Posters

Background Postural hypotension is defined as a reduction in systolic blood pressure of ≥20mmHg or diastolic blood pressure of ≥10mmHg that occurs within 3 minutes of standing [1]. Given that postural hypotension can result in unexplained falls [2,3], current NICE guidance recommends measurement of postural blood pressure (BP) in patients aged 65 years and over that present to secondary care following a fall [4]. Aims To record outcomes related to postural BP measurements, all-cause and fall-related readmission and mortality. Methods We conducted an audit of patients aged over 80 attending ED

Introduction Older adults are at risk of falls, which increases further in care homes. Due to the complexity of care home residents’ conditions and an increasing ageing population, it is important for care staff to have knowledge and understanding in falls awareness, prevention, and management in order to support their residents. Literature searches identified that barriers to care staff implementing falls prevention strategies included limited knowledge of staff and insufficient resources (including lack of staff training). There is scarce research regarding methods to deliver training to

Introduction A suspected urinary tract infection (UTI) is the most common reason to prescribe antibiotics in a frail older patient. Therefore, correct recognition and documentation of UTIs, as well prescribing of antibiotics, is important for optimising patient care. Methods We reviewed UTI antibiotic prescribing practice across the Health and Ageing Unit (HAU) wards at Kings College Hospital over a two-month period. Weekly data we collected from all patients commenced on antibiotics for a suspected UTI highlighted key areas for improvement. We designed and delivered a multifaceted educational

Introduction: Orthostatic hypotension (OH) is common in both community dwelling and hospitalised older adults. It is associated with significant morbidity, falls and all cause mortality. A spot audit of inpatients across all care of the elderly wards in Gloucester Royal Hospital and Cheltenham General Hospital revealed only 67% of appropriate patients where having documented lying and standing blood pressure measurements. Of those with documented orthostatic hypotension 44% had no documented action plan. Methods: Using quality improvement methodology this project aimed to achieve 100% of

Introduction: Falls in older people are associated with multifactorial risks which are often preventable. Last year there were over 220,000 emergency admissions for falls in people aged 65 years and over in the UK. Improving how we assess such patients on admission may help to ameliorate these risks and prevent future admissions. Method: The aim of this quality improvement project was to identify weaknesses in our acute risk assessment of multifactorial falls and to improve on these. We completed a retrospective case note review for 68 patients in their first 48 hours of admission. As an

Background An important modifiable risk factor associated with falling is the use of falls-risk inducing drugs (FRIDs). The World Falls Guidelines identified this as a key domain and recommended that a validated tool should be used in medication reviews targeted to falls prevention in older adults (1). A proforma was created based on the STOPPFall Tool (2) to aid doctors in performing structured medication reviews in patients with falls. The research question was ‘in older adult inpatients with falls, does use of the STOPPFall screening tool increase deprescribing of FRIDs?’ Methods The

INTRODUCTION: In order to improve resident safety and reduce hospital admissions, the ‘Optimizing Bed Height Quality Improvement Study’ aims to raise awareness among healthcare professionals about the importance of ensuring optimal bed height to prevent falls and injuries in residents and to improve bed mobility. The parameters from a 2015 study, ‘Analysis of the Influence of Hospital Bed Height on Kinematic Parameters Associated with Patient Falls During Egress', are taken into account when using intervention techniques. METHODS: Residents aged 65 or over falling out of bed between January

Exercise is beneficial for Parkinson’s disease (PD), but many people struggle to achieve the 150 minutes per a week recommendation. Symptoms of PD or co-morbidity may be barriers for exercise; and physiotherapists can provide expert assessment and tailoring of exercise to accommodate these needs. We developed a remote physiotherapy intervention using videoconference (Attend Anywhere). An ongoing feasibility trial is assessing this intervention, and a process evaluation seeks to understand the broader context and acceptability of the intervention. Here we present a qualitative study of

Introduction Mittens are used to facilitate necessary interventions safely in patients who lack the mental capacity adhere to them. A serious incident (SI) occurred at our Trust when a patient, with delirium, developed pressure ulcers to their wrists as a result of prolonged use of mittens. A subsequent investigation revealed that there had been inadequate skin checks and insufficient documentation, from the medical team, directing the use of mittens. Method A multidisciplinary QIP was initiated: • For the Medical team: An electronic “Mittens Request Form” was created. This included fields to

Introduction Over 250 medications are reported to cause postural hypotension, associated with serious adverse outcomes in older adults. Studies in the literature and guidelines suggest a harmful cumulative risk of postural hypotension with multiple medication use. However, there is limited evidence on the potential for harm in practice, particularly which drugs are co-prescribed and may increase risk of postural hypotension. Methods Retrospective cohort study and cluster analysis using general practice data from IQVIA Medical Research Data (IMRD) in patients aged ≥50 contributing data between

Introduction: Indwelling urinary catheters (IUC) are well-known to cause serious adverse outcomes in older adults; such as catheter associated urinary tract infections (CAUTI), direct trauma, delirium, deconditioning, falls, restrain, prolonged length of stay etc. (Lee E., Malatt C, 2011). Removal of IUCs as soon as the indication is resolved, results in better outcomes (Dawson et al, 2017). We identified high rates of inappropriate catheterisations as a regular practice or part of sepsis protocol in our hospital. This QIP was designed to compare our practice against the standards set by NICE

INTRODUCTION Postural hypotension (PH) is an identifiable and potentially reversible cause of falls in elderly patients. The National Audit of Inpatient Falls recommends lying and standing blood pressure (LSBP) measurement for patients aged over 65. Our project aims to review current clinical practice and to develop a standardised approach to correctly investigate and manage PH in patients admitted following a fall to the geriatric department. METHOD: We performed two cycles of retrospective data collection across three geriatric wards, looking at percentage of patients investigated for PH and

Introduction Delirium is common in hospitalized older patients. It is associated with increased mortality, poorer functional outcomes and increased length of stay. It has also been shown to be positively associated with level of co-morbidity in older postoperative patients. The aims of the study is to assess the correlation between delirium and co-morbidity in older medical inpatients. It also aim to determine the effect of gender on this association. Method: This was a prospective, cross-sectional analysis carried out as part of a Quality Improvement Project on screening for delirium in older

Background The Ageing Well programme within the NHS Long Term Plan promotes person-centred care aligning with the goals of Integrated Care Systems (ICSs) in unifying health and social care aiming to increase the proportion of care to older people delivered in the community (NHS England, 2019). As most older people admitted to hospital are conveyed by ambulance services this presents a focus to reduce hospitalisation (Maynou L, Street A, Burton C, et al. Emergency Medicine Journal 2023). North Central London ICS has invested in ‘Silver Triage’ a pre-hospital telephone support scheme which sees

Introduction Increased frailty is associated with increased post-operative morbidity and mortality in older patients undergoing emergency laparotomy. NELA recommend documentation of frailty in surgical patients over 65. Using QI methodology, we introduced a ‘CARE tool’ for surgical doctors aiming to improve their documentation of an older person’s medical history (including CFS and delirium). Method A collaborative team representing geriatric medicine, anaesthetics and surgery devised the acronym CARE ( Cognition, Assistance at home, Record the CFS, Exercise tolerance). The tool was tested

Introduction: A weekly ward-based teaching programme was designed and implemented using quality improvement methodology. 10 topics were identified to be covered during each 4-month rotation. 1) Topic of the week introduced via a presentation in the weekly teaching session; 2) Daily topic discussions at ward level. Method: 7 wards. PDSA 1 (weeks 1 and 2): Weekly poster with the topic and a daily fact / question PDSA 2 (week 3 onwards): a) Software introduced to enable interaction in the teaching session b) Departmental WhatsApp used to send out daily questions. PDSA 3: a) New topics selected b)

Background: The MDTea is a free open access medical education podcast designed for all healthcare professionals caring for older adults. To date there are 120 episodes. Introduction/Method: The MDTea Podcast has CPD survey logs on its website where listeners who access the website can record their learning and receive a CPD certificate, Listeners provide their professional roles. Listener numbers for episodes were much higher than those recorded in the CPD log, so alternative measures were sought to understand who listens to the podcast. Series 11 was released in January to July 2022 and was

Introduction Dementia and hearing loss (HL) are becoming increasingly prevalent in society and commonly co-exist. People living with concurrent conditions have complex needs and face additional barriers to diagnosis and management. There is a paucity of research regarding the current and optimal management of HL in people living with dementia. This research aimed to: (1) examine the current clinical provision for people living with HL and dementia within UK audiology services, and (2) explore recommendations for the management of co-existing HL and dementia from professionals and people living

Background and Aims Many medical specialty trainees report a lack of confidence in hyperacute stroke management, contributing to inefficient patient care. We identified a lack of knowledge of our pathways, as well as difficulty managing human factors, particularly communication and teamwork. We hypothesised that the implementation of a simulation-based education programme could address these issues amongst medical specialty trainees and lead to improvements in our door-to-needle (DNT) times. Methods We organised a scenario-based simulation education session for our trainees led by a multi

Abstract Content - Introduction Frailty is an important clinical syndrome of increased vulnerability to stressors. The impact of frailty on stroke is a growing research area. We carried out a systematic review for an up to date picture of the prevalence of frailty and its impact on a wide range of outcomes Methods We searched Medline, Embase and CINAHL for studies referencing frailty and stroke. We assessed quality of studies using National Heart, Lung, and Blood Institute (NHLBI) quality assessment tools. We collated prevalence of frailty and impact on outcomes after stroke or transient