Background: Sialorrhoea is the increase of drooling due to poor clearance of saliva and is a common symptom in people with Parkinson’s Disease. It can lead to a decline in confidence, as well as increasing the risk of aspiration pneumonia. Botulinum injections are currently used in select patients to control the sialorrhoea, and the purpose of this project was to assess the benefit this treatment has had on patients. Methods: Data was collected from 40 patients who have received treatment at the sialorrhoea clinic and included Drooling Severity and Frequency Scale (DSFS), EQ5D and Visual
INTRODUCTION: Our QIP was conducted in the Geriatric wards at Royal Gwent Hospital by doctors working in Geriatrics. Delirium, falls, confusion and urinary retention are common reasons for hospital admission in the elderly. Anticholinergic burden (ACB) is the cumulative effect of taking multiple medicines with anticholinergic properties contributing to frequent admissions. The aim of our QIP was to increase doctor’s awareness of ACB and encourage the review and deprescribing of regular medications in elderly patients to decrease ACB. METHODS: ACB was measured on admission and discharge using
Background: Idiopathic Parkinson’s disease (IPD) increases fall risk and is associated with osteoporosis and fragility fractures (FF). Despite the high risk of adverse outcomes from untreated osteoporosis in IPD patients, bone health is clinically overlooked. This study aimed to evaluate the adequacy of bone health assessment among Aneurin Bevan University Health Board (ABUHB) patients. Methods: This observational cohort study retrospectively analysed data from IPD patients at the ABUHB movement disorder clinic, between May 2022 and January 2024. Data collected included: demographics, disease
Introduction Zoledronic acid, a bisphosphonate used primarily for treating osteoporosis and other bone-related conditions, traditionally requires hospital visits for administration, which can be burdensome, especially for frail older patients. The administration of intravenous (IV) Zoledronic acid at home via Community Rapid Response Teams (CRT) represents an innovative approach to enhance patient care and accessibility while offering significant benefits to patients and healthcare services. Service Delivery CRT team is typically composed of highly trained nurses and doctors, equipped to
Introduction The importance of nutritional support has been extensively investigated in studies of people with hip and fragility fractures. Hospital nutritional assessments vary in quality, and this limits the extent to which risk assessment can be viewed as a meaningful indicator of nutritional support. Provision of supplements is an alternative measure, but only if known to have been consumed. For this reason, we developed a protocol to capture actual consumption of prescribed supplements. Methods Following nutritional risk assessment, the prescription and distribution of supplements was
Introduction: Musculoskeletal (MSK) injuries are a common factor in acute presentations to the emergency department (ED). Effective pain management is crucial for patient comfort and recovery, yet pain control for MSK injuries admitted under the medical team often falls short of optimal standards. This quality improvement project aims to evaluate and enhance the prescription practices for pain relief in elderly patients with MSK injuries at the Wrexham Maelor Hospital (WMH) ED. Methods: A two cycle project was completed in which patients with MSK injuries were identified and reviewed regarding
Introduction A good discharge summary for a patient is an important clinical record that narrates and communicates clinical information about the patient's entire hospitalisation. Discharge communications between healthcare facilities play a pivotal role in the coordination of patient care. As geriatric patients’ physical health is intricately woven into their social circumstances, mobility, and available care facilities, the mention of these parameters becomes quite important as it informs the community medical team of the patient’s condition more comprehensively. Crafting a good summary is
Pain management is essential for quality care in all inpatient settings, where pain may stem from trauma, acute medical conditions, or surgery. Patients with cancer or chronic pain often experience acute exacerbations or may develop acute pain related problems. This audit aimed to assess adherence to best practices in pain management for hospitalized patients and compare current pain management services in UK. We conducted an 8-week audit at Derriford Hospital, Plymouth, using patient records from seeEHR. We assessed the effectiveness, safety, and immediacy of pain relief actions and whether
Abstract Content - 'The number of patients being diagnosed with Heart Failure (HF) on a global scale continues to rise, placing a huge strain on the National Health Service (NHS). Caring for patients with HF comes with huge cost implications and exacerbates an already growing economic burden for healthcare systems. HF care needs to be standardised and integrated if we are to provide optimal care. Evidence shows that there is potential to improve the detection, diagnosis and management of HF care through innovative care pathways when delivered consistently through strong leadership and
Introduction This project aims to explore the diagnostic experiences of people with Parkinson’s disease (PD) and compares this with the experiences of healthcare professionals diagnosing PD, to inform areas of improvement to increase patient satisfaction. Method A quality improvement project conducted using two surveys, one aimed at clinicians, and one aimed at people with PD, which were distributed via email and in person, to allow insights to be gained from conversation. Results 31 patients and 24 professionals completed the surveys. 63% of patients were happy with the diagnosis
This service evaluation reviewed the impact of the Perioperative Care of Older People Clinic (POPS) on Anticholinergic Burden (ACB) in older surgical patients and identified areas for improvement. The study assessed 75 patients aged ≥65 years, revealing widespread anticholinergic use. Among patients on anticholinergics, 34% experienced a reduction in ACB post-POPS review. However, maintaining these changes at ≥6 months was challenging, with 50% of patients experiencing a change in their ACB score due to new prescriptions or the re-initiation of old medications. The study identified
People from ethnic minorities face additional challenges in hospital. These contribute to poorer progress and outcomes. We set out to develop an online resource to help hip fracture teams provide answers to questions commonly posed by people presenting with hip fracture, and to address inequalities in patients’ and their families’ access to information. Method In 2021 we surveyed all 167 hospitals in England, Wales, and Northern Ireland which look after people with hip fracture – to identify which provided printed or digital information, and which made this available in languages appropriate
A 75-year-old male presented with worsening lower limb muscle weakness and was initially treated for infection, as blood tests showed high CRP and WBC levels. However, CRP levels remained persistently elevated without improvement. Further investigations revealed a positive Mi2a antibody, suggesting myositis despite normal CK levels. MRI of the lower limb showed increased signalling in the right tibialis anterior muscle, consistent with inflammation and a biopsy confirmed the diagnosis. This case highlights an atypical presentation of myositis with normal CK levels affecting distal limbs. It
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