Posters

Introduction: Inpatient falls are the most common adverse patient safety incidents in hospitals in the UK. The assessment and management following an inpatient fall is often the responsibility of the most junior doctor on call, particularly out of hours. Frequently, there are key omissions in the assessment of these patients, leading to missed diagnoses, poor management and avoidable patient harm. This study aimed to improve the knowledge and confidence of foundation doctors in the assessment and management of inpatient falls. Method: 31 patients were identified who had suffered ‘severe harm’

Introduction Malnutrition is common in patients with hip fractures. Early post-operative ONS (oral nutritional supplements) have been shown to reduce the length of stay in hospital and improve post-operative outcomes. The aim of this audit is to determine the number of people within the Royal Victoria Hospital Fracture Unit with NOF (neck of femur) fractures who are receiving ONS; it also determined the reasons for doses missed. Additionally, it covers if baseline refeeding bloods were done as per Trust Guidelines. Method A two cycle audit was completed on the use of ONS in patients with NOF

Introduction: Falls account for 17% of emergency department (ED) attendances and cause significant morbidity and mortality in older people. An accurate falls risk assessment can identify those at risk of inpatient falls. At Northumbria Healthcare NHS Foundation Trust, the ‘Avoiding Falls Level of Observation Assessment Tool’ (AFLOAT) was developed to identify patients requiring higher levels of observation to prevent falls (Richardson DA. ClinMed (Lond). 2020; 20(6): 545-550). Whilst AFLOAT was commonly used for inpatients, it was rarely completed in ED. A multi-disciplinary and inter

Introduction Fragility fractures are associated with significant morbidity and mortality. The National Osteoporosis Guideline Group advise that a FRAX assessment should be completed in all patients with falls. Despite this only 3% of patients admitted to a geriatric ward following a fall had a bone health assessment completed within 72 hours of admission. Our aim is for a bone health assessment to be completed in >90% of these patients. Method Our intervention focused on promoting bone health assessment with a ‘FRAX proforma’. This was aimed at junior doctors as the main cohort expected to

Vitamin D deficiency is common amongst elderly patients resulting in fragility fractures. Following fragility fractures, patients require vitamin D to be checked prior to initiating bone protection, e.g zoledronic acid/ denosumab. Ideally, all patients should have their first dose of bone protection prior to being discharged from hospital to reduce the risks of fragility fracture. In this project, carried out in Trafford General Hospital (TGH) amongst patients from orthogeriatric wards, we had observed that the time taken for these results varied significantly depending on the hospital

Introduction: Total Laparoscopic Hysterectomies (TLHs) are one of the most common gynaecological surgical interventions in the ageing population. Whilst co-morbidities have huge influence on the perceived patient suitability for surgery, patient factors like age ought to be considered in the pre-operative stage. Clinicians must counsel patients on individualised risks to enable informed decisions.This audit looked to identify the impact of age on the likelihood of operative complications in TLHs, guiding specific counselling for older patients considering this procedure. Methods: Extensive

Aim Emergency laparotomy is associated with a high mortality and morbidity. Early identification of high-risk patients allows for timely involvement of other members of the multidisciplinary team, including care of the elderly (CoE) specialists. This improves the likelihood of a successful post-operative recovery. This study investigated the adherence to the NELA guidelines regarding the use of the clinical frailty score and input from the CoE team. Methods A prospective analysis was conducted, collating data on patients undergoing an emergency laparotomy in one centre in East London. Data

Background Discitis is an infection of the intervertebral disc space that can lead to paralysis, sepsis, epidural abscess, or other life-threatening complications if left untreated and may sometimes present with limited laboratory abnormalities and symptoms to clue a diagnosis. Hematogenous spreading of microorganisms from an infectious site is the most common pathophysiologic cause of vertebral discitis. Case Presentation A 68-year-old female presented to the Medical Assessment Unit (MAU) with a two-week history of increased micturition frequency, dysuria, and constant, dull lower abdominal

Introduction Hospital-acquired deconditioning (HAD) leads to functional decline, extended hospital stays, increased fall risk, and higher readmission rates, resulting in a significant cost burden on the NHS. Preventing HAD through early and regular physical rehabilitation is crucial for improving patient outcomes and reducing healthcare costs. This Quality improvement project , conducted in a ward, aimed to evaluate and enhance the implementation and effectiveness of physical rehabilitation programs to prevent HAD. Method The project began with administering questionnaires to both staff and

Background: OPAL Team cares for elderly patients arriving at hospital front door. 80% of referrals to OPAL team are related to Falls. Early assessment and intervention reduce future risk of falls improving health outcomes. OPAL assessment proforma used for falls assessment varies widely depending on local resources. In our trust Multifactorial risk assessment (MFRA) is included in OPAL proforma to assess any patient presenting with a fall or has had two or more falls in the past six months or needs hospitalisation due to fall. Our MFRA includes assessment of Vision, Continence, Cognition

Introduction Stair falls cause approximately 230,000 injuries and 500 fatalities each year (Roys, 2001). Falls cost the NHS £4.6 million every day (AgeUK, 2010), and approximately £2 billion each year (GOV.UK, 2022), with falls on stairs accounting for the majority of these costs. However, the evidence about how to reduce stair falls is unclear. The aim of this systematic review was to establish which interventions are effective or show greatest potential to improve safety on stairs and reduce falls. Methods Five databases were searched: Medline, Scopus, Web of Science, PubMed and CINAHL

Abstract Content - Introduction. When required to multitask while walking, older adults (OA) will walk slower and use maladaptive stepping strategies such as cross-steps that may increase the risk of falling. However, most studies to date have been limited to steady-state straight-line walking, which requires limited to no visual planning, which is unrepresentative of common outdoor environments. Therefore, this study aimed to (i) investigate the impact of dual-tasking during walking of complex routes, and (ii) assess if such impact can be reduced when older adults deliberately preview their

Introduction: Orthostatic hypotension is very common and increases with age, affecting about 20% of community-dwelling older adults and it increases up to 50% in long-term care units. Measuring lying and standing blood pressure (LSBP) is an important and simple bedside clinical test needed to diagnose the condition. The regulation of blood pressure depends on the baroreflexes, normal blood volume, and defenses against excessive venous pooling. These mechanisms are altered in older adults that lead to increased incidence of OH. Orthostatic hypotension leads to symptoms of dizziness, syncope

Background: Use of bisphosphonates following NOF fracture in patients over the age of 60 has extensive evidence showing up at a 50% relative reduction in fracture risk. However this is variably recorded on the immediate discharge letter (IDL) and subsequently poorly communicated to Primary Care via the emergency care summary (ECS). Aim: To review how often IV Zoledronate is used in hospital, documented in the IDL and on ECS, leading to an improvement of documentation and communication between primary and secondary/tertiary care and therefore the safer management and usage of medicines. Method

Introduction: This audit was performed by the Northumbria-Healthcare NHS Foundation Trust (NHFCT) Falls and Syncope Service to inform the development of the NHFCT Integrated Falls Strategy (IFS). Method: From the opening of the Northumbria Specialist Emergency Care Hospital (NSECH) on 16/06/2015 all ED records were prospectively screened to identify the first 1000 patients aged 65 years and over that had attended with a fall. The 5-year outcome data was obtained from NHFCT electronic records. Results: Of the 1000 attends aged 65 years and over with a fall (13.7 attends daily), 55 were patients

Introduction: At Warrington hospital, a small district general, the orthogeriatric team adheres to national guidelines by conducting bone health assessments for inpatients with neck-of- femur (NOF) fractures and commencing suitable secondary prevention measures. However, there is a noticeable gap in secondary prevention for patients with non-NOF fractures requiring admission (such as tibial or humeral fractures). This predisposes patients to a future increased risk of disability, morbidity and mortality following discharge. Method: A Quality Improvement initiative was launched, introducing

Introduction The fall risk factors in older adults living in residential care homes for the elderly (RCHEs) are multifactorial. In Hong Kong, around 9.5% of RCHEs have a fall rate over 30% (Elderly Health Service, 2022)1. The objective of this survey is to identify the common fall risk factors among frequent fallers in RCHEs in biological, environmental, and behavioural domains, based on the World Health Organization (WHO)’s risk factor model for fall (World Health Organization, 2021)2. Methods 197 frequent fallers from 67 RCHEs with fall prevalence over 30% in Hong Kong were included in this

There is a 35-week waiting time to be seen in a gastroenterology clinic for investigations such as UGI endoscopy and colonoscopy for a condition such as low Hb, weight loss, dysphagia and so on. Most of the time without adequate initial workup and ruling out iron-deficient anaemia and differentials as per the British Gastroenterology Society. The hospital is witnessing an exponential influx of patients, reflecting in long waiting times to accommodate clinic patients. The current established low Hb referral pathway via GP to gastroenterologists does not consider the co-morbidities and frailty

A 75-year-old male presented with chronic fatigue and gradually worsening generalised muscle weakness over three years. He was treated by his GP for two months for a suspected case of polymyalgia rheumatica with a two-month course of steroids, which resulted in no significant improvement. His medical history included post-COVID syndrome and mixed anxiety and depressive disorder. He lives at home with his wife and requires assistance to navigate stairs, using a walking stick for mobility. On examination, he exhibited grade 4/5 muscle weakness in both proximal and distal muscles. Blood tests

Introduction: Inpatient falls are a common problem, and it is important that newly qualified doctors feel confident in conducting competent assessments of patients after they fall. This project seeks to assess the confidence levels of final year Manchester Medical School (MMS) students surrounding the topic of inpatient falls assessments, as well as to determine whether another resource from MMS regarding this topic would be beneficial. Method: A survey was conducted and disseminated amongst final year students at MMS through email and social media, with questions designed to address the