Posters

Introduction Fracture prevention is a key component in the care of frail patients who fall. Patients that have already fallen and suffered a fractured neck of femur are highly likely to fall again, and have proven themselves high risk for fracture. Bone protection is a priority, and recent guidelines recommend IV Bisphosphonates as an appropriate 1st line drug. Vitamin D level should be 50 or above before this is given. Method: I audited the notes of 41 patients age 60 years or over who were admitted in 2022 with a fractured neck of femur. I reviewed their admission Vitamin D level, and

Abstract: Ageing is a complex biological process that is progressive in nature. There is a decline observed in the muscle mass and the sensorimotor systems which may contribute to decreased balance and stability while walking.Balance is one of the most crucial intrinsic risk factor for the occurrence of falls. Falls are the leading cause of fatal and non fatal injuries among the elderly.Multiple studies indicate that a structured exercise program helps in improving balance and reducing risk of falls.Exercises can be performed on land as well as in water.Thereby the need of the study to

Introduction:Aging has been defined as a progressive, generalized impairment of function resulting in a loss of adaptive responses.Balance impairment is a major contributor to falling in elderly as efficiency of postural control system decreases with aging.Several different exercise programs have been suggested to address balance and falls in elderly.Virtual reality gaming and dual task training on balance may be an effective tool for addressing these problems because it includes different elements of balance which may improve functional mobility and is at the same time enjoyable and engaging

Introduction Using a patient centred, valued based health care approach to reshape the acute frailty unit with the University Hospital of Wales. Our multi-disciplinary team provide our patients with a compressive geriatric assessment. The goal is to ensure our patients are treated in a timely, thorough manner to avoid deconditioning and hospital induced harm. We want our unit to be guided by the needs of our patient population. Methods A redesign of the service structure within the acute frailty unit was undertaken as a result a patient survey taken in 2021. The aim was to focus on concerns

Introduction: The benefits of early frailty scoring for patients over 65 presenting to emergency settings are well established. A scoping exercise in the Emergency Department (ED) at the University Hospital of Wales (UHW) identified lack of familiarity with the Clinical Frailty Scale (CFS) and time pressures as barriers to achieving frailty screening at triage. In response, the Frailty Intervention Team (FIT) at UHW developed the Self-Assessment of Frailty in the Emergency Settings Tool (SAFE-T). Methods: A PDSA cycle was performed to assess SAFE-T validity and the feasibility of

Falls and fall related injury are a common problem within our older adult population and are associated with an impact on quality of life and functional independence. The first phase for reducing adverse effects from falls is to identify risk factors that can cause or exacerbate the risk of falling and then act to minimise these risk factors. Method A retrospective audit was undertaken to review how falls are assessed in a front door frailty service within the emergency department (ED) and acute medical units (AMU). The notes of each patient who had attended following a fall and was assessed

Introduction The World Health organisation states that polypharmacy is a major global challenge. Older people in care homes are at risk of harm with 91% taking 5 or more medications. Pharmacists play an essential role in conducting medication reviews, identifying potential drug related problems, and implementing appropriate interventions to optimise treatment. Method As part of a pilot project for The Welsh Government Six Goals For Urgent and Emergency Care Pharmacists in Swansea Bay University Health Board’s Medicines Management team worked in collaboration with Consultant Geriatricians at

Objective: To evaluate the environmental impact from home visits the ESD team carry out and the implementation of electric vehicles to reduce the carbon footprint. Methods: Travel expense data of the ESD team across the last 2 weeks of April was collected and CO2 emissions from each team member was derived. A focus group was conducted to gather the team’s stance on electric vehicles for home visits. Results: A significant amount of CO2 is produced daily, with the total across the two weeks being close to that of a small-to-medium enterprise. Introducing an electric vehicle would help reduce

Introduction Keeping our standing balance is a crucial capability in preventing falls. Nevertheless, older adults may focus attention internally to their movement mechanisms during stance, through conscious movement processing (CMP), when facing balance difficulties. However, this may interfere with movement automaticity that could cause balance problems. The primary aim of this pilot study is to examine the effects of attention focus balance training on CMP propensity in older adults at risk of falling. Method Twenty-four older adults (mean age = 79.92 ± 7.61) with moderate to high risk of

Aims This closed loop audit aims to primarily assess and improve the number of geriatric patients who fell on elderly wards in a District General Hospital using cost effective methods. The secondary aim is to improve documentation of falls and assess for contributing factors. Hypothesis The primary hypothesis is that number of falls can be reduced through better nursing training and co-locating high risk patients. The secondary hypothesis is that improvements in documentation can be made with nursing training specified to falls and to corroborate risk factors with existing literature. Methods

Background: Good nutrition and hydration are essential to patient’s health and wellbeing. Reduced nutrition leads to increased hospital admissions, re-admissions, longer length of recovery, poor wound healing and sarcopenia. Introduction: In hospital inpatients, especially when frail or vulnerable, the ward’s duty is to ensure that appropriate pathways exist to support their nutritional status and identify those who need additional support, additionally making sure patients have access to food and drink. Our ward wasn’t compliant with hospital standards. Additionally, patients experienced

Introduction The Cardiff and Vale Memory Team is comprised of a range of healthcare professionals who provide direct and indirect contact to coordinate the care of dementia patients. Memory link workers (MLWs) are a single point of contact for patients; they contact patient’s post-diagnosis and at 6-month intervals. Clinical Nurse Specialists (CNSs) assist patients with medical aspects of their care, including diagnostic home assessments with the support of the medical team. This evaluation aimed to establish the impact of these roles on people living with dementia and their carers. Methods

Introduction The weekend on-call team attends ward emergencies and front door new assessments. The extra routine ward work results in delays in the new assessments and adds further exhaustion for the on-call team, impacting junior doctor’s well-being and patient safety. Objective Aim to improve patient safety by facilitating the continuity of patient care over the weekend Method Group discussions among junior doctors, nurses, pharmacists, and ward managers were done to understand the challenges that impact communication. The average time spent on a ward by on-call team was 60 minutes. Plan-do

Introduction  People with Parkinson’s (PWP) are twice as likely to fracture and over twice as likely to develop osteoporosis (1. Henderson et al, Parkinsonism & Related Disorders, 2019, Vol.64, pp.181-187). This is associated with significant morbidity (1). Assessment of bone health is often overlooked in clinic (2. UK Parkinson’s Excellence Network, 2019, pp.4-56), deeming it a priority area for improvement. Our project focuses on implementing routine bone health assessment for PWP in clinic, to achieve better standards of care.    Methods  This was a 12-week medical student led project

Postural Hypotension also known as orthostatic hypotension is defined as an abnormal drop in blood pressure on standing after periods of sitting or lying down, with a sustained reduction of systolic blood pressure of at least 20mmHg and/or diastolic blood pressure of at least 10mmHg. The prevalence of postural hypotension increases with age with one in five community-dwelling adults over the age of 60 years old and one in four people in long term residential care, which will ever grow with the growing elderly population. By discussing with patients on our ward it was clear that patients were

Introduction Old age psychiatry wards facilitate patients who have physical health needs alongside mental health needs, deeming them high risk for falls. Following a fall, best practice suggests a doctor should perform a medical review. An audit of this was performed within the Harplands Hospital in-patient elderly care psychiatric ward, which revealed incomplete documentation or the absence of a review. Subsequently, a post-falls proforma was implemented and a re-audit was performed. Method Audit cycle one gathered data on post-falls documentation between August and September 2020. A falls

Introduction: The Older Person's Assessment Unit (OPAU) Physiotherapy team have been collaborating with Breathe Arts Health Research (BAHR) to provide ‘Dance for Strength and Balance’ (DSAB) classes for Older Adults as an alternative to traditional, long-established Strength and Balance Group (SABG). Previous preliminary data established DSAB to be safe and effective in falls risk reduction for participants. The primary aim of this service evaluation was to determine if DSAB is at least as effective as SABG for improving outcomes and reducing falls risk for OPAU patients. Methods: 46 DSAB

An 86-year-old lady, presented with an unwitnessed fall with no obvious head injury. Her Glasgow Coma Scale (GCS) was 15 on arrival. She denied precipitating factors, taking blood thinners or seizure medication. Her examination revealed tongue biting, suprapubic tenderness, and pain in both hips and arms. An X-ray of the possible affected joints was ordered. Bloods and venous blood gas (VBG) were unremarkable. Within a few hours, she had a witnessed tonic-clonic seizure with a swollen tongue, for which lorazepam and adrenaline were administered. Repeat VBG (post-ictal) revealed a high lactate

Fractures occurring after “low energy trauma” are described as fragility fractures. They most commonly happen in the spine, hip and wrist due to osteoporosis and its associated risk factors, including gender, age, medications (e.g. steroids), etc (1). Menopause in women also has a drastic impact on the risk of osteoporosis. In 2019, 3,775,000 UK citizens had a diagnosis of osteoporosis - 820,000 men and 2,955,000 women. In the same year, there were 527,000 new fragility fractures in the UK (2). Nevertheless, osteoporosis and fragility fractures do not only pose a problem within the UK. It is

During the pandemic, diagnosing Dementia has declined significantly by over 35%. A Collateral history refers to information obtained from individuals other than the patient, such as family members, friends, or caregivers. This information is often crucial and can provide valuable insights into a patient's medical history, symptoms, behaviours, and social circumstances. Studies have proven a collateral history can enhance medical assessment, improve treatment planning, aids safety concerns and act as a diagnostic aid. By obtaining information from multiple sources, Doctors can compare the