based education (SBE) is a recognised modality for replicating experiences to enhance and consolidate learning in a safe environment. We have developed an undergraduate geriatric medicine themed SBE experience, which aims to consolidate learning for core geriatric medicine concepts. METHODS Three geriatric medicine simulation scenarios have been

Introduction: BPPV is a condition characterised by the displacement of the calcium crystals within the vestibular system. Whilst BPPV itself is not life-threatening, symptoms can cause complications and lead to falls, injuries, and in severe cases, head injury. The diagnosis and treatment for BPPV are manoeuvres, which in some patients especially the elderly cannot be performed adequately leading to untreated BPPV. This study aims to assess whether patients are being affected by frailty factors and comorbidities which is hindering their treatment. Methods: This study was part of a prospective

Introduction: The COVID-19 pandemic has raised concerns about its long-term effects, leading to conditions such as "Long COVID." Neurological manifestations, including "Brain Fog" with impaired cognitive function, have been reported, but their relationship with age and memory decline remains unclear. Method: This study aimed to investigate the effects of COVID-19 infection on memory function and explore the relationship between age and memory scores. The research utilized data from the 'COVID-19 Online Rapid Objective Neuro-memory Assessment' (CORONA) study, employing an online survey with a

Introduction: Modifiable risk factors are an important part of secondary prevention of ischaemic stroke. Many of these are modifiable lifestyle choices. We identified a lack of provision of written information to patients on the stroke ward regarding modifiable lifestyle risk factors, and undertook a quality improvement project which aimed to improve provision of information - both written and verbal - via a "Stroke Passport" document to help patient understanding. Method: Data was collected from inpatients admitted with ischaemic stroke in the stroke ward in Prince Charles Hospital (District

Frailty is defined as a state of increased vulnerability to poor resolution of homoeostasis after a stressor event, increasing the risk of adverse outcomes (1). The Clinical Frailty Scale (CFS) is a validated infographic tool used to assess frailty in clinical settings (2). It aims to provide a standardised framework for frailty assessment, however determining the CFS is primarily subjective in nature, relying on clinical judgement and observation. NHS Elect have launched a CFS application, helping to improve the objectiveness of the CFS outcome. A quality improvement project performed at

Swansea is one of oldest cities by population in the UK (more than 1 in 5 people over 65) leading to an increasing number of frail patients and has a high prevalence of Welsh speakers in the over 65 age group 12% of Swansea Bay employees identify as speaking Welsh. The Welsh language act awarded equal status to both English and Welsh, encouraging public bodies to publish official documents bilingually.As part of our work in developing frailty screening for elective surgical patients we use the clinical frailty score (CFS) and noted there was not a Welsh language version available. As we are

INTRODUCTION The Cardiff and Vale Parkinson's service is an integrated, multidisciplinary service providing support and input from initial diagnosis to end of life care, undertaking comprehensive, specialist assessments for patients. Traditional care models have focused on physical disease, with neuropsychiatric symptoms often requiring input from other (e.g. Mental Health) teams to manage even the less- complex symptoms of dementia. Our service aims to manage both physical and neuropsychiatric symptoms via non-pharmacologic and pharmacologic means. METHODOLOGY From our total clinic population

INTRODUCTION Dementia in Parkinsons is common and under-recognised with a significant impact on person and their carer. Contrary to other services, Cardiff and Vale Parkinson's services run an integrated Parkinson's clinic where People with Parkinsons (PwP) developing dementia continue to be managed by the same clinical team. METHODOLOGY An review of 425 patients diagnosed with dementia with a background of Parkinson's over last 10 years was undertaken. A random sample of 50 patients assessed for demographics, duration of Parkinson's, presentation of dementia and outcomes including place of

Introduction High number of clinically optimised patients in a DGH were having daily clinical input. RAAC clinical incident resulted in movement of clinically optimised patients from the district general hospital to a community hospital increasing the community bed base from 32 to 72. This gave the opportunity to review how these patients were managed. Method It was recognised that a daily medical ward round for clinically optimised patients was neither necessary or optimal and potentially perpetuated the impression that patients required in hospital care. National guidance supports delegation

Introduction During 2022, non-femoral fractures that didn’t require operative management had 30 days median inpatient length of stay (LOS) at SBUHB. Femoral fracture patients >65 years had LOS 36 days (GIRFT average 19 days), with 720 admissions. High local incidence is believed to be contributed by historical failures to identify and treat non-femoral fragility fractures. A new service was created from a collective effort to do better for our patients and prevent avoidable harm by breaking down barriers between services and promoting effective collaborative working. Methods A collaboration

Aim: Several scores have been developed to identify SDEC patients from Emergency Department (ED) triage and acute medical intakes. Scores are designed to improve system efficiency, overcrowding and patient experience but none have been developed for older adults. Previous work has shown that existing scores e.g. Glasgow Admission Prediction Score, Sydney Triage to Admission Risk Tool and the Ambulatory Score were not able to predict admission in our population(1). We have developed a novel, frailty-focused score. Methods: The Older Person’s Assessment service (OPAS) is ED based, accepting

Introduction Swansea Bay Health Board is covered by eight community clusters (240 virtual beds), each with their own Virtual Ward (VW) MDT which provides community based Comprehensive Geriatric Assessment and reablement. The VW governance structure includes the routine collection of person centred metrics. There is no recognised PROM or PREM specifically designed for needs of frail older people and PROMs and PREMs are rarely used to inform quality and continuity in services at transitions of care (e.g. at discharge from hospital) Methods VW data from June 2023 to February 2024 was analysed

Introduction – NHS England have included the identification and response to frailty in emergency departments (ED) as an area of clinical priority, producing the CQUIN05. At the Oxford University Hospitals Trust (OUH) we have designed a front door frailty service and are participating in the CQUIN05 scheme. The Clinical Frailty Scale (CFS) score is recorded by nurses in ED. Following the CQUIN05 criteria, patients aged above 65 years old and scoring 6 or above on the CFS (moderately frail) are identified by the front door frailty service and a comprehensive geriatric assessment (CGA) initiated