Posters

1. Introduction Delirium is a very common and treatable condition, and approximately 20-30% of older patients in medical wards in hospitals presented with delirium. Hence it is important to do timely assessment and correct management of delirium. This QIP was carried out to improve adherence to the trust’s clinical guideline for delirium and to improve the communication with patients, relatives, and primary care doctors. 2. Method 40 patients’ notes were randomly reviewed in the geriatric wards of the Addenbrooke’s hospital as baseline, then 20 patients’ notes were reviewed again after PDSA

Background: Delays in documenting a valid DNACPR (Do not attempt cardiopulmonary resuscitation) form in medical notes, for patients with advanced decisions, presses the cardiac arrest team to make difficult decisions about resuscitation, with little time to establish the patient’s wishes. This removes the right, for some patients, to die with dignity and peacefully. Local policy states patients with DNACPR forms should have this reviewed by the senior clinician in charge of their care as soon as is possible. Aim: To reduce the percentage of geriatric patients in Colchester hospital (with

Introduction As we face a 7th wave of Covid in our geriatric wards, we as caregivers are exhausted and find it increasingly difficult to repeat these isolation measures again and again. We are aware of the importance of avoiding clusters but it is mostly the elderly who are positive for Sars-Cov-2 and hospitalised. Fortunately the virus no longer kills, but nevertheless has enormous deleterious consequences on the mental health of our elderly. Methods To expose the practical consequences of clinical cases experienced during these successive waves of Sars-Cov-2 and make a review of the

Introduction Important parts of the comprehensive geriatric assessment (CGA) include medication review and assessment of bone health. Such aspects of CGA can be missed in clinical practice in the busy acute hospital setting. We aimed to improve performance of medication review, and assessment of bone health in patients with falls in the form of vitamin D levels and Fracture Risk Assessment Tool (FRAX) scoring, in admissions to the acute Care of the Elderly (COTE) team in a district general hospital in South Wales. Methodology Data were collected from documentation of the initial review of

Aim STOPPFrail criteria identify potentially inappropriate medications (PIMs) in frail older adults with poor predicted one year survival. This study aimed to determine the proportion of older adults in which STOPPFrail criteria are applicable; measure the prevalence of STOPPFrail PIMs and identify potential medication cost savings. Methods We prospectively reviewed patients who received Comprehensive Geriatric Assessment following an attendance at the Emergency Department (ED) at a large regional hospital. We recorded Charlson Comorbidity Index, Medications, Rockwood Frailty Status and

QIP topic was to improve emollient prescriptions for patients admitted to Elderly Care Unit as not all elderly care patients who are already prescribed emollients by General Practice through regular medication or current acute medication are being prescribed these when inpatient. The aim of the QIP was: By April 2022 we will increase the number of emollient prescriptions for elderly care patients admitted to elderly care unit who are already prescribed these in general practice by 20% The QIP measures were identified which included % emollients correctly prescribed to relevant patients and

Introduction Ambulance offload delays at the Emergency Department (ED) are linked to adverse outcomes. By 2030, 25% of patients attending the ED are projected to be over 80 years old. Geriatric frailty syndromes can be difficult for triage systems to assess, leading to older people being allocated lower priority status and a higher chance of a 4-hour target breach vs a younger patient(1). We assessed whether ambulance offload time is associated with frailty, death or re‐attendance at an emergency department at a large regional centre. Methods Retrospective analysis of adult ambulance offload

Introduction: The number of older people living with frailty in Swansea Bay is increasing. Currently there is no dedicated rapid access multidisciplinary team (MDT) clinic for older adults living with frailty within Swansea Bay University Health Board (SBUHB). As a response to this, the team at Singleton Hospital (SBUHB) piloted a rapid access MDT clinic. Method: The ‘Rapid Access Clinic for the Older Person’ (RACOP) pilot ran for eight weeks across May and June 2022, delivering three clinics per week. Comprehensive Geriatric Assessment was provided via a multidisciplinary team consisting of a

Introduction Dopamine transporter scan (DaT scan) nuclear imaging can be a useful tool in the diagnostic work up of conditions such as Parkinson’s disease (PD) where the underlying physiology of the disease involves striatal dopamine transporter loss. Selective serotonin reuptake inhibitors (SSRIs) bind with high affinity to the dopamine transporter, competing with test compound, ioflupane. There is inconsistent guidance on stopping SSRIs prior to DAT scan due to lack of robust evidence. However, case studies suggest the interaction may result in false positive results. We investigated

Introduction Zoledronic Acid has been shown to reduce the incidence of vertebral, non-vertebral and hip fractures[1]. Once Zoledronic Acid has been administered as an inpatient, follow-up communication to primary care teams should be completed however no formal process was in place. A checklist was developed to ensure consistency in administration processes on Care of the Elderly wards and to ensure adequate documentation and appropriate follow-up communicated to primary care teams. Method Baseline data was collected from 25 patients who received Zoledronic Acid as inpatients under Care of the

Introduction: The General Surgery directorate at Cardiff and Vale University Health Board secured funding for the appointment of a Memory Link Worker (MLW) for a 12-month pilot in the emergency stream. The aim of the MLW is to improve patient experience for those living with dementia/ cognitive impairment, or those who experience delirium whilst in hospital. In addition, the MLW role should increase awareness and completion rates of “Read About Me” (RAM). Method: The pilot scheme started in February 2022. Eligible patients were identified by ward staff or the Perioperative care of Older People

Introduction: Older patients undergoing surgery are often living with frailty and are subsequently at increased risk of morbidity, mortality and loss of independence in the perioperative period. Accurate identification of frailty using an objective tool such as the Clinical Frailty Scale (CFS) is an imperative part of preoperative risk assessment. It also informs which patients should undergo Comprehensive Geriatric Assessment (CGA) by our Perioperative care of Older People undergoing Surgery (POPS) service. Method: The POPS team provided training to Surgical Assessment Unit (SAU) triage staff

Introduction  An increasing number of older people living with frailty are undergoing surgery. The Centre for Perioperative Care (CPOC) published guidelines in 2021 to improve the care of this patient group through the perioperative pathway. Whilst significant progress has been made in Cardiff and Vale in improving unscheduled surgical care for older people, there remains a dearth of services for patients undergoing elective procedures.  Method  A Perioperative Frailty team was formed to deliver a service based on Comprehensive Geriatric Assessment principles, for older people undergoing

Introduction Perioperative geriatrics is an emerging specialty with immense importance to all medical and surgical specialties. Only a small number of papers have been published on the topic. A bibliometric analysis is used to identify themes and trends in current research and practice. Objectives To identify and describe research topics relating to perioperative geriatrics. Methods Thompson Reuters Web of Science indexing database was searched for all manuscripts relating to perioperative geriatrics. Of these, the top 100 were subcategorised into manuscript type, age, theme, specialty

Introduction Delirium affects up to 50% of the elderly who are admitted to in-patient facilities. Delirium is preventable in 30-40% of geriatric in-patients. Trust guidance recommends an initial screening for all admissions >65, followed by continuous monitoring. This initial screening is documented using the 4AT delirium assessment tool and documented as a proforma. ‘’Do you think the patient is more confused than before ?’’ is the single question in delirium (SQiD) rated positive or negative by clinical staff on reviews. The concept of SQiD is to facilitate a quicker and easy-to-use approach

Introduction In The UK around 519,000 new fragility fractures occur each year, with vertebral compression fractures among the most common1. Around 21% of vertebral fractures are incidentally found on radiological imaging2. Within Aneurin Bevan University Health Board (ABUHB) there is no formal pathway for managing incidental vertebral fractures identified on radiological imaging. Objective To retrospectively quantify the burden of incidental vertebral fractures and their subsequent management across a large UK Health Board. Method Patients with incidental fractures on CT scans were identified

Introduction Geriatric and general medical wards have nationally been troubled with an ever increasing patient population requiring carer support at home and a widespread shortage of those able to deliver it. This pilot project aimed to assess patient understanding of the care they were awaiting, their understanding of the reason for ongoing hospitalisation and their satisfaction with the care on discharge. We aimed to improve patient understanding with the use of a patient information leaflet (PIL). Method Patients identified during multi-disciplinary team meetings at two district general and

Introduction On graduation medical students need to be equipped to recognise and manage acute stroke and TIA (Transient Ischemic Attack). Despite inclusion of acute stroke and TIA in our local curriculum less than 10% of students (2/30) reported directly observing stroke thrombolysis during their placement. Due to COVID restrictions no student had been able to attend TIA clinic. To improve students practical understanding of the assessment and management of acute stroke and TIA a simulation-based teaching session was designed. Method The simulation session consisted of a hyperacute stroke

Introduction Back pain is a common presentation in general practice and a significant cause of morbidity in the elderly population. While the majority of cases are secondary to chronic degenerative changes, a number of sinister pathologies may prompt referral beyond primary care. This project assesses whether RADAR is the appropriate service to refer elderly patients with back pain through analysis of patient demographics and NICE guidance. Methods A total of 373 RADAR appointments from October 2020 until April 2022 were screened for record of “Back”/”Spinal” pain. Of the 104 appointments

Introduction Parkinson’s Disease is the second most common neurogenerative disorder and has a pervasive effect on health-related quality of life. There is increasing evidence of the importance of the endocannabinoid system in pre-clinical models of disease. However, there is a paucity of clinical evidence on cannabis-based medicinal products (CBMPs) in Parkinson’s Disease. This study presents a preliminary analysis of those with Parkinson’s Disease enrolled in the UK Medical Cannabis Registry (UKMCR). Method Patients prescribed CBMPs for Parkinson’s Disease symptoms for longer than one month