Posters

Introduction The weekend on-call team attends ward emergencies and front door new assessments. The extra routine ward work results in delays in the new assessments and adds further exhaustion for the on-call team, impacting junior doctor’s well-being and patient safety. Objective Aim to improve patient safety by facilitating the continuity of patient care over the weekend Method Group discussions among junior doctors, nurses, pharmacists, and ward managers were done to understand the challenges that impact communication. The average time spent on a ward by on-call team was 60 minutes. Plan-do

Introduction  People with Parkinson’s (PWP) are twice as likely to fracture and over twice as likely to develop osteoporosis (1. Henderson et al, Parkinsonism & Related Disorders, 2019, Vol.64, pp.181-187). This is associated with significant morbidity (1). Assessment of bone health is often overlooked in clinic (2. UK Parkinson’s Excellence Network, 2019, pp.4-56), deeming it a priority area for improvement. Our project focuses on implementing routine bone health assessment for PWP in clinic, to achieve better standards of care.    Methods  This was a 12-week medical student led project

Postural Hypotension also known as orthostatic hypotension is defined as an abnormal drop in blood pressure on standing after periods of sitting or lying down, with a sustained reduction of systolic blood pressure of at least 20mmHg and/or diastolic blood pressure of at least 10mmHg. The prevalence of postural hypotension increases with age with one in five community-dwelling adults over the age of 60 years old and one in four people in long term residential care, which will ever grow with the growing elderly population. By discussing with patients on our ward it was clear that patients were

Introduction Old age psychiatry wards facilitate patients who have physical health needs alongside mental health needs, deeming them high risk for falls. Following a fall, best practice suggests a doctor should perform a medical review. An audit of this was performed within the Harplands Hospital in-patient elderly care psychiatric ward, which revealed incomplete documentation or the absence of a review. Subsequently, a post-falls proforma was implemented and a re-audit was performed. Method Audit cycle one gathered data on post-falls documentation between August and September 2020. A falls

Introduction: The Older Person's Assessment Unit (OPAU) Physiotherapy team have been collaborating with Breathe Arts Health Research (BAHR) to provide ‘Dance for Strength and Balance’ (DSAB) classes for Older Adults as an alternative to traditional, long-established Strength and Balance Group (SABG). Previous preliminary data established DSAB to be safe and effective in falls risk reduction for participants. The primary aim of this service evaluation was to determine if DSAB is at least as effective as SABG for improving outcomes and reducing falls risk for OPAU patients. Methods: 46 DSAB

An 86-year-old lady, presented with an unwitnessed fall with no obvious head injury. Her Glasgow Coma Scale (GCS) was 15 on arrival. She denied precipitating factors, taking blood thinners or seizure medication. Her examination revealed tongue biting, suprapubic tenderness, and pain in both hips and arms. An X-ray of the possible affected joints was ordered. Bloods and venous blood gas (VBG) were unremarkable. Within a few hours, she had a witnessed tonic-clonic seizure with a swollen tongue, for which lorazepam and adrenaline were administered. Repeat VBG (post-ictal) revealed a high lactate

Fractures occurring after “low energy trauma” are described as fragility fractures. They most commonly happen in the spine, hip and wrist due to osteoporosis and its associated risk factors, including gender, age, medications (e.g. steroids), etc (1). Menopause in women also has a drastic impact on the risk of osteoporosis. In 2019, 3,775,000 UK citizens had a diagnosis of osteoporosis - 820,000 men and 2,955,000 women. In the same year, there were 527,000 new fragility fractures in the UK (2). Nevertheless, osteoporosis and fragility fractures do not only pose a problem within the UK. It is

During the pandemic, diagnosing Dementia has declined significantly by over 35%. A Collateral history refers to information obtained from individuals other than the patient, such as family members, friends, or caregivers. This information is often crucial and can provide valuable insights into a patient's medical history, symptoms, behaviours, and social circumstances. Studies have proven a collateral history can enhance medical assessment, improve treatment planning, aids safety concerns and act as a diagnostic aid. By obtaining information from multiple sources, Doctors can compare the

Background: The serious outcomes of outbreaks of COVID-19 in care homes have been described internationally. The experiences of professionals working through outbreaks has received less attention, missing opportunities to acknowledge and learn lessons. Our aim was to explore the experiences of care home staff in Scotland of managing COVID-19 within their homes to help inform understanding and future practice. Methods: From April to August 2022, 34 individual semi-structured interviews were conducted with care home staff working in homes which experienced an outbreak(s) of COVID-19. Reflexive

Introduction: One of the key action areas of the World Health Organization (WHO) third Global Patient Safety Challenge ‘Medication Without Harm’ (WHO, 2017) is to reduce severe avoidable medication-related harm and address polypharmacy. NICE guidance on falls risk assessment and prevention also includes medication review as part of its recommended multifactorial risk assessment (NICE, 2013). Use of Falls Risk Increasing Drugs (FRIDs), along with polypharmacy and anticholinergic burden (ACB) are known to increase the risk of falls, particularly in older people. Method: This research

Introduction: The number one reason for older people to be taken to hospital emergency departments is a fall 1. An “Ambulance Improvement Programme Pillar” 2 is trying to reduce conveyance to hospital for falls, however it is not understood how the attending clinician’s confidence impacts decision-making. The objectives were to assess recruitment rate and feasibility of online survey delivery, and determine the experiences and confidence of frontline emergency clinicians in attending older adults who have fallen. Method: Online cross-sectional survey, undertaken in one English ambulance

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. Previous work highlights drivers, but not experiences that explain why they occur. Aim: to determine the experiences and confidence of frontline emergency clinicians

In 2021, Cardiff and Vale University Health Board’s average length of stay (LOS) in Assessment Unit (AU) for over 75-year-olds was 24.2 days, due to long waits for inpatient beds. Once admitted, 23% of patients moved wards three or more times. Patient experience scores indicated poor satisfaction levels, with nearly 50% of patients feeling their needs had not been met. Staff consensus was that the environment was unsuitable for older patients. The implementation of an enhanced frailty service began in November 2022. This was managed by a geriatrician-led team, with support from junior doctors

Introduction: The use of pneumonia scores to stratify the prognosis is very useful in general terms, since it allows objectively evaluating the risks in these patients. The main objective was to determine the usefulness of pulse oximetry as a substitute for urea of the CURB 65 score in the evaluation of the severity of comunity acquired pneumonia (CAP) in patients. Methods: open-label, mixed-type study, first cross-sectional phase Test vs. Test, second phase follow-up at 8 and 30 days. Carried out between November 2017 and April 2018. Results: 5 patients, gender distribution was comparable

Introduction: Ischaemic stroke has a poor prognosis, and hemorrhagic transformation after intravenous thrombolysis may increase morbidity and mortality in these patients. Methods: By means of a retrospective analysis, related risk factors were recruited for the analyses, including: smoking, alcohol, hyperlipidemia, and diabetes, among others. The statistical analysis was performed by ANOVA for quantitative variables and the Chi-square test for qualitative variables. Results: The study was carried out on 52 patients with acute ischaemic stroke treated with recombinant tissue-type plasminogen

Introduction: It is still debated whether hypothyroidism is an independent risk factor for cardiovascular events. Our objective was to evaluate the association between hypothyroidism and the risks of cardiovascular events and mortality through 3 stratification systems. Methods: A retrospective study was carried out by reviewing medical records in the period of January 2015 - December 2017 in a South American hospital. Geriatric patients who had fasting total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, and plasma glucose were included. Quantitative variables are

Introduction We plan fast-track discharges when a person has limited life expectancy and is reaching end of life. When such patients are identified, we use a simple fast-track tool to minimise the delay and reduce the need for in-depth assessments and paperwork. Despite being used very widely, there is very little data in literature regarding the indications for fast-track discharges and life expectancy of patients following discharge. We conducted this observational study to answer these questions. Methods We collected data over a three month period from the fast-track applications focusing

Introduction Postural BP readings are important in assessing older people, but are infrequently measured (1) The National Audit of Inpatient Falls (NAIF) 2022 has shown measurement of lying standing blood pressure (LSBP) remains below 50% (2) NICE guidelines suggest checking LSBP in patients with: 1) Hypertension and postural hypotension symptoms 2) Hypertension and Type 2 diabetes 3) Hypertension and age ≥ 80 years (3) 4) Patients presenting with falls (4). We aimed to update local data for LSBP recording and investigate LSBP measurements in hypertensive patients. Method Data was collected

Introduction: Delirium is a common presentation in older people and associated with falls risk, longer inpatient stay, post-discharge institutionalisation, accelerated cognitive decline and higher mortality. While median duration of delirium is reported as 1 week but for one third patients, symptoms may persist 3 months or more, even a proportion of patients will never fully recover to their pre-delirium cognitive baseline. It is essential we are sharing the diagnosis with people and their relatives in order to provide information, facilitate discussions around the risks of hospital versus

Introduction: Urinary incontinence, one of the original geriatric giants, is frequently overlooked despite its potential for reversibility and profound impact on older adults. The purpose of this audit was to evaluate the prevalence of continence and utilisation of incontinence wear among inpatients in a rehabilitation facility. Methods: Continence care quality in a medical gerontology ward was evaluated using the Royal College of Physicians (RCP) National Audit of Continence Care (NACC) standard. A prospective audit was conducted over a five-day period, documenting continence wear and urinary