Posters

Introduction Delirium affects up to 50% of older patients (aged over 65 years) in hospital and is associated with serious consequences including greater morbidity and mortality, longer hospital stays with consequent hospital acquired complications, and an increased likelihood of hospital readmission. Early recognition prompting effective management is critical in improving outcomes for patients with delirium.  Methods  This QIP was conducted amongst Foundation Year 1 doctors (FY1) working across all wards in a busy district general hospital to improve knowledge of delirium through educational

Background Physical inactivity in community-dwelling older adults is modifiable, and physical interventions are effective in reducing age-related decline and disease. Despite this, engagement and retention of older adults in community physical activity (PA) programmes are limited. This review explores factors affecting implementation of effective PA programmes for older people in the community. Methods Review of qualitative literature identified from MEDLINE, Social Policy and Practice, PsycINFO, CINAHL, Cochrane Library and Frontiers in Rehabilitation Science from 1999-2024. Data were

Background Chronic inflammation and metabolic dysfunction are posited to contribute to sarcopenia and physical frailty; both are targets for metformin therapy. We investigated correlations between physical performance measures and inflammatory and metabolic biomarkers in a group of older people with sarcopenia and frailty/prefrailty and investigated the effect of metformin treatment on this biomarker panel. Methods We analysed samples collected at baseline and follow-up (4 months) from the randomised controlled MET-PREVENT trial. MET-PREVENT recruited participants aged 65 and over with

Background Cognitive frailty, defined as the presence of physical frailty and cognitive impairment in the absence of dementia, is a common finding among older adults. The causative factors for cognitive frailty are not well understood. It is known that vascular factors such as arterial stiffness are associated with ageing and frailty. In the Frailty and arterial stiffness- role of oxidative stress and inflammation (FRAXI) study, the correlation between cognitive frailty (assessed by the mini-mental state examination (MMSE)), clinical frailty score (CFS) and arterial stiffness was explored

Background Frailty is known to be associated with vascular ageing. The causative factors for frailty are not well understood. Inflammation and oxidative stress are suggested to contribute to frailty, with some studies in humans investigating this. In this study, the correlation between biomarkers of inflammation and frailty were explored. Methods Fifty community dwelling adults ≥70years (mean age ± standard deviation: 79 ± 5years, 46% male) with clinical frailty score (CFS ≤ 6) were followed up for six months. Vascular parameters such as pulse wave velocity and cardio-ankle vascular index were

Introduction: Menopausal hormone replacement therapy (HRT) is first-line treatment for distressing vasomotor symptoms, and increasingly popular. However data on the association of HRT with ageing-related conditions including frailty is lacking. Method: We analysed women in the Danish population registry (n=471206) , Danish Twin Registry and TwinsUK cohort (n=1547). In Denmark, we assessed frailty age 65, 70 and 75, using a modified Hospital Frailty Risk Score. This linked to national prescribing data, to ascertain HRT use by age 55, adjusting for birth year, education and income. In TwinsUK

Older patients admitted to hospital with a surgical pathology often have multiple medical comorbidities, or develop medical complications during their admission. Such issues include delirium, electrolyte derangement, acute kidney injury, respiratory complications and diabetic or haematological pathologies. Where geriatricians are not integrated into the surgical team, the senior surgeon will often rely on junior doctors to manage these conditions. This can leave Foundation Year 1 doctors feeling overwhelmed and under-supported in the management of the frail and co-morbid surgical patient. Our

Introduction Blood tests are frequently ordered in geriatric wards, often without clear clinical justification. This can lead to patient discomfort, increased costs, and unnecessary workload on staff and laboratory services. This audit aimed to evaluate the frequency and appropriateness of blood test ordering and reduce unnecessary investigations in geriatric wards. Method We reviewed blood tests ordered over a 2-week period across the four geriatric wards at Leicester Royal Infirmary. Seven commonly requested tests were included: full blood count (FBC), urea and electrolytes (U&E), C-reactive

Introduction We know continence is important to older people but can often be overlooked in clinical practice. Continence can now be selected as a theme for service in the new geriatric medicine curriculum but there is concern that the uptake of this is poor. Our aim was to understand and quantify continence training opportunities and understand current and potential uptake of Continence as a Theme for Service. Method A short online survey was created and resident doctors training in geriatric medicine were invited to complete it from December 2024-April 2025. The survey was included in the

Introduction The transition period for new resident doctors is often overwhelming, requiring rapid adaptation while maintaining safe and effective patient care. The British Medical Association (BMA) advocates new resident doctor for induction. To support this process and improve efficiency, we developed an “Older People’s Handbook”, designed to familiarise new resident doctors with common conditions in geriatric medicine, provide practical guidance on navigating the hospital’s computer systems, and offer clear instructions for completing essential documentation. Method Resident doctors

Co-amoxiclav is a commonly prescribed, semisynthetic, empirical antibiotic. It is metabolised in the liver and eliminated via the kidneys. According to the trust guidelines, patients with severely reduced eGFR should receive a reduced dose of intravenous (IV) co-amoxiclav. This audit was conducted to assess whether IV co-amoxiclav dosing in elderly patients with an eGFR less than 30 ml/min was appropriately reduced in accordance with these guidelines. The standard dose is 1.2 g every 8 hours, but in patients with an eGFR <30, a reduced dose of 1.2 g every 12 hours is recommended. This is to

Introduction: Thorough clinical evaluation is crucial in all specialties, but especially in geriatrics. Frailty, cognitive impairment, and reduced patient cooperation can obscure typical features, making diagnosis more challenging. Musculoskeletal, neurological, and cognitive assessments are particularly important for falls or confusion, where missed diagnoses such as delirium or fractures can worsen outcomes. This audit evaluated the quality of clinical examination during clerking and subsequent senior review on the Geriatric Assessment Unit (GAU), focusing on musculoskeletal, neurological

Introduction Royal College of Emergency Medicine and NHS England define reduction of delays and omissions of critical medication as important strategic objectives. Data from Parkinson’s UK indicate that only 37% of doses of PD medication are delivered on time during hospital stays. The aim of this QI project was to evaluate data from previous 2.5 years and evaluate effectiveness of our improvement work. 2. Method Utilising hospital electronic reporting system, information was obtained on time from Emergency Department (ED) Triage document completion to time that PD medication was prescribed

Background This project at St James’s University Hospital involves resident doctors, advanced care practitioners, and patients on Elderly Care Wards where advance care planning (ACP) is commonly needed. Introduction ACP helps patients express future care preferences but can be challenging to initiate and document. The ReSPECT form standardises the recording of patient wishes, and the Clinical Frailty Score (CFS) predicts mortality risk, particularly if ≥5. This project aims to improve ACP discussions and documentation for patients with CFS ≥5 and to boost doctors’ confidence in leading these

Introduction: Osteoporosis affects approximately 3.5 million individuals in the UK, resulting in over 500,000 fragility fractures annually. An initial fracture significantly increases the risk of subsequent fractures, particularly in very high-risk patients. Current clinical guidelines advocate a "treat-to-target" strategy, recommending anabolic treatment for individuals at very high risk of fracture. The objective of this study was to evaluate biochemical safety, service delivery efficiency, and imminent fracture risk among osteoporosis patients receiving anabolic agents. Methods: We

Introduction: Pelvic fractures are a common fragility fracture, associated with adverse clinical outcome but often under recognised. There is a wide range of incidence 6.9-78.6/100,000/year being reported in the UK. There is a paucity of studies describing incidence and adverse outcomes including mortality and re-fracture risk. The objective of this study is to measure incidence of fragility fracture for the population of Gwent (592,000), compare baseline characteristics with all fragility fractures and measure clinical outcomes of pelvic fractures. Methods: All fragility fracture patients

Introduction: Fracture liaison services (FLS) aim to prevent secondary fractures by promptly identifying patients above 50 years with fragility fractures. The standard recommendation by FLS Database (FLS-DB) is to identify 80% expected fragility fractures, commencing treatment for 50% and monitor 80% at 52 weeks. Methods: A quality improvement methodology based on the model of improvement; Plan-Do-Study-Act (PDSA) cycles was introduced in 2022. The fragility fracture case identification increased from 22.7% (2021) to 41.1% (2022) and 58.4% in 2023, a 149% increase. Process mapping for the

Introduction: Dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis and guiding osteoporosis treatment, particularly when used alongside fracture risk assessment tools such as FRAX. Limited access to DXA scans in some centres, highlighting the need to prioritise their use effectively. The project is aimed to improve DXA access and prompt reporting to meet Fracture Liaison Service Database (FLS-DB) national standards. Methods: This multi-dimensional improvement project began in 2022 using the Model for Improvement. Process mapping identified inefficiencies

Introduction: Fragility fractures are a major cause of morbidity in older adults and are often preceded by falls. Identifying patients at greatest risk of refracture is vital for optimising secondary prevention strategies within Fracture Liaison Service (FLS). This study measures impact of history of single or recurrent (2 or more) falls on the incidence of re-fracture and mortality among patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS). Methods: This study included fragility fracture patients (n= 2,176) reviewed by AB-FLS between January and December 2023. Complete data on

Introduction: Hospital at Home (HAH) is an admission avoidance service where patients receive hospital-level care in their own homes. We conducted a retrospective cohort study to compare patient outcomes in older adults with community-acquired pneumonia (CAP) treated through HAH versus an acute frailty ward in hospital. HAH patients received once daily IV ceftriaxone whereas hospital inpatients were prescribed IV antibiotics as per hospital guidelines. Method: All patients diagnosed with CAP requiring IV antibiotics under HAH and on an acute frailty ward were identified between January and