Posters

Delirium in hip fracture patients admitted from home is associated with higher mortality, longer total length of stay, need for post-acute inpatient rehabilitation and readmission to acute services: The IMPACT Delirium study RS Penfold1,2, AJ Hall2,3,4, A Anand5, ND Clement2,4, AD Duckworth4,6, AMJ MacLullich1,2 1. Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, UK 2. Scottish Hip Fracture Audit, Edinburgh, UK 3. Department of Orthopaedics, Golden Jubilee University National Hospital, Clydebank, UK 4. Edinburgh Orthopaedics, Royal

Introduction Despite the high prevalence of frailty among older people, the clinical definitions and implications of frailty are not well understood by the public. Existing communication material is predominantly technical in nature and aimed at healthcare professionals. This project integrated expertise in geriatric medicine, data science, user design and patient and public involvement (PPI) to develop an accessible visual communication resource on frailty that linked data stories, clinical perspectives and public views of frailty in later life. Methods We recruited three public contributors

Introduction: Perioperative medicine for the Older Patient undergoing Surgery (POPS) is an established, evidence based medically led service across many Trusts. However, with consultant workforce constraints, the aim was to determine if an alternative ACP led model of care, with consultant geriatrician oversight, delivered the same benefits. Method: • A senior nurse, with POPS expertise, was seconded for one year to oversee the project. NHS Elect network supported, from February to October 2022, with monthly meetings, data analysis and facilitated shared learning from other sites • An ACP from

Introduction: The study is to explore how childhood health status ( X), early life adversities ( M1), financial condition ( M2), and satisfaction with social networks ( M3) are associated with the development of suicidal ideation ( Y) over time among older adults in 13 European countries. Respondents were drawn from the Survey of Health, Ageing, Retirement in Europe (SHARE) conducted in 2013 (Wave 5), 2015 (Wave 6), 2016 (Wave 7), and 2020 (Wave 8). 56.8% (n=10043) of respondents were female, and 43.2% (n=7642) were male. The mean age at Wave 8 was 72.35 (range 60-103). Method: The conditional

Introduction: Oral nutritional supplement (ONS) prescription is commonly recommend for malnourished patients in hospital. However, compliance to ONS is often low. Ice cream may be a promising nutritional intervention. We undertook a study designed to compare the acceptability of high protein, fortified, ice cream called Nottingham-Ice Cream (N-ICE CREAM) with routinely prescribed milkshake ONS. Methods: Fifty older (≥ 65 years) inpatients with hip or spine fractures were recruited from Queens Medical Centre, Nottingham. Patients were randomised into two groups, receiving two days of N-ICE

Introduction : The delayed discharge is defined as patient is deemed medically fit to leave hospital but is unable to do so for non-medical reasons. Delayed discharges are associated with mortality, infection, depression, reduction in patients' mobility and their daily activities. Aim and Objectives: 1.Recognition of different causes of discharge delays will allow health professionals, hospital administrators to propose potential strategies for minimising delays. 2.To identify causes of prolong delays in discharge among elderly patients.3. To propose strategies for eliminating advisable delays

Introduction: Following COP26, the NHS pledged a ‘Net Zero’ health service by 2040. Incineration of clinical waste has a negative impact on the environment whilst also being extremely costly. NHS Grampian spends over £1m annually on disposal of clinical waste, whilst 20% of the waste incinerated is unsuitable for that waste stream. An excess of clean plastic packaging from visors, used when managing respiratory viruses, was a particular contributor in our unit. To improve sustainability, the aim of this quality improvement project was to reduce unnecessary disposal of plastic packaging in

Background Effective communication is a vital attribute in the healthcare profession. Ineffective communication between healthcare professionals and patients can impede patient safety. The three most common complaints received by GMC were related to medical treatment, communication problems and perceived lack of respect for the patient 1. In a study undertaken across three NHS trusts in England between May 2013 and September 2014, 22% of the incidents reported were associated with communication 2. Inefficient record-keeping related to communication was the issue. Methods To evaluate the

Background: The role of rehabilitation medicine in treating post-acute COVID-19 survivors is currently ill-defined. Recently developed evidence-based initiatives, such as Cochrane REH-COVER, aim to describe the management of COVID-19 patients, but the variance and overlap in intervention types result in clinical uncertainty. Objective: To provide a summary of delivered rehabilitation services for COVID-19 patients during the pandemic. Methods: We collected evidence from the full set of REH-COVER Rapid living Systematic Reviews between March 2020 and February 2022 using the supplementary tables

Introduction: Frailty is a state of increased vulnerability to physiological stressors, which is associated with increased risk of adverse outcomes such as falls and delirium in older adults. For this patient group, healthcare decisions (as in whether to undergo elective surgery or continue a burdensome outpatient treatment) often have far-reaching consequences. Despite broad consensus that healthcare decision making should be a collaborative process, studies have shown frail older adults struggle to make healthcare choices and often do not feel fully involved in the decision-making process

Background: Populations in sub-Saharan Africa are ageing rapidly and Tanzania is one country experiencing this acute demographic shift. Multimorbidity (the presence of two or more chronic conditions (1)) is common in the community and associated with greater risk of hospitalisation. To-date, the prevalence amongst older hospital inpatients is unknown. Objective: To establish the prevalence of multimorbidity amongst older hospitalised adults in northern Tanzania. Methods: For 6-months, adults aged ≥60 admitted to medical wards in four hospitals were invited to participate. A standardised

Background: As global populations age, healthcare systems are facing challenges posed by multimorbidity, disability and geriatric syndromes. In high-income countries, frailty is a strong predictor of poor hospital outcomes. Comprehensive Geriatric Assessment is effective but resource-intensive and unavailable in sub-Saharan Africa where specialist geriatric training and allied health infrastructure are limited. Objective: To establish clinical outcomes of older adults with frailty admitted to hospital in northern Tanzania.= Methods: All adults aged ≥60 years admitted to medical wards at four

Background and Aims Many medical specialty trainees report a lack of confidence in hyperacute stroke management, contributing to inefficient patient care. We identified a lack of knowledge of our pathways, as well as difficulty managing human factors, particularly communication and teamwork. We hypothesised that the implementation of a simulation-based education programme could address these issues amongst medical specialty trainees and lead to improvements in our door-to-needle (DNT) times. Methods We organised a scenario-based simulation education session for our trainees led by a multi

Aims: i) Develop and test a theory-based diagnostic instrument to assess barriers and facilitators accurately and prospectively; and ii) survey barriers and facilitators to the delivery of skin hygiene care in care homes. Background: There is an ageing population and an increasing number of people residing in care homes. As skin ages it become vulnerable to dryness, itching, cracks, and tears. These are experienced by many older people and cause discomfort, compromised quality of life, skin breakdown, increased dependency, longer hospital stays, and greater financial and human costs. These

Introduction: Sleep is an essential requirement for good health. The hospital environment is often not compatible with adequate, restorative sleep. Disruption is multifactorial and affecting parameters can be environmental, physical, or psychological. Aims: To observe the difference in sleep quality in patients on medical wards compared with their baseline and highlight areas where sleep quality can be improved. Methods: This observational study analysed patients on four medical wards at Chelsea and Westminster Hospital. Inclusion criteria: Patients with good cognition who had been in hospital

Introduction: Cognitive impairment and dementia are prevalent in Parkinson’s disease (PD) and significantly impact patients’ quality of life. Accurate prognostic indicators of cognitive decline in this population are needed. Electroencephalography (EEG), a non-invasive measure of brain activity, is one such measure. The current study aimed to systematically review which EEG indices are associated with mild cognitive impairment (PD-MCI) and dementia in PD (PDD). Method: A systematic literature search was conducted in Embase, MEDLINE, PsycINFO and Web of Science in November 2022 to identify

Background: Dementia with Lewy bodies (DLB) is one of the most common degenerative dementias, and it is associated not only with cognitive symptoms, but motor, neuropsychiatric, sleep and autonomic symptoms. There is increasing emphasis on the involvement of patients and their representatives in dementia research, but little is known about the extent and nature of surveys and qualitative research methods capturing the views of those affected by DLB. The objective of the scoping review is to determine the extent and nature of published literature that uses surveys and qualitative methods to

Introduction: At present no single symptom appears to be favoured in choosing primary outcomes for dementia with Lewy bodies (DLB) trials, nor are the perspectives of people affected by DLB reflected in their design. The aim of this study is to elicit the preferences of DLB patients and their care partners with respect to the DLB symptoms that they would most like to see improved upon by a potential therapy. We will do so using two complimentary health economic approaches in a single online survey: a best-worst scaling (BWS) exercise and a discrete choice experiment (DCE). Methods: Using

Introduction Across inpatient HSC settings ward based medicines management pharmacy technicians support ward based multi-disciplinary teams. The aim of this study was to explore the potential role and impact of a medicines management pharmacy technician and ‘stock solution’ in a Care Home facility. Method A 30 bedded private Care Home was identified for the pilot. A medicines management pharmacy technician liaised with senior nursing staff to review and understand the monthly medication ordering process. The technician audited the Care Home’s medication destruction records for 4 months and

Introduction Age is a risk factor for digital exclusion, but many older people have excellent access to digital services. Frailty may offer a clearer mechanism of exclusion. The aim of this study was to assess the association between living with frailty and digital exclusion from video consultation. Methods We undertook a multicentre cross-sectional study across primary care, interface, and secondary care services in South-West England. Patients were enrolled between 21st February and 12th April 2022. The primary outcome was complete digital exclusion from video consultation (defined as the no