Posters

Introduction: Malnutrition is a debilitating condition in hospitalised older people. There has been limited studies exploring dietary intake and oral nutritional supplement (ONS) compliance in these people. The purpose of this service evaluation was to observe daily energy and protein intake, plate waste and ONS compliance and to report food waste at ward level. Methods: Three-day dietary (food-only) intake and plate waste of 19 older (≥ 65 years) people on a hospital trauma and orthopaedic (T&O) ward were assessed. Patients were categorised as ‘nutritionally well’ or ‘nutritionally vulnerable

Introduction Demographic evaluation of urgent community response teams [UCR] is important to ensure equity of access and clinical outcomes for patients from all socio-demographic groups using such services. This retrospective descriptive study aimed to evaluate demographic and mortality differences between patients referred to UCR in terms of those managed in the community [Group1] versus those subsequently hospitalised [Group2]. Methods Data was obtained over a 12-month period [2021-2022] for all new patients referred to a 7-day consultant-led UCR that serves a multi-ethnic, inner-city

Introduction: Recent evidence suggests extensive grey matter abnormalities in Parkinson’s Disease Psychosis (PDP), as well as dysfunction of dopaminergic and serotonergic receptors. However, findings remain unclear. This meta-analysis aimed to identify neuroanatomical correlates of PDP and to examine the relationship between grey matter and key candidate receptors. Method: Peak coordinates were extracted from structural magnetic resonance imaging (MRI) studies (identified through systematic searches on PubMed, Web of Science, and Embase) for PDP patients and Parkinson's Disease patients

Background - The CQC inspection of the Royal Lancaster Infirmary (RLI) in May 2021 rated the performance of the stroke department unsatisfactory, leading to a number of changes. A retrospective audit was performed to determine the impact of these changes for thrombolysed stroke patients. Aim – This retrospective audit assessed the performance of the stroke department at the RLI against the parameters set by the ‘Sentinel Stroke National Audit Program’ (SSNAP), comparing 6-month periods before and after the CQC inspection in May 2021. Method – Using electronic medical records and SSNAP data, we

Introduction Frailty is a syndrome associated with increasing numbers of elderly hospital admissions and prolonged inpatient stays (Archibald et al, Geriatrics, 2020, 20, 17). In 2015, an estimated 14% of inpatients in the UK were considered to have a degree of frailty, representing an approximate annual cost to the NHS of £5.8 billion (Soong et al, BMJ Open, 2015, 5, e008456; Han et al, Age and Aging, 2019, 48, 665-671). Frailty is poorly defined; there are discrepancies in existing literature on how to best quantify frailty. It is recognised there is a higher risk of adverse outcomes in this

Introduction: According to the Health Education England (HEE) Framework for Enhanced Health in Care Homes 2020, 33% of people over 65 and 50% of people over 80 have one or more fall a year, figures which significantly increase in care home residents. Prevention of falls promotes the quality of life of elderly patients and could significantly reduce the burden on primary and secondary care stemming from fall induced fractures, loss of mobility and community follow up. The Comprehensive Geriatric Assessment (CGA) for falls includes a full falls assessment questionnaire, medication review, lying

Background Hospital based Quality Improvement Project focusing on adapting language used on Recommended Summary Plan for Emergency Treatment and Care (ReSPECT) forms to improve patient understanding. Introduction ReSPECT forms have been used to document patient wishes and appropriate escalation of treatment in our hospital since 2019. There continues to be a lack of understanding of phrases used amongst both patients and healthcare professionals; the hospital receives regular complaints. This project explored patients’ perceptions of language used and their thoughts on the ReSPECT discussion

Introduction The decision to admit an older patient to the intensive care unit (ICU) should reflect shared goals of care. Resource limitations during the Covid-19 pandemic highlighted challenges in selecting candidates for escalation. Patients and next of kin (NoK) who have experienced ICU are well-placed to reflect on whether the admission was right for them. Objective: To explore older patients’ (65 years) and their loved ones’ views on escalation decision making. Methods Qualitative study involving semi-structured interviews with patients, NoK of survivors and NoK of deceased who

Background: People living with dementia are more likely to move into care homes. The true prevalence of dementia among care home residents in Scotland is not known. People living with dementia often interact with multiple social and healthcare services, thus routine data may offer a way to enhance understanding. Aim: To compare national health and social care data sources recording dementia status for Scottish care home residents. Methods: A retrospective cohort study of adult (≥ 18 years) care home residents in Scotland during financial years 2012/13 and 2013/14. An indexing process linked

Introduction Heart failure (HF) is a common problem managed in our West Lothian multi-disciplinary hospital at home (HaH) service, however significant variation in practice was noted with considerable resource implications. We aimed to standardise and improve this by developing a dedicated protocol. Methods We developed a protocol to guide the assessment and management of HF within HaH. We collected baseline (n=25) and follow-up data (n=10) after protocol introduction from patients referred to HaH with heart failure. Outcomes reviewed included anticipatory care planning (ACP) decisions, length

Introduction Integrated care potentially improves coordination and health outcomes for older people with frailty. We aimed to assess the effectiveness of a new, proactive, multidisciplinary care service in improving the well-being and quality of life of older people with frailty. Methods A community-based non-randomised controlled trial. Participants (≥65 years, electronic Frailty Index ≥0.36) received either the new integrated care service plus usual care, or usual care alone. Data collection was at 3-time points: baseline, 2-4 weeks, and 10-14 weeks; the primary outcome was patient well

Whilst providing an Emergency Department based Older Person Assessment and Liaison service (OPALs), patients were identified to attend following a fall when they had previously been seen in ED following falls during the preceding 3 months. When notes were reviewed, few fall referrals had been documented. A prospective audit was conducted to identify the number of eligible patient referrals to falls team for patients who attend the emergency department. Electronic patient records were screened to identify patients' discharge diagnosis of ‘fall’ ‘elderly fall’ or ‘head injury’ (included if the

Introduction: Dementia is one of the leading contributors of disability in the UK. Evidence of a downward trend in age-adjusted incidence of Dementia has highlighted the potential impact of modifiable risk-factors in reducing the disease burden of Dementia. This research will determine how risk-factors of Dementia have varied over time, between the different countries of the UK, the different regions of England and by sex in the UK. Methods: This is a descriptive time-series of risk factors of Dementia within the United Kingdom (UK) between 1990 and 2019. Data was extracted from the Global

Background: The prevalence of urinary incontinence and frailty increases with ageing. As an adaptive mechanism patients become socially isolated resulting in worsening of mental health anxiety and depression. Aims/Objectives: We undertook a retrospective observational study of frail patients with an eFI above 0.33 to look for a correlation between eFI, GAD and phQ-9 scores. Methods: The records of 600 patients with an eFI above 0.33 ( n=600 ) were analysed for declared symptoms of incontinence using the Michigan Incontinence Score Index (MISI) to see if there was a correlation with mental

Introduction The medical intake at Morriston Hospital is accepted on two units; Rapid Assessment Unit (RAU) and Acute Medical Assessment Unit. Both were acute physician-led until July 2021 (Phase 1). From July 2021, RAU became geriatrician-led (Phase 2). This evaluation concerns the performance of RAU. Phase 1 (Acute Physician-Led Unit) Between 01/08/2020-30/06/2021, there were 3102 admissions with a median length of stay (LOS) of 2 days on RAU. 37.2% of patients were discharged directly from the unit. (SBUHB data). A detailed analysis of 496 patients consecutively assessed between November

Introduction: Large numbers of geriatric inpatients within acute settings are deemed medically safe for discharge (MSFD) but stranded within the hospital due to a lack of community services and social care packages, leading to increasing length of patient stay and reduced hospital flow. These patients do not require inpatient care and would otherwise be discharged to their home or residential care. This project aimed to identify these patients and rationalise their medical input to mirror a community setting (without routine daily medical reviews). Methods: MSFD patient were identified by the

INTRODUCTION The National End of Life Care (EOLC) Strategy highlighted the need for individualised, accessible, multi-disciplinary care plans for people nearing the end of life. Proformas provide a systematic approach to recording end of life discussions. Our Trust uses an electronic patient record (Cerner), which includes an “End of life care agreement” for people in the last days of life. An initial staff survey on a Medicine for the Elderly (MFE) ward highlighted a lack of familiarity with required documentation. The aim of this project was to improve end of life care documentation. METHODS

Hypocalcemia is seldom encountered in patients with multiple myeloma. It is usually due to secondary causes. Most reported cause amongst this population is bisphosphonate therapy. We report a case of a 65-year-old gentleman with a background of multiple myeloma presenting with worsening numbness and tingling in arms and legs. These symptoms eventually led to a fall. Blood tests revealed severe hypocalcemia. He had never been on any bisphosphonates. Despite repeated calcium replacement during admission, the severe hypocalcemia persisted, and his symptoms failed to resolve. His renal function

Introduction Objectives of this retrospective study were to describe clinical presentations and mortality outcome of hospitalised patients with COVID-19 omicron variant within two acute district general hospitals and to evaluate demographic factors associated with these presentations and mortality. Methods Data was obtained over a month in 2021-22 from a retrospective survey of all patients hospitalised and detected to have SARS-COV-2 omicron variant infection. The trust serves a diverse multi-ethnic inner-city population. Data included socio-demographic details, vaccination status, admitting

Introduction Diagnosis of Transient Ischaemic Attack [TIA] is important to minimise risk of future strokes. This retrospective descriptive study aimed to describe frequency of alternative diagnoses in a busy inner-city neurovascular clinic and evaluate processes of assessment and investigations of ‘true’ TIA patients. Methods Data was obtained over a 2-year period [2019-2020] for all new patients assessed in a busy consultant-provided daily week-day neurovascular service that serves a million multi-ethnic, population. Data collected included socio-demographic details, final clinical diagnoses