Posters

Introduction: Older patients undergoing surgery are often living with frailty and are subsequently at increased risk of morbidity, mortality and loss of independence in the perioperative period. Accurate identification of frailty using an objective tool such as the Clinical Frailty Scale (CFS) is an imperative part of preoperative risk assessment. It also informs which patients should undergo Comprehensive Geriatric Assessment (CGA) by our Perioperative care of Older People undergoing Surgery (POPS) service. Method: The POPS team provided training to Surgical Assessment Unit (SAU) triage staff

Introduction  An increasing number of older people living with frailty are undergoing surgery. The Centre for Perioperative Care (CPOC) published guidelines in 2021 to improve the care of this patient group through the perioperative pathway. Whilst significant progress has been made in Cardiff and Vale in improving unscheduled surgical care for older people, there remains a dearth of services for patients undergoing elective procedures.  Method  A Perioperative Frailty team was formed to deliver a service based on Comprehensive Geriatric Assessment principles, for older people undergoing

Introduction Perioperative geriatrics is an emerging specialty with immense importance to all medical and surgical specialties. Only a small number of papers have been published on the topic. A bibliometric analysis is used to identify themes and trends in current research and practice. Objectives To identify and describe research topics relating to perioperative geriatrics. Methods Thompson Reuters Web of Science indexing database was searched for all manuscripts relating to perioperative geriatrics. Of these, the top 100 were subcategorised into manuscript type, age, theme, specialty

Introduction Delirium affects up to 50% of the elderly who are admitted to in-patient facilities. Delirium is preventable in 30-40% of geriatric in-patients. Trust guidance recommends an initial screening for all admissions >65, followed by continuous monitoring. This initial screening is documented using the 4AT delirium assessment tool and documented as a proforma. ‘’Do you think the patient is more confused than before ?’’ is the single question in delirium (SQiD) rated positive or negative by clinical staff on reviews. The concept of SQiD is to facilitate a quicker and easy-to-use approach

Introduction In The UK around 519,000 new fragility fractures occur each year, with vertebral compression fractures among the most common1. Around 21% of vertebral fractures are incidentally found on radiological imaging2. Within Aneurin Bevan University Health Board (ABUHB) there is no formal pathway for managing incidental vertebral fractures identified on radiological imaging. Objective To retrospectively quantify the burden of incidental vertebral fractures and their subsequent management across a large UK Health Board. Method Patients with incidental fractures on CT scans were identified

Introduction Geriatric and general medical wards have nationally been troubled with an ever increasing patient population requiring carer support at home and a widespread shortage of those able to deliver it. This pilot project aimed to assess patient understanding of the care they were awaiting, their understanding of the reason for ongoing hospitalisation and their satisfaction with the care on discharge. We aimed to improve patient understanding with the use of a patient information leaflet (PIL). Method Patients identified during multi-disciplinary team meetings at two district general and

Introduction On graduation medical students need to be equipped to recognise and manage acute stroke and TIA (Transient Ischemic Attack). Despite inclusion of acute stroke and TIA in our local curriculum less than 10% of students (2/30) reported directly observing stroke thrombolysis during their placement. Due to COVID restrictions no student had been able to attend TIA clinic. To improve students practical understanding of the assessment and management of acute stroke and TIA a simulation-based teaching session was designed. Method The simulation session consisted of a hyperacute stroke

Introduction Back pain is a common presentation in general practice and a significant cause of morbidity in the elderly population. While the majority of cases are secondary to chronic degenerative changes, a number of sinister pathologies may prompt referral beyond primary care. This project assesses whether RADAR is the appropriate service to refer elderly patients with back pain through analysis of patient demographics and NICE guidance. Methods A total of 373 RADAR appointments from October 2020 until April 2022 were screened for record of “Back”/”Spinal” pain. Of the 104 appointments

Introduction Parkinson’s Disease is the second most common neurogenerative disorder and has a pervasive effect on health-related quality of life. There is increasing evidence of the importance of the endocannabinoid system in pre-clinical models of disease. However, there is a paucity of clinical evidence on cannabis-based medicinal products (CBMPs) in Parkinson’s Disease. This study presents a preliminary analysis of those with Parkinson’s Disease enrolled in the UK Medical Cannabis Registry (UKMCR). Method Patients prescribed CBMPs for Parkinson’s Disease symptoms for longer than one month

Aim: There been several studies validating the Hospital Frailty Risk Score (HFRS) to identify frailty. (1),(2). We proposed that it could identify patients in the Emergency Department (ED) who would benefit from the Older Persons Assessment Service (OPAS). Methods: OPAS is an ED service which accepts patients on frailty criteria (aged >70 years, falls, confusion, care dependence, polypharmacy and poor mobility). A retrospective analysis of the OPAS databank was conducted using HFRS to divide patients in High/Intermediate and Low Frailty Risk. We considered Age, Clinical Frailty Score (CFS)

INTRODUCTION Type 2 diabetes mellitus (T2DM) is associated with poor health outcomes (1) and few people aged >70 years likely benefit from HbA1c METHODS Older Persons Assessment Service (OPAS) is an Emergency Department service which accepts patients on frailty criteria (aged >70 years, falls, confusion, care dependence, polypharmacy and poor mobility). OPAS databank was retrospectively analysed for people with T2DM admitted with a fall June 2020 to April 2022. Interactions between clinical outcomes with therapeutic agents used, age, Charlson Co-morbidity index (CCMI) and Clinical Frailty

Introduction Frail adults should be offered comprehensive geriatric assessment. Falls are the most common reason for conveyance to hospital for Nursing Home (NH) residents in SBUHB and are associated with mortality, morbidity and are a significant burden on Welsh Ambulance Service (WAST) and the Emergency Department (ED). Older people are often subject to long ambulance waits and offload delays. By using a collaborative approach, we aim to reduce hospital conveyance rates and adverse patient outcomes. Methods Phase 1 - WAST calls analysed January 2020 – February 2022 from Swansea Bay UHB NH

Introduction An Acute Medical Unit at Morriston Hospital became geriatrician-led in July 2021. From January 2022 the unit received patients on frailty criteria for Comprehensive Geriatric Assessment (CGA). Clinical Nurse Specialists actively manage patients until discharge. Methodology The first phase (November 2020 -January 2021) was acute physician-led. Phase 2(September-November 2021) and Phase 3 (March-July 2022) were geriatrician-led. Phase 3 evaluates a frailty specific intake. Patient age, LOS (length of stay), number of referrals to other medical specialities and overall hospital LOS

Introduction: Acute Kidney Injury (AKI) is a common acute medical problem that has been identified in practice as having increased risk for patients who also have concurrent frailty (BGS 2021). National and Global strategies (WHO 2020) (NHS 2019) emphasise the importance in integrating care across the healthcare systems with aim to reduce admissions to secondary care. Completing comprehensive geriatric assessments (CGA), that highlight long term care needs and provide a basis for individualizing care plans can help to achieve this goal and reduce adverse outcomes such as increased length of

Introduction: Most stroke patients fail the swallowing assessment, hence the need to have NGT. Sometimes, it is impossible to get an aspirate from these NGTs, other times, the pH of the aspirate is quite high. As such times, to confirm NGT position, in line with the National patient safety agency an Xray is used. Recently, incidents in the trust (UHCW) have been documented regarding NGT Xray interpretation, thus the need to undertake this audit Methods: Patients (n=15) who had NGT in the stroke ward (24th March to 20th June,2022) were reviewed against University of Coventry and Warwickshire

Introduction: Suprapubic catheter (SPC) insertion is recognised as an alternative to urethral catheterisation to enable urinary drainage or continence control. This audit aims to establish the 1 and 2 year mortality associated with SPC insertion and to identify factors that may be linked with mortality. Methods: Data were collected for demographics, medical co-morbidities, indication for procedure and mortality from 1st February 2018 to 1st February 2020 across three NHS trusts. Multivariate regression analysis was undertaken to assess correlation between mortality and collected data. Results

Introduction People receiving haemodialysis, have the highest medicine burden of all chronically ill populations. This high medicine burden, exposes people to medication related problems impacting on quality of life and healthcare experience. Medicines optimisation, reviewing medicines to manage polypharmacy and improve outcomes, in the general population, is associated with decreased risk of death, decreased referral to nursing home, lower drug costs and improvements in patient’s perception of health. Method A literature review searching, Cochrane, Google scholar, Delphi, CINAHL, Medline and

Background: Ward round entries form the backbone of medical documentation, forming the context in which new diagnoses and safe handovers are made. They are also an important legal record that should be clear and up to date. Ward round entries without important information, including vital observations and examination findings, cause ambiguity as to whether these aspects of patient care have been reviewed. Aims: To ascertain the level of completeness of ward round entries with respect to salient features of patient care. To design and implement a ward round proforma which aids this completeness

Listen to “What Matters Most” to the individual however it is expressed. A gap persists for people with advancing frailty, dementia, neurodegenerative conditions whose end-of-life needs are NOT recognized NOR appropriately met but nonetheless have no acute specialist palliative needs. End of life is harder to recognize with slowly deteriorating trajectory. Challenge indiscriminate use of single condition protocols as underlying frailty becomes increasingly irreversible at this stage. Identification: CFS 7 – 9 registered with a local GP on acute frailty unit, other medical and surgical wards

Pancreatic cancer represents one of the most prothrombotic neoplasms secondary to high tumoral expression of tissue factor, cytokine release, activation of leukocytes and hypofibrinolysis. Studies have shown that the incidence of thrombotic complications can reach up to 36%. We present a case of an 84-year-old male patient who was admitted onto the Geriatrics ward with a 3-day history of sudden-onset dyspnoea, productive cough, pallor, and general malaise. Admission blood revealed microcytic anaemia (Hb 91 g/L), neutrophilic leukocytosis (WCC 29.9 x 10^9/L, Neut 26.9 x10^9/L) and elevated C