Introduction: The number of older adults has been constantly growing around the world. Chronic disease occurrence and concurrency increase with age, and medication use rises correspondingly. The World Health Organisation (WHO) defines multi-morbidity as the “ co-occurrence of two or more chronic medical conditions in one patient.” The most commonly used definition of Polypharmacy is “taking co-currently five or more medications daily by an individual.” Polypharmacy is associated with increased mortality, falls, adverse drug reactions, hospital stay, readmission, and medication costs. STOPP
The 2022 national heart failure audit noted, "Older patients are less likely to access diagnostics, lifesaving drugs, and specialist care.” Additionally, there is evidence suggesting that they are less frequently initiated on disease-modifying drugs (DMD). The National Institute for Health and Care Excellence (NICE) supports the use of SGLT2 inhibitors for those with heart failure with reduced ejection fraction (HFrEF). However, this has recently expanded to those with preserved ejection fraction (HFpEF). This is significant for elderly heart failure patients as SGLT2 inhibitors offer a
Background: Clear and accurate documentation of a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision is vital to ensure patients receive appropriate care and autonomy regarding their end-of-life management. Inaccuracies or omissions allow potential for unnecessary or harmful interventions to occur. Aims/Objectives: To produce ≥20% improvement in accuracy and overall completion of all sections of respiratory inpatient ReSPECT forms, with particular focus on DNACPR decisions, during a four-month respiratory
The 4AT Score is a simple tool recommended by NICE to help detect Delirium in everyday practice. In QEH Gateshead, clerking sheets include this score however it is frequently missed by admission doctors. Our QIP standard was that all patients >65 should be screened for Delirium in accordance with NICE Guidance and to improve this. Clerking sheets were audited to assess completion of 4AT scores. Improvement Methodology included prompt cards on working computers, posters in handover rooms, verbal reminders and quick teaching after morning handover. Run charts shows improvement in patients >65