Posters

Introduction: Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision and plan for escalation of care are essential components of holistic care for frail and elderly patients. Inappropriate resuscitation attempts in those populations lead to distress and harm. Improving communication about end-of-life care plan between healthcare professionals and patients/ families is key to delivering dignified care and reducing emergency “inappropriate crash calls”. Aim: The aim of this project was to assess and improve the completion rate of DNACPR forms and care escalation plans for patients

Background: The Comprehensive Geriatric Assessment (CGA) is a multidimensional interdisciplinary tool, designed to promote holistic care of elderly patients and provide a framework for intervention. There is evidence that the CGA reduces mortality and slows progression of frailty. Performing such interventions in the acute setting can be complex and time-consuming. Introduction: The Older Person’s Assessment Unit (OPAU) at Weston General Hospital allows early identification of frailty and prompt intervention. We aimed to promote elements of the CGA by providing a tool for utilisation

A lighter load: Tackling ACB (Anticholinergic burden) in geriatric wards: Background: Exposure to high levels of anticholinergic and sedative medications significantly increases the risk of fall-related hospitalizations, delirium, and mortality in the elderly. While the dangers of traditional anticholinergic medications are well-documented, the cumulative effects of drugs with mild to moderate anticholinergic properties often go unrecognized in everyday clinical practice. Objectives: To identify the primary contributors to anticholinergic burden (ACB) in geriatric wards and propose practical

INTRODUCTION Polypharmacy represents a significant challenge in the vulnerable elderly population, where concurrent use of multiple medications increases the risk of interactions and adverse reactions, often precipitating acute events and complicated hospital stays. This necessitates thorough medication reviews to mitigate these risks; a hospital admission allows for such opportunities. METHODS This project aimed to evaluate and address the medication burden among elderly patients, following WHO's Global Patient Safety Challenge: Medication Without Harm. 50 patient’s medications were reviewed

Background: The UK National Osteoporosis Guideline Group (NOGG) guidelines 2021 recommend that all older patients presenting to geriatric clinics or wards should have a FRAX assessment guide BMD measurement and referral for DEXA or starting of drug treatment. Aims: 1) To increase the proportion of patients assessed by the acute frailty service (AFS) undergoing FRAX assessment to 85%. 2) Offer 85% of AFS patients with low-risk FRAX scores lifestyle advice. 3) Refer 85% of AFS patients with intermediate (below treatment threshold) FRAX scores for DEXA scans. 4) Refer 85% of AFS patients with

Improving Advance Care Planning Within Residential Homes Introduction: As care home residents are living with advancing frailty and multi-morbidity, it is important to initiate advance care planning as part of the comprehensive geriatric assessment and create universal care plans (UCPs). There is evidence that it can reduce inappropriate escalations of care, reduce hospital admissions, increase the proportion of residents dying in their preferred place and improve both resident and relative satisfaction. Method: Retrospective audit in June 2024 of residents within the five residential homes

The elderly population ( cut off 65 and over, for this audit) are being increasingly prescribed direct oral anticoagulants(DOAC) for prevention of stroke in atrial fibrillation/ prevention and treatment of DVT/PE.This poses significant difficulties when stopping/ restarting these medications in the peri-operative period , due to the ever changing clinical circumstances in this period. Therefore , we performed an audit( in Glangwili Hospital, Jan-July 2024) , using the Welsh Frailty Fracture Network guidelines as our standard and found out(during the first cycle) that around 40 percent of

Introduction: Delirium is common in hospital inpatients, under-recognised, and associated with increased morbidity and mortality. NICE quality standards are that all at-risk adults newly admitted to hospital receive tailored interventions to prevent delirium. Aims: 1. To reduce time to diagnosis of delirium. 2. For 100% of patients with delirium to have tailored interventions, including behaviour/ bowel/ food charts, medication reviews, and family involvement. 3. To increase junior doctors’ confidence in recognising and managing delirium. Methods: Two changes were implemented and three cycles

Introduction: There is limited data on the prevalence of hypertriglyceridemia (HTG), a recognized risk factor for cardiovascular disease, in the northeastern region of Colombia. Therefore, we aimed to characterize the local prevalence of HTG and cardiovascular disease-related variables in the subsidized regime population of a city in northeastern Colombia during the period 2020-2022. Materials and Methods: We conducted a retrospective review of medical records from all health centers in Bucaramanga, Santander, Colombia. The study included patients aged 60-95 years who were part of the

Introduction Physical activity (PA) and replete nutritional status are key to maintaining independence and improving frailty status among frail older adults. We aimed to evaluate the feasibility and acceptability of training volunteers to deliver a remote intervention, comprising exercise, behaviour change, and nutrition support, to older people with frailty after a hospital stay. Methods Volunteers were trained to deliver a 3-month, multimodal intervention to frail (Clinical Frailty Status ≥5) adults ≥65 years after hospital discharge, using telephone, or online support. Feasibility was

Introduction: There are abundant anecdotal reports of healthcare professionals undergoing strain, specifically moral distress, in advance care planning (ACP) related work. This study measured perceptions of morally challenging scenarios (MCS) faced by ACP facilitators and frontline clinicians. Method: An online survey, which is currently ongoing, was sent to the ACP community and also frontline clinicians in Singapore. Purposive and snowballing sampling approaches were employed. Result: Participants rated their opinions on 23 MCS in ACP-related work that were earlier identified from 30

Introduction: A Clinical Audit was recommended by the ME following identification of potential safety signal because of possible non-compliance with guidelines on Anticoagulation in AF. The audit data collection tool was developed in discussion with the Chief Pharmacist and took account of up-to-date prescribing guidance from the Integrated Commissioning Board (ICB). Aim of the audit was to identify if, as per NICE guidelines patients had: o Risk for stroke (CHA2DS2-VASc) and bleeding (ORBIT) is assessed upon new diagnosis of AF? o Made aware of their risk assessments and involved in

Background: Prostate cancer and bladder outlet obstruction, often treated surgically, are increasing in the aging population, leading to more cases of stress urinary incontinence (SUI). While implantable continence devices are beneficial for many, a growing number of frail patients are unsuitable for surgery and rely on incontinence pads or penile clamps, which are limited to three-hour use to prevent tissue ischaemia. We present the first UK evaluation of the new PaceyCuff penile clamp, designed for 24-hour wear while maintaining blood flow, to assess its efficacy, safety, and impact on

Background: This cross-sectional study aimed to assess the socio-demographic, anthropometric, and patient characteristics of 94 Yoruba speakers aged 60 years and older, and to validate the Yoruba version of the Clinical Frailty Scale (CFS). Methods: This study used a cross-sectional design with a purposive sampling technique and a sample size of 94 participants. This study also made use of the World Health Organization methodologic guidelines on cultural adaptation of clinical scales. Convergent validity was assessed by evaluating the context that the Clinical frailty scale (CFS) relates to

Introduction: Hospital at home (HAH) is growing apace in the United Kingdom, offering hospital-delivered treatments at home. In parallel, increasingly structured alternative training pathways are being created to enable doctors to train outside of formal specialty training programmes. With a need to train doctors to work in community settings, a HAH rotation within a locally developed internal medicine training (IMT) programme at one large NHS Foundation Trust was evaluated. Method: A questionnaire was designed to review the alignment of HAH rotation experience with the IMT curriculum and its

Background: Delirium is a common and reversible neurobehavioral condition with significant morbidity and mortality ramifications for older patients. Consequentially, clear guidelines exist pertaining to its swift identification and management. However, studies suggest that adherence to these guidelines are poor. This audit aimed to evaluate compliance to the National Institute for Health and Care Excellence’s (NICE) delirium guidelines in an Acute Senior Health Unit (ASHU) and to present a single centre experience of a low-cost ward-based intervention for improving delirium guideline adherence

Introduction: Navigating dementia care is challenging, but patient navigation (PN) offers valuable support for this population. The "Navigating Dementia NB / Naviguer la démence NB" program piloted a PN program in New Brunswick, Canada, targeting people living with dementia (PLWD) and their carers. The program aimed to assist participants in navigating health and social care systems, matching their needs with available services. Methods: Navigating Dementia NB was co-developed by researchers, patient partners, and clinicians. This pilot program embedded six PNs in primary care clinics/centers

Introduction: Receiving a dementia diagnosis can be overwhelming for persons living with dementia (PLWD) and their carers. Accessing information and home supports can be challenging. Having access to a Patient Navigation (PN) program is one way that may assist PLWD and their carers. Methods: This study used a mixed methods design and involved the implementation of a Patient Navigation (PN) program in 6 primary care settings in New Brunswick, Canada, between July 2022-July 2023. PLWD/carers living in their own homes were eligible to enroll. Results: There were 150 PLWD with a mean age of 76.77

Introduction: Orthostatic Hypotension is a significant cause of falls leading to injury and morbidity in elderly population. In an online survey by Royal College of Physicians (RCP) 271 out of 316 clinicians routinely performed these measurements and there were significant variations in how lying and standing BP is performed. This could have adverse effects on detection rates and accuracy of the procedure resulting in misdiagnosis. As a result, RCP has released guidance on L/S BP2 measurements in view of standardising practice and improving accuracy. The purpose of this QIP is to improve how L

1. Introduction Both increased frailty and multi-morbidity are independently associated with high mortality and increased risk for nursing home placement. There is limited data on the best ways of assessing frailty and complex comorbidities to guide patient selection for rehabilitation. It is important we do not deprive an individual of the chance of inpatient rehabilitation, but this needs to be balanced with potential poor outcomes at one year due to frailty and comorbidities. 2. Method Data was collated retrospectively on all discharged patients over a 90-day period from May to July 2023. A