Posters

Background & Introduction In response to the recent publication of the new British Geriatrics Society undergraduate medical curriculum (1), the medical education department at Glasgow Royal Infirmary created a session focussing on frailty for undergraduate medical students. The aim of the session was to introduce the concept to students by exploring and expanding on their experiences of frailty on placement. Methods - The session We used a pedagogical approach in a short, 90 minute session for small groups of students. The session was split into three activities; the first activity was a case

Promoting Bone Health by ensuring in-patient Ortho-geriatrician Bone Health plan in patient notes following Neck of Femur Fracture (NOF). Introduction & Aims Osteoporosis affects 3 million people in the UK with more than 500,000 hospital presentations annually due to fragility fractures costing in excess of £4.4 billion to the NHS. Bone protective medications are a cost-effective way of reducing fracture and admission following a fall. The Royal College of Physicians National Hip Fracture Database targets that patients are: “given suitable bone strengthening treatment and followed up to ensure

Introduction Iron Deficiency Anaemia (IDA) is a highly prevalent co-morbidity in older patients with advanced frailty. It’s associated with adverse outcomes and heightened all-cause mortality. IDA is frequently multifactorial and can stem from various gastrointestinal causes. The British Society of Gastroenterology and National Institute for Health and Care Excellence advocate a combination of endoscopy and computerised tomography (CT) as the gold standard investigations for IDA. The aim of this review was to evaluate oesophagogastroduodenoscopy (OGD) findings and management outcomes of

Introduction: It is recognised that there are pressures on the NHS particularly the emergency services. Therefore, a focus of the 21/22 Priorities and Operational Guidance was to develop community services to prevent emergency department (ED) attendance and avoidable hospital admissions. This informed the funding of urgent community response services (UCR). An urgent response is defined as a presentation that would likely result in hospital admission if a response were not made within 2 hours. Quality Improvement methodology was applied to evaluate the potential impact an advance clinical

Older people with diabetes are often admitted with falls, dizziness or confusion that may stem from undiagnosed episodes of hypoglycaemia. We examined the use of a 10-day period of round the clock glucose monitoring (CGM), to detect hypoglycaemia in older people with diabetes with symptoms potentially related to hypoglycaemia. Methods Population: Age 75 years and older, on sulfonylureas and/or insulin, presenting to hospital with a fall and/or symptoms suggestive of unrecognised hypoglycaemia. Design: Single-centre, observational study (no change to standard diabetes care). Intervention: 10

Rationale Inpatient glycaemic management is a challenge in older people. Clinicians at the Norfolk and Norwich University Hospital noticed substantial numbers of finger-prick capillary blood glucose (CBG) tests being documented. This quality improvement project explored the frequency of CBG testing on older people’s medicine wards, to determine if improvements in service provision and patient safety could be made. Methods Setting: Electronic records of inpatients on geriatric medicine wards at NNUH (May-July 2023) Patient selection: Older people with recorded CBG testing Measures: 1. Type of

Introduction: Socio-economic costs of hip fractures are formidable. Despite osteoporosis and falls being major risk factors, preventative screening in Primary Care does not occur. Evidence shows screening older women for osteoporosis prevents hip fractures, but to make a greater clinical and economic impact simultaneous screening of falls and fracture risks is logical. This cross-sectional study evaluates an innovative digital questionnaire and computer programme to combine person-reported data with medical data, and auto-calculate fracture and falls risks without the need for clinician time

Inpatient falls remain a huge problem in hospital, causing significant injuries to patients and are an avoidable cost to the NHS. Therefore, the National Audit of Inpatient Falls (2015-2017) set out key recommendations for management of falls, including the measurement of LSBP within 3 days of hospital admission. Our project was conducted in a major acute teaching hospital in North West London across three geriatric wards. Our aim was to improve the measurement of LSBP and correct documentation across the wards in line with the NAIF guidelines. We excluded patients unable to mobilise to

Introduction: Effective board rounds improve the patient’s experience and reduce the risks associated with a prolonged hospital stay. Ward C54 at Queen’s Medical Centre is a 30-bedded ward dedicated to the provision of care for older, frail (CFS ≥ 6) patients. Board round on C54 was unstructured and could take over an hour. The project team set out to reduce the duration of board round, improve the quality of information handed over and improve staff satisfaction with board round. Method: Pre- and post-intervention data on the daily duration of board round were collected by the junior doctors

Introduction: Recent studies show the use of comprehensive geriatric assessment (CGA) in older patients with cancer can result in better quality of life, improved treatment tolerance and reduced hospital admissions, leading to international consensus that CGA should be routinely included in care. We have piloted an onco-geriatric MDT, consisting of oncologists, geriatricians and therapy input, alongside a rapid-access geriatrician-led onco-geriatric clinic Method: Referrals were invited from oncologists for older patients (>70) with a new diagnosis of cancer, with expected prognosis of more

Same Day Emergency Care (SDEC) at St James’ Hospital, Leeds provides urgent care at the interface between primary and secondary care, offering comprehensive geriatric assessment (CGA) to those living with frailty, aiming to prevent hospitalisation and delay frailty progression. Advance care planning (ACP) is a vital component of prioritising care preferences including at end-of-life, but timing often falls short in practice. This quality improvement (QI) initiative aims to proactively open ACP discussions, allowing patients to consider their care goals, ensuring our care is aligned with their

Introduction: Many elderly patients admitted to hospital have presented following a fall. Causes for falls are often complex and multifactorial, but causes such as postural hypotension and cardiac arrhythmias are easily diagnosed with lying and standing blood pressure (LSBP) and ECG respectively. Therefore these investigations should be offered as a minimum to any elderly patient after a fall. We aim to review and improve the number of patients receiving LSBP and ECG after presenting to the Acute Frailty Unit (AFU) with a fall. Methods: Falls admissions were reviewed over two four-week periods

Introduction: Assessment of lying and standing blood pressure is commonly undertaken in geriatric medicine to make a diagnosis of orthostatic or postural hypotension. We carried out the audit to review the clinical practice and assess its adherence to the Royal College of Physicians (RCP) guidance on how to accurately measure the lying and standing blood pressure (Falls and Fragility Fracture Audit Programme). Method: It was a prospective audit. The first audit cycle was conducted in July 2020 and the second cycle in April 2021 Results: During the first data collection, the practice was

Background: Nutrition is one of the cornerstones of healthy aging. As we age there are many changes in our bodies, including decreased appetite and poor dentition, that contribute to increasing malnutrition. The MUST (Malnutrition Universal Screening Tool) score is a quick and effective tool to assess this. Aim: In this project, we aimed to review MUST score and food chart completion on the frailty wards at EDGH to attempt to improve the nutrition of elderly patients. Methods: The charts of 75 patients were reviewed over a period of one month. Following this, a training program for all the

Background End-of-life (EOL) care aims to anticipate, prevent and treat symptoms experienced by the dying patient. An EOL care strategy described by King’s Health Partners (KHP) outlines the ‘ICARE’ framework, created from the five priorities for the dying patient, giving generalist hospital teams a memorable prompt to consider holistic needs of patients. We aim to reconcile performance of Acute Medical Unit (AMU) in providing EOL care, against KHP's framework, to reduce patient suffering and improve care. Methods A prospective review was performed of all AMU deaths from March-September 2021

Introduction The Mental Capacity Act is designed to protect patients who may lack the mental capacity to make decisions about treatment. At the Nuffield Orthopedic Centre (NOC) in Oxford, nurses obtain a baseline AMTS during the pre-operative assessment clinic. Following on from this, any patient over 64 years old that is seen by the orthogeriatrics team will have a post-op AMTS done to assess for cognitive impairment. If the AMTS is less than 8, or the patient is clinically believed to be delirious, then an MCA form will be completed for the decision to accept treatment. The aim of this QI

Improving the assessment and management of blood pressure in older populations Introduction Managing blood pressure in patients above 65 years old remains controversial with limited evidence in relation to balancing cardiovascular benefit and risks of postural hypotension. National guidelines highlight appropriate medications and contraindicated drugs. An initial audit identified a large proportion of elderly Wigan borough residents being on inappropriate medication alongside poor compliance in assessing and managing abnormal blood pressure. This quality improvement project aims to increase

“I would imagine it needed a review…” A qualitative study exploring the experiences of people with dementia and their informal carers of long-term condition reviews in primary care Introduction Multimorbidity is common for people with dementia (PWD) and is associated with increased healthcare utilisation and poorer outcomes. Part of the management of long-term conditions (LTCs) occurs through annual LTC reviews conducted in primary care. Little is known about the experiences or needs of people with dementia and informal carers in regard to LTC reviews. Aim To explore the experiences of PWD and

Introduction: The incidence of fragility fractures is rising with increased life expectancies. Most hip fractures require surgery. Acute kidney injury (AKI) is a preventable clinical syndrome that raises the risk of mortality. The aim of this study was to investigate the prevalence of AKI in hip fracture patients. Methods: Data relevant to reported risk factors for developing AKI were collected before and after surgery within hip fracture patients in 2020. This included serum blood tests, anthropometric data, surgical factors and length of inpatient hospital stay. Results: A total of 190

Introduction: Care home residents often have multiple long-term conditions and experience polypharmacy. Deprescribing is the reduction or stopping of prescription medicines that may no longer be providing benefit. Previous research has found that deprescribing is generally safe but it is unknown how to make it work well in practice, like care homes. Methods: Using the findings from the NIHR-funded STOPPING project, which aimed to support the development of better deprescribing practice approaches within care homes, considering different views and environments, recommendations for designing a