Posters

Background NICE and SIGN guidelines recommend screening of inpatients at risk of delirium using the 4AT ( www.the4at.com) and communication of delirium to patients’ General Practitioners (GP). The aim of this audit was to establish whether delirium is currently being screened and documented, as recommended, in our Orthopaedic Trauma unit. Methods Data was collected by two junior doctors across four days (14/11/2022, 29/11/2022, 08/12/2022, 05/02/2023). Trauma and orthopaedic inpatients over the age of 65, who were more than four days post-surgery were included. Each patients’ medical notes

Introduction: Discharging patients from hospital is a complex process which requires multiple professions and processes. Late afternoon discharges can lead to admission bottlenecks and contribute to emergency department overcrowding. Focusing on discharging patients earlier in the day, can contribute to greater flow through the hospital and greater patient satisfaction. Leeds Teaching Hospital Trust (LTHT) aims to achieve 70% of discharges before 3pm. The Specialist and Integrated Medicine (SIM) department care for frail elderly patients who are at increased risk of harm following prolonged

Introduction Older adults with multimorbidity can experience poor health-related quality of life (HRQOL). Yoga has the potential to improve HRQOL. The British Wheel of Yoga’s Gentle Years Yoga© (GYY) programme was developed for older adults with chronic conditions. We investigated the effectiveness and cost-effectiveness of the GYY programme in older adults with multimorbidity. Method This was a multi-site, individually randomised, open, superiority trial with embedded economic and process evaluations. Community-dwelling adults aged ≥65 years with ≥2 chronic conditions were recruited from

Introduction Older patients admitted to the emergency department (ED) do not have a pharmacist-led medication review within the comprehensive geriatric assessment (CGA), yet the presenting complaint can be attributed to overprescribing and problematic polypharmacy. Taking ten or more medications increases the risk of hospital admission by 300% due to adverse drug reactions (ADRs)1, therefore a medication review can reduce this outcome by optimising current therapy2. Responsibility of safely transferring this medication information between care settings is a healthcare professional's duty, as

Delirium is common especially in the older adult (≥65 years) and is characterised by disturbed consciousness, cognitive function or perception. It develops acutely, often has a fluctuant course and is associated with several adverse outcomes including increased length of hospital stay, increased mortality and increased incidence of developing dementia. Delirium is under-recognised, however assessment tools such as 4AT and abbreviated mental test score (AMTS) have been developed to help clinicians assess for the presence of delirium. The “TIME” bundle developed by Healthcare Improvement

Introduction SDH is a community hospital within Cardiff and Vale University Health Board. There are 60 -70 beds, over three geriatric wards. The primary focus is for patients requiring rehabilitation and complex discharge planning. All admissions are transfers from the acute setting. There is a high level of frailty. There are ward doctors and a consultant geriatrician within working hours (Monday-Friday), OOH cover is provided by primary care. The concern of ‘blanket’ DNACPR orders, during the COVID-19 pandemic has featured in national news reports. In part, this led to our question and audit

Introduction Person-centred care is recognised as best practice for the care of people with delirium or dementia. In Cardiff and Vale University Health Board (CAVUHB), “Read About Me” (RAM) documents are used to support person-centred care in these patient groups. However, there are significant barriers to their routine use in clinical practice (Clark, E, Wood, F, Wood, S. Health Expect. 2022; 25: 1215- 1231). We conducted a two-cycle audit investigating the use of these documents on geriatric wards in two acute hospital sites, and trialled two interventions to increase their usage. Methods

Introduction Frailty is defined as “a condition characterised by loss of biological reserves, failure of physiological mechanisms and consequent increased risk of experiencing a range of adverse outcomes, including hospitalisation, longer length of inpatient stay, and delirium” [1-4]. We aim to investigate the association between baseline frailty and functional recovery amongst hospitalized older adults and its association with inpatient delirium. Method Retrospective analysis of patients admitted to a Geriatrics ward from August to November 2022. Interactions between clinical outcomes with

Introduction: With the anticipated rise in the annual number of dementia cases in Cardiff and the Vale of Glamorgan (C&V), improvements in dementia diagnosis rates are essential. However, barriers to accessing support still exist, precipitating delays in diagnosis and establishing appropriate interventions. This article aims to highlight potential barriers patients attending the C&V Memory Assessment Service (MAS) may face, as well as ascertain possible delays within diagnostic pathways of cognitively impaired patients. Methodology: Demographic and primary data analysis was undertaken using a

Background & Aim: While the significance of prehospital trauma care is increasingly recognised for older patients, limited research has been conducted to gain in-depth understanding of current paramedic practice. We aimed to explore Saudi paramedics and emergency medical technicians’ understanding of impacts of ageing changes, how they acquire and apply relevant knowledge as well as the barriers and facilitators to providing improved care for older trauma patients. Methods: We undertook semi-structured qualitative interviews with 20 paramedics and ambulance technicians from the Saudi Red

Introduction People with frailty (Rockwood Frailty Score of 4 or more) represents 43% of the medical take at Withybush Hospital. There was a lack of front door frailty and comprehensive geriatric assessments (CGA). It was postulated that this was leading to delays in discharge and limiting the number of patients receiving a CGA by teams led by a geriatrician Methods In mid-November 2022, the acute medical take was adapted to stream stable patients with frailty through a frailty assessment unit. Prior to this, the area was being used as a surge ward for short stay acute medical patients. On the

Aim: Several patient selection scores have been developed to identify patients suitable for ambulatory care from triage in the Emergency Department (ED) and from the acute medical intake. These scores are designed to improve system efficiency, overcrowding and patient experience. Studies have been conducted that compare the ability of several scoring systems; none specifically in frail older adults (1-4). This study compared the Glasgow Admission Prediction Score (GAPS), Sydney Triage to Admission Risk Tool (START) and the Ambulatory Score (Ambs). Methods: The Older Person’s Assessment service

Introduction Alcohol excess is a risk factor for falls in all ages. However, it is important to establish the relationship in older patients, who are at a greater risk of falling, to allow for appropriate risk management. Methods The Older Persons Assessment Service (OPAS) is an Emergency Department service which, accepting patients on the basis of the presence of frailty syndromes in patients aged >70 years (falls, confusion, care dependence, polypharmacy and poor mobility).The OPAS databank was retrospectively analysed for people with alcohol excess admitted with a fall between June 2020

Introduction - The POPS service (SOPAS) in Morriston Hospital receives over 300 referrals a year. However, many of these referrals did not meet service criteria. Inefficient direction of referrals has a negative impact on service efficiency and can result in poor patient experience and outcomes. This is a quality improvement initiative to increase the quality and suitability of referrals made to the service. Aim - To implement a referral system able to offer safe, rapid assessment for surgical patients who would benefit from geriatrician-led intervention. Method - We developed a list of

Introduction The NHS backlog in Elective Surgery are a subject of societal concern and political pressure. Over 6,400 patients >65 yrs are currently awaiting surgery at Swansea Bay. What role, if any, can geriatricians play in improving patient and organisational outcomes? Intervention We wrote to all 258 patients on the Cholecystectomy waiting list > 65 yrs with a letter explaining the project and a patient experience questionnaire. An attempt to contact all patients by telephone was made with an intention to ask questions about their health, activities of daily living and frailty and

Introduction As part of a planned care initiative undertaken with the Bevan Commission to improve surgical waiting lists in Swansea Bay we contacted patients on the waiting list for a cholecystectomy, undertook frailty screening and invited those with frailty markers to undergo clinic based geriatric assessment . Clinical governance requires patient input into the setup of any service (1). A patient satisfaction survey following clinic, along with a patient focus group were conducted. Methods 27 patients completed an online survey regarding their experience at clinic. 8 patients attended the

Introduction Many elderly patients presenting to ED with falls and suspected head injury are anticoagulated. The current National Institute for Health and Care Excellence (NICE) guideline recommends patients on anticoagulation should have a CT head scan within 8 hours of head injury. An updated guideline was drafted for consultation in November 2022. The indication for CT head scan has not changed for patients on anticoagulation. There is currently a lack of evidence to inform best practice in the management of anticoagulated older patients who present with falls and head injury. The Older

BACKGROUND A multidisciplinary (MDT) approach is increasingly recommended as the standard of care for patients with Parkinson’s disease (PD). Research has shown that an MDT approach can lead to better quality of life and improve patient outcomes in a number of domains depending on set up. We established an MDT clinic with a PD specialist physiotherapist and pharmacist to assess how this would improve patient outcomes at a DGH hospital. METHOD An MDT clinic led by a consultant geriatrician with a PD specialist pharmacist and a physiotherapist that could assess patients attending the clinic was

Introduction The term ‘frailty’ is increasingly being used in clinical practice. NHS services established to assess frail older people are described using various names including ‘Frailty Unit’ (FU). Little is known about patient’s self-perception on being frail and their views on the use of these terms and nomenclatures. Following the development of a new FU in the Emergency Quadrant of our DGH, this study was undertaken to assess how elderly in-patients in the unit perceive ‘frailty’ as a concept. Their views on the nomenclature of the unit and the service were also evaluated. Methods A semi

Introduction Training in the subspecialty of Movement Disorders (MD) has been previously identified to be lacking in geriatric medicine, through a survey in Northern and Yorkshire regions (2006). In anticipation of the new geriatric medicine curriculum, the MD Special Interest Group Committee of the British Geriatric Society (BGS) sought to evaluate current experiences of training and perspectives of trainees for their subspecialty training. Method An online survey was designed by trainees with input from supervisory clinicians. Alongside demographic details, a combination of multiple choice