Posters

Introduction Early identification and multidisciplinary management of frail patients in acute care is a national priority, as reflected in the NHS Long Term Plan1, NHS Improvement (NHSI)2, and Getting It Right First Time (GIRFT)3. Sunderland Royal Hospital’s acute frailty services run daily from 08:00–20:00 across the Emergency Department (ED) and Emergency Admissions Unit (EAU), assessing patients with a clinical frailty score (CFS) ≥5. Morning duties are primarily dedicated to reviewing overnight admissions on EAU, which can lead to a delay in assessment of new patients arriving in ED. As

A Quality Improvement Project in Managing AKI in post operative femur fracture and other orthopaedic patients. Authors:; B Khoshnaw1; W Y Ooi1; M Motsara1 Provenance: 1. Lincoln County Hospital, United Lincolnshire Teaching Hospitals NHS Trust. QIP supervised by Dr P Mathew, Orthogeriatric Consultant, Lincoln County Hospital. Introduction Acute Kidney Injury (AKI) is a serious and preventable complication in older adults following orthopaedic surgery. At Lincoln County Hospital, inconsistent AKI recognition and response led to a Quality Improvement Project (QIP) aiming to embed the trust’s AKI

Introduction The Clinical Frailty Score (CFS) allows appropriate frailty assessment to guide management plans for oncology patients. CFS documentation is not standard at our trust. We aimed to introduce CFS documentation in the Acute Oncology Service (AOS) clerking proforma and evaluate its use in patients aged >65 to help guide management. Methods Data was obtained from inpatients on the oncology wards via NerveCentre. Three PDSA cycles were completed: Cycle 1: An evaluation to identify how many patients had a documented CFS. Based on this, a poster was created, emailed to oncology staff, and

Introduction Parkinson’s disease increases fracture risk due to higher fall rates and increased osteoporosis prevalence. This two-cycle bone health audit assessed adherence to the BONE-PARK algorithm at Florence Nightingale Community Hospital’s Parkinson’s clinic and evaluated improvements over 12 months. Methods Fifty patient records were reviewed to assess bone health management, focusing on fracture risk assessments (FRAX/QFracture), serum calcium, vitamin D, and follow-up actions, establishing a baseline before intervention. A re-audit of 39 patients after 12 months assessed progress

Introduction: Delirium is a common acute presentation among older adults, particularly following acute illness or surgery e.g. neck of femur fractures. Early recognition is crucial, as delirium is associated with increased morbidity, mortality, and prolonged hospital stays. NICE guidelines recommend the use of a validated tool, 4AT, for delirium screening in all patients aged ≥65 upon admission. Aim & Objectives: Compliance with 4AT screening on admission 4AT assessment on new onset of confusion Train nursing staff on 4AT screening for early identification of delirium Methods: Prospective data

Introduction: Syncope is a common clinical problem[1] posing a diagnostic and therapeutic challenge, due to varied presentations and underlying pathologies[2]. Although an MDT approach is a recognised key component in patient care[3], there is no current guidance in the context of syncope. The Syncope Service in QEUH Glasgow is run by Geriatricians with a specialist interest in Syncope. A formalised monthly MDT, introduced in November 2017, involves Geriatricians, Cardiologists, a Neurologist and Cardiac Physiologists. Method: A retrospective case note analysis undertaken for patients reviewed

Introduction This Quality Improvement Project aimed to increase patient engagement and improve documentation of individual care preferences on geriatric wards. The focus was on enhancing communication—particularly for patients with cognitive impairment—to support personalised, patient-centred care. This was achieved by promoting the use of the "Getting To Know Me" (GTKM) form and "What Matters To Me" (WMTM) icon through dedicated staff support and visual aids. Method Activity Coordinators were assigned specific days to assist patients in completing the GTKM form and WMTM icon. Laminated visual

Background: Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use. Older adults are at higher risk of antibiotic associated complications, especially C. diff infection. Methods: Baseline data were collected from the hospital's electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance

Orthogeriatrics: Improving Assessments and the use of Bisphosphonates Introduction At Doncaster Royal Infirmary we targeted an improvement in the care of patients admitted with a hip fracture. The first objective was to deliver more consistent Orthogeriatric Assessments. The second objective was to improve bone health assessments and the use of bisphosphonates for secondary prevention of fragility fractures. Method After a period of limited Orthogeriatric service, from January 2025, new medical support was provided in the form of 12 hours per week of Consultant time and support from a recently

Introduction. Our perioperative service for older people undergoing surgery (POPS) commenced inpatient reviews in September 2024. Method. Patients being considered for laparotomy aged 80 and over were prioritised as part of the national emergency laparotomy audit (NELA) recommendations1. Other patients reviewed were multi-morbid and frail patients with other pathologies, aged between 65-80. All patients reviewed had a comprehensive geriatric assessment (CGA) and shared decision making (SDM) as required2. Results. In 3 months, 115 patients were seen. Median age 83, median clinical frailty score

Introduction: Care home residents and staff have limited, though increasing, opportunities to participate in research. This project aimed to describe motivating and limiting factors for research participation and priorities in Scottish care homes. Methods: In a cross-sectional study, a 21-item questionnaire was distributed to Scottish care homes for older people by ENRICH (Enabling Research in Care Homes) Scotland. It included questions on demographics and previous research involvement, with multiple choice and free-text response options. Mixed methods analysis was used including non

Introduction Approximately 70,000 hip fractures occur annually in the UK, costing the NHS over £2 billion each year. These injuries carry significant morbidity and up to 30% one-year mortality. One in five patients will sustain another further fragility fracture within five years - most commonly in the first year. Zoledronic acid, a parenteral bisphosphonate, significantly reduces subsequent fracture risk and mortality. Although timely inpatient use is supported by National Osteoporosis Guideline Group (NOGG) guidance and a 2023 British Geriatrics Society Call To Action, uptake remains low

THE EFFECT OF UNILATERAL, LOW-INTENSITY, UPPER LIMB MOTOR CONTROL TRAINING ON COGNITIVE FUNCTION IN HEALTHY OLDER ADULTS: A PILOT STUDY Introduction Age-related cognitive decline, particularly in executive function and processing speed, is a major concern. Physical exercise is recognised as a strategy to support cognitive health (1), however not all older adults are physically able to perform the ‘traditional’ forms of exercise (i.e., resistance and endurance exercise), which have been shown to elicit this benefit. Motor control training (MCT) is emerging as a potential alternative exercise

Introduction: Frail older adults with diabetes are particularly vulnerable to harm from tight glycaemic control. Hypoglycaemia can increase the risk of falls, delirium and prolong hospital stay especially in those with frailty. Regional and National guidelines (NICE NG28, JBDS) recommend individualised HbA1c targets based on frailty status, yet in routine inpatient practice this is often overlooked. The aim of this quality improvement project (QIP) was to improve frailty scoring and individualised HbA1c targets in frail diabetic inpatients Method: This quality improvement project was conducted

Re-evaluation of National Institutes of Health Stroke Scale (NIHSS) Score <5 at Sunderland Royal Hospital Author: Dr Fruzsina Bako (FY2) Supervisor: Dr Min Myint (Stroke Consultant) Clinical Audit Registration: CA11032 Cycle 2 INTRODUCTION Controlling BP minimises the rate of ICH and reperfusion to promote adequate cerebral perfusion (2). Antiplatelets reduce the risk of recurrent stroke and other vascular events (3). Cholesterol reduction reduces the risk of stroke by reducing harming lipids (4). Diet and exercise are independent stroke reducers and positively impacts both weight and blood

Introduction  Orthostatic hypotension is a significant risk factor for falls and is associated with increased morbidity and mortality in older adults. The National Institute for Health and Care Excellence (NICE) recommends recording Lying-Standing Blood Pressure (LSBP) for all patients ≥65 years, with the Royal College of Physicians (RCP) advising readings after 1 and 3 minutes. On a geriatrics ward,  LSBP  assessments were frequently delayed, missed , or performed incorrectly. This Quality Improvement Project (QIP) aimed to improve the timeliness and quality of LSBP assessments to enhance

Background: Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use. Older adults are at higher risk of antibiotic associated complications, especially C. diff infection. Methods: Baseline data were collected from the hospital's electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance

Introduction Simulation is widely considered as a valuable tool in medical education. It offers a controlled 'practice' environment for all medical professionals to develop their skills clinically and in communication. Geriatric medicine is a complex speciality in which simulation can be particularly beneficial, allowing trainees to manage age-related conditions and multimorbidity in a safe setting, where errors can be corrected and through reflection, practice can be improved. By using simulation, Mersey trainees have enhanced their confidence in managing the unique challenges of caring for

Introduction: Constipation affects up to one-third of adults over 65, with prevalence nearly doubling amongst hospitalised patients. Effective bowel management is crucial in older patients recovering from neck of femur (NOF) fractures, as postoperative constipation can delay mobilisation, increase complications, and prolong hospital stay. Despite debate on the reliability of pelvic X-rays (PXR) for assessing faecal loading, they offer an opportunity for early identification and proactive management. Aim: To evaluate and improve constipation management in patients admitted with NOF fractures by

Introduction: In 2023, we introduced a new interdisciplinary clinic to raise awareness of the choices available for older patients with advancing, near end-stage kidney disease. Patients and their close family were invited to attend the clinic for assessment and discussion of future options. Rationale and Method: Many older patients with advanced kidney disease are relatively asymptomatic and have not considered what might happen and what would be their preferred option when they do become symptomatic. A proportion of such patients develop end-stage kidney failure in the context of an