Posters

Background Sarcopenia, defined as age-related loss of muscle function and strength, has a reported prevalence of up to 40.4% in the older adult. Despite its association with frailty, disability and mortality, it is underdiagnosed among hospitalized older patients. Exercise interventions have also been shown to improve fall risk scores for sarcopenic patients. Objective A QI initiative was started by a team comprising doctors and physiotherapists. Our aim was to enhance detection of possible sarcopenia and reduce time to delivery of targeted physiotherapy interventions to 1 working day from

Intravenous diuretics remain the mainstay of treatment for patients admitted with decompensated/acute heart failure. NICE recommends close monitoring of the renal function, body weight and urine output during diuretic therapy as part of the initial pharmacological treatment of acute heart failure. The aim is to ensure a safe and satisfactory response to treatment. We looked at the compliance to serial measurement of Body Weight and Fluid Balance in the geriatric population admitted with Decompensated/Acute Heart Failure to Acute Care Units at Kettering General Hospital. Fifty (50) patients, 65

Title: An audit examining the post-fall management of inpatient falls resulting in neck of femur (NOF) fractures. Background: Inpatient hip fractures are a significant cause of morbidity and mortality in older patients. National audits have identified multiple delays in the care of these patients. Aims To analyse the pathway of patients sustaining an inpatient hip fracture at our trust Method: We examined medical records of patients sustaining inpatient hip fractures from 2020-2021 to collect data on; transfer method from floor, time to medical and geriatrician review, documentation of

Introduction: Aspiration pneumonia is a common condition, particularly in older patients, with impaired swallowing being a significant risk factor; however, it can be difficult to recognise and no specific management guidance existed nationally until the British Thoracic Society Clinical Statement was published in March 2023. In this audit, we assessed the management of patients admitted with aspiration pneumonia to Leighton Hospital, Crewe. Methods: We retrospectively collected data from a random sample of patients ≥64 years old admitted to the Acute Medical Unit with aspiration pneumonia

Catheter-associated urinary tract infections (CAUTIs) represent a large proportion of nosocomial infections. Hence, catheters should be inserted only when indicated and plans should be made to remove them as soon as possible. This will reduce the incidence of CAUTIs, lead to a better patient experience and reduce overall NHS burden. The aim of this audit is to identify whether the catheter care bundle is being filled as per NICE guidance. This is a prospective audit involving 50 patients from the geriatrics ward who were catheterised from November to December 2021. We analysed the

Background Patients aged over 65 years old account for a significant proportion of the attendances to emergency departments (EDs). Cognitive impairment (CI), including delirium and dementia, can be a common finding in this population and when undiagnosed, can be a significant contributor to morbidity and mortality. Our aim is to audit, against clinical standards, the assessment of cognitive impairment in those aged over 65 in the Birmingham City Hospital ED. Standard All patients aged over 65 are assessed for CI in ED, using a validated tool. Whenever CI has been identified, there is

Background Nationally, the average rate of discharges drops by over a third over the weekend and prioritising these discharges is recognised by NHS England in improving patient care and facilitating the flow of patients through the hospital.(1) Aims To assess the documentation of criteria for discharge in Care of the Elderly wards for patients who were identified as having an estimated date of discharge within 72 hours and could be discharged over the weekend.Guidance from NHS England recommends clear plans to be documented in all patients notes detailing social, physiological and functional

Background: This project was carried out in a district general hospital, it included multiple teams working under the supervision of the same clinical lead, between 2019 and 2021. Introduction Asymptomatic bacteriuria is commonplace among patients above 75 years of age (Manisha Juthani-Mehta MD, Volume 23, Issue 3 , August 2007, Pages 585-594). Local guidelines informed by the Scottish Intercollegiate Guidelines Network on UTI management July 2012, therefore advise the importance of sending urine for culture only in cases, where minimum clinical diagnostic criteria are met. Methodology The

Background: Elderly patients report less positive experience of hospital admission than younger patients 1. Targeted interventions have been shown to improve patient ability to perform activities of daily living and reduce frequency of discharges to long-term care facilities. Additionally, non-pharmacological interventions reduce incidence of delirium and prevent falls 2. We aimed to improve the inpatient experience on a care of the elderly ward through use of a recreation room for mealtimes and recreational activities. Methods: We performed a quality improvement project using patient and

Background: Type II Diabetes Mellitus (T2DM) is a common condition managed by geriatricians. Drugs and treatment goals for T2DM are individualized to patient profile and physician preference. Some diabetic medications are also known to affect appetite and subsequently, nutrition. The authors examined whether there is a correlation between glycemic control and malnutrition in older adults. Methods: This cross-sectional study enrolled patients > 70 with T2DM in a teaching hospital in Singapore. Data was collected on age, sex, ethnicity, body-mass index (BMI), function (iADL-impairment), Barthel

Poster Title: CT head requests – Are they clinically indicated? A QIP conducted in Acute Frailty Unit (AFAU) at Princess Royal University Hospital. Aim: 1. To find out how many inpatient CT heads are being completed for patients reviewed at AFAU. 2. To assess the main indications for requesting a CT head. 3. To assess how many CT heads were not clinically indicated, and to explore if there are any particular reasons why non-indicated scans are being done. 4. To identify areas of improvement in relation to CT head requests. 5. To improve the CT head request practice to 90% in a period 3 months

Background: Older individuals living with frailty face a heightened risk of experiencing significant deterioration in their mental and physical well-being following seemingly minor health challenges. Our aim was to assess and enhance the practice of the Clinical Frailty Scale (CFS) during inpatient assessments within a large teaching hospital. Methods: We conducted 2 cycles of retrospective data collection within a single centre setting, screening a total of 600 patients focussing on; age ≥65, level of frailty, location of CFS assessment - Emergency Department (ED), Medical Assessment Unit

Introduction Older people living with frailty are often prescribed many medications exposing them to potential medicine-related harm. Pharmacists are a new addition to the East Kent Community Frailty Team, which otherwise consists of doctors and advanced clinical practitioners at various levels of training. Pharmacists are ideally placed to develop medication review processes and support fellow clinicians with deprescribing efforts in frailty. This audit set out to determine current levels of medication review and associated cost-savings through deprescribing. Method All patients admitted to

Introduction Factors contributing to frailty result in increased hospitalisations, with 5- 10% of patients attending Accident and Emergency department living with frailty, and 30% of those patients admitted to acute medical units (Conroy, 2013). Hospital admissions result in functional decline and deconditioning (Get It Right First Time, 2021). The number of people in the UK over the age of 85 is set to double in the next 20 years and treble in the next 30 (Office of National Statistics, 2013). Their needs are best met in the community with a multi-disciplinary approach. Method Patients

Introduction -The use of anti-psychotics is higher in older people than their younger adult counterparts due to high prevalence of dementia/delirium. Anti-psychotic drugs cause side effects which include cardio vascular, metabolic, extra pyramidal and high risk of falls. So, we set out to do a QIP on antipsychotic medication prescription on our Geriatric wards and compared it with NICE guidelines. Method- We had 2 approaches to use. Firstly, we prepared a check list for anti-psychotic medication monitoring according to NICE guidelines 2021 and we applied this retrospectively to 17 patients who

Introduction: The number of older adults has been constantly growing around the world. Chronic disease occurrence and concurrency increase with age, and medication use rises correspondingly. The World Health Organisation (WHO) defines multi-morbidity as the “ co-occurrence of two or more chronic medical conditions in one patient.” The most commonly used definition of Polypharmacy is “taking co-currently five or more medications daily by an individual.” Polypharmacy is associated with increased mortality, falls, adverse drug reactions, hospital stay, readmission, and medication costs. STOPP

The 2022 national heart failure audit noted, "Older patients are less likely to access diagnostics, lifesaving drugs, and specialist care.” Additionally, there is evidence suggesting that they are less frequently initiated on disease-modifying drugs (DMD). The National Institute for Health and Care Excellence (NICE) supports the use of SGLT2 inhibitors for those with heart failure with reduced ejection fraction (HFrEF). However, this has recently expanded to those with preserved ejection fraction (HFpEF). This is significant for elderly heart failure patients as SGLT2 inhibitors offer a

Background: Clear and accurate documentation of a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision is vital to ensure patients receive appropriate care and autonomy regarding their end-of-life management. Inaccuracies or omissions allow potential for unnecessary or harmful interventions to occur. Aims/Objectives: To produce ≥20% improvement in accuracy and overall completion of all sections of respiratory inpatient ReSPECT forms, with particular focus on DNACPR decisions, during a four-month respiratory

Introduction The PROMOTe trial was conducted entirely remotely, which aimed to enable a wider recruitment of participants, minimise risk of Covid-19 exposure and adhere to former travel restrictions. Participant experiences with remote clinical trials are not well understood. This work aimed to characterise participant perspectives on the remote delivery of the PROMOTe trial. Methods The trial involved remote measurement of short physical performance battery and grip strength, and remote collection of stool, urine, saliva, and capillary blood. Equipment including a dynamometer was posted to

Effect of Early Intervention By Physiotherapy And Occupational Therapy On Older Inpatient Population S Kotak 1, C Miller 2 1 Senior Physiotherapist, University Hospitals of Leicester NHS Trust 2Consultant Geriatrician, University Hospitals of Leicester NHS Trust Background: Currently, on inpatient medical wards at University Hospitals of Leicester NHS Trust, the first contact by therapy teams (physiotherapy and occupational therapy) is made when patients become medically optimised for discharge. This is due to a number of reasons such as staffing and resource shortages. Aim: Analyse the