Posters

Introduction: The Enhanced Health in Care Homes Framework recognises personalised advance care planning (ACP) as a key component of optimal healthcare for care home residents. We established a multi-disciplinary care home team providing comprehensive geriatric assessment (CGA), structured medication review (SMR) and advance care planning (ACP) to a pilot cohort of frail residents in 17 care homes. We aimed to explore the acceptability and perceptions of proactive ACP alongside CGA from the perspective of resident’s next-of-kin (NOK), primary care staff and care home managers (CHMs). Methods

Introduction The Scottish Care of Older People (SCoOP) collaborative regularly reports outcomes of acute geriatric medicine admissions across Scottish hospitals. The covid pandemic caused major and highly variable restructuring of acute services across the country. Their impact on activity and outcomes is unknown. Methods We collated all SMR01/SMR01E hospital episodes from Public Health Scotland from 1 st April 2017 to 31 st March 2022 where over 50% of the total episode was spent under acute geriatric medicine (code AB) and the diagnosis was not stroke. Activity and outcomes in 19 major

Introduction: Pharmacogenomics is using a patient’s genetic information to predict their likely response to a medicine. There is evidence that patients who receive pharmacogenomic-guided care benefit from a reduction in clinically significant adverse drug reactions. Therefore, pharmacogenomic testing can be used as a medicines optimisation tool to prevent adverse drug reactions in older people and reduce associated hospital admissions. This qualitative study aimed to identify the facilitators and barriers to implementing pharmacogenomic-guided prescribing in acute care for older patients by

An Acute Frailty Unit with focused MDT input decreases inpatient length of stay for older persons presenting with frailty syndrome(s). A Warner Introduction Older persons experiencing frailty are at risk of prolonged hospital stay causing adverse outcomes including mental and physical deconditioning, infections and falls (1). Tackling length of stay by ensuring patients return to their usual place of residence promptly, improves patient’s health and hospital flow (2) An Acute frailty unit (AFU) consisting of 3 male, and 3 female beds was established on the older persons ward (OPW) providing

Introduction Predicting outcomes after hip fracture is important for identifying high-risk patients who may benefit from additional care and rehabilitation. Pre-operative scores based on patient characteristics are commonly used to predict hip fracture outcomes. Mobility, an indicator of pre-operative function, has been neglected as a potential predictor. We assessed the ability of pre-fracture mobility to predict post-operative outcomes following hip fracture surgery. Methods We analysed prospectively collected data from hip fracture surgery patients at a large-volume trauma unit. Mobility

Introduction Alcohol use disorder (AUD) in older adults is increasingly common, under-recognised and under-treated within acute hospitals. Methods Consecutive patients seen by the Alcohol Care Team (ACT) at an acute NHS trust between January-April 2021 were invited to take part in a service evaluation. Baseline demographic and clinical data was collected in addition to community alcohol service referrals for all patients. For older adults (>64years), Older People’s Mental Health (OPMH) referral and hospital use data (ED attendances and admissions) in the 12 months prior/post index admission

Introduction The British Geriatrics Society and NHS England recommend that patients aged 65 and over should be screened for frailty when presenting to healthcare services to facilitate early comprehensive geriatric assessment (CGA). Recognition of frailty frequently relies on assessment by FY1s. We sought to assess a) how confident FY1s are in recognising and managing frailty, b) their understanding of CGA, and c) how these change during the year. Methods Questionnaires (quantitative and qualitative data) were given to FY1s at induction, 6 months, and 12 months. Teaching sessions on frailty

Introduction: The Enhanced Health in Care Homes Framework recognises personalised advance care planning (ACP) as a key component of optimal healthcare for care home residents ​(1)​. Documented ACP discussions guide decision-making in acute situations and may facilitate avoidance of inappropriate hospital admissions. Methods: We established a multidisciplinary care home service which aimed to provide comprehensive geriatric assessment (CGA) based ACP to all residents within three pilot care homes. We evaluated the effect of proactive, systematic CGA and ACP. Ambulance call-out and conveyance

Intro Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic method of recognising physical, psychosocial, and functional abilities & limitations of an elderly person. Assessment of the skin is an essential element of the physical domain of CGA as aging skin is more susceptible to loss of skin integrity. Common conditions including pressure sores, purpura from long term anticoagulation and steroid use, and venous stasis eczema put patients at high risk for developing infections. Therefore, it is essential to be cognizant of the condition of the elderly patients’ skin. We

Introduction: Many people with dementia (PwD) are affected by anxiety and depression, leading to significant changes in patient behaviour, carer burden and negative patient outcomes. Anxiolytics and antidepressants are commonly prescribed for PwD and may contribute to potentially inappropriate prescribing. This study aims to explore patients’ and carers’ experiences and perspectives of the management of depression and anxiety in PwD. Methods: An online discussion forum, Talking Point, hosted by the Alzheimer’s Society, was searched for relevant archived threads and posts. These were identified

Introduction: In Scotland, more than 18,000 older people are admitted to hospital after a fall each year. One in three people over the age of 65 experience a fall at least once each year (1). Neurological examination is an essential part of the initial assessment of these patients in hospital and can determine the cause of falls such as stroke, peripheral neuropathies and Parkinson’s disease. Local anecdotal evidence suggested that this was often not carried out, with the potential for delayed diagnosis and treatment. Method: Baseline data was collected from clinical notes of admissions to the

Introduction Patient and public involvement and engagement (PPIE) is essential to delivering patient centred, quality research. Older adults constitute an increasing proportion of the surgical population but are unintentionally excluded from traditional models of engagement. We describe the process and outputs of conducting PPIE to support future research examining the scale up of CGA-based perioperative services such as POPS (Perioperative medicine for Older People undergoing Surgery). Methods Patients undergoing elective surgery at four NHS hospitals in England and Wales were asked to

Background Prehabilitation in clinical trials improves fitness, improves quality of life, reduces complications, and reduces hospital length of stay It is not standard of care in routine clinical practice. This prospective observational study reports the outcomes of a clinical AHP prehabilitation service for older people undergoing major cancer surgery. Methods The LUHFT Prehab service commenced in August 2017, patients prior to major abdominal surgery for cancer were eligible for referral, this was inclusive of 8 different surgical specialties. Referred patients were invited to attend a multi

Introduction About 300,000 people living with Frailty undergo operations annually. Current evidence suggests that comprehensive geriatric assessment (CGA) pre-operatively enhances shared decision making (SDM), equity of access to surgery, length of stay (LOS) and mortality. Multiple NCEPOD reports, the National Emergency Laparotomy Audit (NELA) and National Hip Fracture Database (NHFD) programs have highlighted the unmet need in caring for these patients. Our aim was to introduce a novel combined Geriatrician/Anaesthetist pre-assessment clinic to provide better SDM and perioperative

Introduction During the COVID-19 pandemic, restricted hospital visitation policies were implemented to reduce the spread of the viral infection. As a result, telephone has become the main communication method despite the complexity of the elderly patients' medical and psychosocial issues. This has heightened anxiety and reduced satisfaction among patients and their families. This quality improvement project aimed at improving communication with patients' families. We introduced several strategies with the aim to update patients' families within 48 hours of admission and then at least once a

Introduction. Older people with frailty are at risk of adverse outcomes from hospital admission. Early identification of frailty at can help reduce these. The Clinical Frailty Scale (CFS) identifies frailty, is quick to perform and can be done in acute settings. We have a well-established a Frailty Assessment Unit (FAU) which supports comprehensive geriatric assessment (CGA) for older adults with frailty in hospital. We developed direct admission pathway for frail patients direct from our emergency department (ED) to FAU and we needed to ensure that CFS was performed in the ED. Methods. A

Introduction ‘Older People in Hospital Standards’ (2015) identifies that Older People should have care/treatment in the most suitable settings. In University Hospital Monklands (UHM) a liaison service was provided to frail patients who needed care outwith our older peoples’ wards (eg Surgical wards), led by clinicians (Consultant Geriatrician/ specialty doctor) twice weekly with support from Frailty nurses (FN). Patients were referred via multiple routes (email, letter, phone). Our aim was to develop a single point of referral, to increase capacity, be more responsive and FN led. Methods: We

Introduction: Older patients often struggle to manage and take polypharmacy. Intervention studies have measured a variety of outcomes to improve adherence to polypharmacy. However, the scarcity of well-designed trials and inconsistencies in outcomes reported and measured have resulted in low-quality evidence. It is now recommended that researchers consider using a Core Outcome Set (COS); the minimum number of outcomes that should be measured and reported in all studies in a specific area. This study explored stakeholders’ perspectives regarding the challenges older patients face when taking

Introduction: Scotland's National Dementia strategy (2017) highlights the need to improve identification and management of dementia. Hospital at Home (H@H) teams often identify undiagnosed cognitive decline as part of comprehensive geriatric assessment. A trainee ANP in dementia services was appointed in 2019 in West Lothian; before this, the average waiting time to memory clinic assessment was 6 months for a home visit, and 12 months for outpatient clinic review. Affiliated with REACT H@H, the ANP identified a significant unmet need for assessment of cognitive decline in a patient cohort

Background Person-centred structured medication review (SMR) is associated with reduced polypharmacy, adverse drug reactions (ADRs), admission to hospital and mortality. Our service development aimed to explore the cost-efficacy of a multi-disciplinary team (MDT) providing SMR as part of a comprehensive geriatric assessment for care home (CH) residents. Method We established an MDT consisting of a consultant geriatrician, specialist clinical pharmacist, two general practitioners, clinical fellow, physician associate and frailty paramedic practitioner. Training on SMR was given by the