Posters

Introduction CompreHensive geriAtRician-led MEdication Review (CHARMER) is a behaviour change intervention to support geriatricians and pharmacists to proactively deprescribe inappropriate medicines with older adults in hospital. The intervention comprises: formulating a deprescribing action plan, workshops, benchmarking reports and weekly briefings between geriatricians and pharmacists. We assessed feasibility and acceptability of the CHARMER intervention and study processes. Method A two-arm purposive allocation feasibility study was undertaken in four hospitals (three intervention, one

Introduction Reduction in outpatient appointments during the COVID-19 pandemic and patient concern surrounding risk of contracting COVID-19 by attending day-case settings, resulted in delayed or cancelled medical treatments including Zoledronic Acid infusions as management for Osteoporosis. This, alongside recent research concluding that these treatments can be given safely as early as 1-2 weeks post-fracture, lead to the adaptation of protocol at Hull University Teaching Hospitals Trust in 2021, to provide rapid loading of Cholecalciferol over 6 days, prior to administration of Zoledronic

Introduction: Around 10% of calls received by English ambulance services are for older adults who have fallen 1; with an ageing population there are significant care provision needs. Decision-making on the treatment for people who fall, can impact their future physical and mental health. Previous research in decision-making of ambulance staff found perception of role, confidence, service demands and training to be key drivers 2. The previous work highlighting drivers, but not the experiences that explain why they occur, leads this study aim to determine the experiences and confidence of

Introduction: In-hospital CPR has survival rates of 15-20%[ BMA. Decisions on CPR, 3 rdedition, 2016], further reduced with frailty and multimorbidity. Successful CPR is associated with significant morbidity and prolonged suffering. Do not attempt resuscitation (DNACPR) is an advanced medical decision, aimed at preventing harm where CPR is considered futile.[ GMC Guidance.p128-145] Aims: To reduce the burden of inappropriate CPR within surgical specialties using the following standards: DNACPR status reviewed on admission, and all decisions implemented within 24hours of clerking. DNACPR

Background: An estimated 10% >65-year-olds and 25-50% >85-year-olds live with frailty in the UK, 1 making up a greater proportion of surgical caseloads. Perioperatively, frailty is an independent risk factor for adverse outcomes. 2,1 Timely recognition and assessment is vital in prevention, however, awareness of frailty and the Clinical Frailty Scale 3 (CFS) is limited amongst clinicians. 4 Methods: A survey was completed by doctors of all grades across surgical specialties in Sandwell General Hospital. Questions explored recognition of frailty, use of CFS, and their influence in perioperative

Aim: Several patient selection scores have been developed to identify patients suitable for SDEC from triage in Emergency Departments (ED) and the acute medical intake. Scores are designed to improve system efficiency, overcrowding and patient experience. Studies have been conducted that compare these; none in frail older adults. This study compared the Glasgow Admission Prediction Score (GAPS), Sydney Triage to Admission Risk Tool (START) and the Ambulatory Score (Amb). Methods: The Older Person’s Assessment service (OPAS) is ED based, accepting patients with frailty syndromes aged >70 years

Introduction: Frailty is a condition that makes it increasingly difficult for individuals to recover from adverse health events and gradually erodes independence. NHS interventions in England have focused on those with more severe frailty. We tested HomeHealth, a home-based, tailored, multi-domain (six-session) behaviour change intervention to promote independence in the over-65s living with mild frailty, in a RCT recruiting 388 people (intervention 195; control 193). HomeHealth was delivered by the voluntary sector in three diverse areas and addressed mobility, nutrition, socialising, and

INTRODUCTION Postural hypotension (PH) is an identifiable and potentially reversible cause of falls in the elderly patients admitted to hospital. The National Audit of Inpatient Falls recommends lying and standing blood pressure (LSBP) measurement for patients aged over 65. Our project aims to review current clinical practice and to develop a standardised approach to correctly investigate and manage PH in patients admitted following a fall to the geriatric department. METHOD: We performed two cycles of retrospective data collection across three geriatric wards, looking at percentage of

Background: Delirium is a fluctuant clinical syndrome caused by an underlying condition not better explained by a pre-existing neurocognitive disorder. Clinical presentation is characterised by alterations in attention, cognition and consciousness. It is categorised into hyperactivity and hypoactivity based on behaviours displayed. 25% of elderly patients are diagnosed with a delirium on admission to hospital. Delirium is associated with a 70% mortality rate 6 months post discharge. R.A.D.A.R is a 3 part questionnaire recommended by NICE to use as a daily screening tool to aid early diagnosis

Title: A quality improvement project on falls prevention in patients admitted under the surgical team. Modifiable and non-modifiable factors contribute to falls in older people. Our aim was to examine prevalence of risk factors for falls in patients >65 admitted under the surgical team and prevent readmittance through signposting to falls clinic. The first cycle of this QIP involved a review of all sets of charts for patients >65 (n=12) admitted under the surgical team with fall-related injuries between Dec 2022- April 2023. Parameters examined included whether an electrocardiogram (ECG), CT

Background: The development of integrated care occurs alongside climate emergency, where transport is a large contributor to carbon emissions (1). Care previously delivered in hospital outpatients, or a central ‘hub’ is now being delivered in integrated care clinics, “spokes”. We aimed to assess the environmental impact of transport to integrated care clinics. Methods: Geriatric Medicine Integrated Care attendances from January 2023 to March 2023 were included. Distance from the patient’s home address to the location of Integrated Care Clinic(spoke), and to the affiliated hospital(hub) were

Background: Environmental changes make hospitals a difficult place to sleep, especially in busy units such as acute medicine (AMU). Poor sleep can lead to a deterioration in stress responses, slower wound healing, delirium, acute worsening of dementia, along with many other complications. Elderly patients are particularly susceptible to these effects. In turn, these effects lead to longer hospital stays and poorer outcomes. Objectives: Evaluate the factors leading to reduced sleep quality on AMU Put into place effective measures to improve sleep quality Determine if the standardised use of

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