Posters

Introduction Diagnosis of Transient Ischaemic Attack [TIA] is important to minimise risk of future strokes. This retrospective descriptive study aimed to evaluate sociodemographic and risk factor differences between TIA and TIA ‘mimics’ in patients presenting to an inner-city neurovascular clinic. Methods Data was obtained over a 2-year period [2019-2020] for all new patients assessed in a consultant-provided daily week-day neurovascular service that serves a million multi-ethnic, population. Data collected included socio-demographic details, clinical risk factors, source of referral and final

Introduction Most of the patients completely recovered after COVID-19 infection. However, a substantial proportion of patients infected with COVID-19 continue to have symptoms long past the time they recovered from the initial disease. Understanding the burden of post-COVID-19 symptoms is vital in planning Post COVID care. We assessed the burden of persistent post-COVID-19 symptoms and functional status after 12-14 weeks among those who recovered from COVID-19. Method We obtained the list of COVID-19-positive cases between February 25 and March 09, 2021, from the COVID-19 surveillance unit in

Introduction Infective Endocarditis (IE) is an uncommon disease that can lead to serious complications and mortality. It is diagnosed based on modified duke criteria, with relevant findings on clinical examination, echocardiography, microbiological studies, and imaging, and the sensitivity of the same can be improved by new imaging techniques as per the European Society of Cardiology (ESC) 2015, if echocardiography/Microbiological studies are inconclusive, particularly to diagnose Prosthetic Valve Endocarditis (PVE). Case report A 79-year-old female presented with confusion and high-grade

Introduction: Primary care-based frailty identification and proactive comprehensive geriatric assessment (CGA) remains challenging. Our Devon-based Primary Care Network has developed and introduced an innovative, community-based IT-assisted CGA (i-CGA) process, which includes advance care planning (ACP). We wished to see if this process could improve effectiveness of ACP in residential care home (CH) residents. Methods/Intervention: 1) GPs clinically assessed all CH residents for frailty. 2) Proactive i-CGAs completed using our IT-assisted CGA tool, which prompts to review/consider/address

Introduction: Syncope is a common clinical problem with a lifetime prevalence of 20%. 1 Syncope shares clinical features with other disorders including seizures, metabolic disturbances and sleep disorders. 2 The assessment and management of syncope can be challenging. The syncope service at the QEUH is run by geriatricians and cardiologists with an interest in syncope. Although MDTs are recognised key components in contemporary patient care in areas such as heart failure and cancer management, there is no guidance on MDT working in syncope management. 3/4 In November 2017, a syncope MDT was

Introduction Delirium is a common condition in older hospitalised patients causing high morbidity and mortality. The neurobiological basis for delirium is uncertain and, for numerous reasons, research in this area has been limited. Several recent studies have demonstrated that functional neuroimaging in delirium is achievable and has suggested that a brain region termed the default mode network (DMN), may play a cardinal role in delirium pathogenesis. We set out to develop a pilot study to demonstrate that it is feasible to undertake functional magnetic resonance imaging (fMRI) scans in older

A platform presentation to allow evaluation of diagnostics used in a Frailty Hospital at Home . An analysis of the data and a chance to explore the affect of diagnostics on subsequent hospital admissions or number of community team visits. Affect of diagnostics on management plans developed and whether they align with a person's documented goals. Data collected as part of an audit looking at the number of diagnostic tests taken by the Frailty Hospital at Home team. Subsequent outcomes including the number of hospital admissions, treatments started at home, subsequent number of community team

Introduction Gorseinon Hospital (GH) is a community rehabilitation facility which offers reablement following an acute admission to hospital. Patients are accepted from both medical and surgical specialty wards. Between 2015-2019 GH had median length of stay (LOS) 32 days. In 2018, 81% of patients returned to their own homes. Methodology A retrospective review of all admissions to GH from January to December 2021 (n= 256) to identify opportunities for service improvement. Results Median GH LOS was 53 days. Patients transferred from acute frailty and stroke services who received early

Introduction Dysphagia affects a large proportion of patients in hospitals and the community. Poor management of dysphagia results in aspiration pneumonia, malnutrition, and poor quality of life. Management, as recommended by Speech and Language Therapists (SALT), with the strongest evidence base for reducing aspiration pneumonias, is diet modification such as thickened fluids (Rosenvinge S, Starke I. Age and Ageing. 2005;34(6):587-593). Safe management of dysphagia is important discharge, as such this study focused on patients being discharged with fluid thickeners. Method We assessed current

1. Introduction Delirium is a very common and treatable condition, and approximately 20-30% of older patients in medical wards in hospitals presented with delirium. Hence it is important to do timely assessment and correct management of delirium. This QIP was carried out to improve adherence to the trust’s clinical guideline for delirium and to improve the communication with patients, relatives, and primary care doctors. 2. Method 40 patients’ notes were randomly reviewed in the geriatric wards of the Addenbrooke’s hospital as baseline, then 20 patients’ notes were reviewed again after PDSA

Background: Delays in documenting a valid DNACPR (Do not attempt cardiopulmonary resuscitation) form in medical notes, for patients with advanced decisions, presses the cardiac arrest team to make difficult decisions about resuscitation, with little time to establish the patient’s wishes. This removes the right, for some patients, to die with dignity and peacefully. Local policy states patients with DNACPR forms should have this reviewed by the senior clinician in charge of their care as soon as is possible. Aim: To reduce the percentage of geriatric patients in Colchester hospital (with

Introduction As we face a 7th wave of Covid in our geriatric wards, we as caregivers are exhausted and find it increasingly difficult to repeat these isolation measures again and again. We are aware of the importance of avoiding clusters but it is mostly the elderly who are positive for Sars-Cov-2 and hospitalised. Fortunately the virus no longer kills, but nevertheless has enormous deleterious consequences on the mental health of our elderly. Methods To expose the practical consequences of clinical cases experienced during these successive waves of Sars-Cov-2 and make a review of the

Introduction Important parts of the comprehensive geriatric assessment (CGA) include medication review and assessment of bone health. Such aspects of CGA can be missed in clinical practice in the busy acute hospital setting. We aimed to improve performance of medication review, and assessment of bone health in patients with falls in the form of vitamin D levels and Fracture Risk Assessment Tool (FRAX) scoring, in admissions to the acute Care of the Elderly (COTE) team in a district general hospital in South Wales. Methodology Data were collected from documentation of the initial review of

Aim STOPPFrail criteria identify potentially inappropriate medications (PIMs) in frail older adults with poor predicted one year survival. This study aimed to determine the proportion of older adults in which STOPPFrail criteria are applicable; measure the prevalence of STOPPFrail PIMs and identify potential medication cost savings. Methods We prospectively reviewed patients who received Comprehensive Geriatric Assessment following an attendance at the Emergency Department (ED) at a large regional hospital. We recorded Charlson Comorbidity Index, Medications, Rockwood Frailty Status and

QIP topic was to improve emollient prescriptions for patients admitted to Elderly Care Unit as not all elderly care patients who are already prescribed emollients by General Practice through regular medication or current acute medication are being prescribed these when inpatient. The aim of the QIP was: By April 2022 we will increase the number of emollient prescriptions for elderly care patients admitted to elderly care unit who are already prescribed these in general practice by 20% The QIP measures were identified which included % emollients correctly prescribed to relevant patients and

Introduction Ambulance offload delays at the Emergency Department (ED) are linked to adverse outcomes. By 2030, 25% of patients attending the ED are projected to be over 80 years old. Geriatric frailty syndromes can be difficult for triage systems to assess, leading to older people being allocated lower priority status and a higher chance of a 4-hour target breach vs a younger patient(1). We assessed whether ambulance offload time is associated with frailty, death or re‐attendance at an emergency department at a large regional centre. Methods Retrospective analysis of adult ambulance offload

Introduction: The number of older people living with frailty in Swansea Bay is increasing. Currently there is no dedicated rapid access multidisciplinary team (MDT) clinic for older adults living with frailty within Swansea Bay University Health Board (SBUHB). As a response to this, the team at Singleton Hospital (SBUHB) piloted a rapid access MDT clinic. Method: The ‘Rapid Access Clinic for the Older Person’ (RACOP) pilot ran for eight weeks across May and June 2022, delivering three clinics per week. Comprehensive Geriatric Assessment was provided via a multidisciplinary team consisting of a

Introduction Dopamine transporter scan (DaT scan) nuclear imaging can be a useful tool in the diagnostic work up of conditions such as Parkinson’s disease (PD) where the underlying physiology of the disease involves striatal dopamine transporter loss. Selective serotonin reuptake inhibitors (SSRIs) bind with high affinity to the dopamine transporter, competing with test compound, ioflupane. There is inconsistent guidance on stopping SSRIs prior to DAT scan due to lack of robust evidence. However, case studies suggest the interaction may result in false positive results. We investigated

Introduction Zoledronic Acid has been shown to reduce the incidence of vertebral, non-vertebral and hip fractures[1]. Once Zoledronic Acid has been administered as an inpatient, follow-up communication to primary care teams should be completed however no formal process was in place. A checklist was developed to ensure consistency in administration processes on Care of the Elderly wards and to ensure adequate documentation and appropriate follow-up communicated to primary care teams. Method Baseline data was collected from 25 patients who received Zoledronic Acid as inpatients under Care of the

Introduction: The General Surgery directorate at Cardiff and Vale University Health Board secured funding for the appointment of a Memory Link Worker (MLW) for a 12-month pilot in the emergency stream. The aim of the MLW is to improve patient experience for those living with dementia/ cognitive impairment, or those who experience delirium whilst in hospital. In addition, the MLW role should increase awareness and completion rates of “Read About Me” (RAM). Method: The pilot scheme started in February 2022. Eligible patients were identified by ward staff or the Perioperative care of Older People