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Displaying 121 - 140 of 1130
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Jacqueline Gilbert 1; Victoria Gray 2; Lorna Shadbolt 1; Kim Fittall 1; Barimah Yaw Darko 1
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Introduction Clinical simulation training is an effective active learning technique that is now incorporated into UK undergraduate and post graduate training. It is commonly used for advanced life support scenarios but to date its use in frailty education is limited. In view of the increasing numbers of people living with frailty, there is a need to develop frailty-specific education programmes that are inclusive for a range of multi-disciplinary team members. Methods A single day frailty simulation programme has been developed, using a mix of table top exercises and scenarios with actors and
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Kambele M, Hosty J, Gaur P, Pratt G
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Background: The National Clinical Guideline for Stroke recommends bone health assessment for patients at higher risk of falls. Following stroke, patients have reduced bone mineral density, correlated with functional deficit. Stroke can result in reduced mobility, asymmetric weight bearing, poor nutrition and impaired Vitamin D stores. This results in higher risk of fragility fracture. However, bone health is often overlooked. An initial review on a stroke rehabilitation unit in March 2024 found no bone health assessment process. Objectives: Patients with stroke and high risk of fragility
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JL Yong1; F Johnston1
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Introduction The timely administration of Parkinson’s Disease (PD) medications is essential for better motor symptom control, leading to improved patient outcomes. The NICE Guidelines and Parkinson’s UK recommend all hospital in-patients with PD should get their PD medications on time – within 30 minutes of their prescribed administration time. This audit aimed to assess the adherence of timely administration of PD medications amongst in-patients at South Tyneside and Sunderland NHS Foundation Trust, and to compare this pre- and post-interventions. Methods A two-cycle retrospective audit was
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Francesca Morgans-Slader (1); Chloe Cropper (1); Alex Bulcock (1); Helen Jackson (1)
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Introduction: The Frailty Same Day Emergency Care (SDEC) unit at Fairfield General Hospital provides same day Comprehensive Geriatric Assessments (CGA). Bone health is an integral part of CGA, however recognition and management of osteoporosis is often not prioritised in acute hospital settings. We noticed that bone health was an area that was often overlooked within our CGAs. Our goal was to increase the number of bone health assessments performed and improve access to appropriate treatment for patients in the Frailty SDEC. The aim of this project was to increase the number of appropriately
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Liam Dunnell¹*, Hugh Logan Ellis²³*, Ruth Eyres⁴, Dan Wilson⁵, Cara Jennings⁵, Jane Tippett⁵, Julie Whitney⁵⁷, James T Teo²⁵⁶, Zina Ibrahim², Kenneth Rockwood³
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Background: Laboratory-based frailty indices (FI-Lab) offer potential alternatives to manual assessment in emergency care settings, but how should we select features and time-frames to find the best balance between coverage and performance? We evaluated multiple FI-Lab configurations to determine the optimal configuration requirements for reliable automated frailty assessment. Methods: We analyzed 74,493 ED visits from 54,075 patients aged ≥70 years across two London hospitals (2017-2021), comparing five FI-Lab configurations and a drug-adjusted version against nurse-assessed Clinical Frailty
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Liam Dunnell¹*, Hugh Logan Ellis²,³*, Ruth Eyres⁴, Dan Wilson⁵, Cara Jennings⁵, Jane Tippett⁵, Julie Whitney⁵,⁷, James T Teo²,⁵,⁶, Zina Ibrahim², Kenneth Rockwood³
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Background: Our recent research found significant visit-to-visit variability in nurse-assessed Clinical Frailty Scale (CFS) scores in Emergency Departments (ED), potentially limiting their reliability across patient encounters. This study investigated whether laboratory-based frailty indices could provide more stable assessments while maintaining clinical utility. Methods: We conducted a retrospective cohort study focusing on patients with multiple ED attendances between July 2017 and December 2021 across two London hospitals. From 23,956 patients with repeated visits (total visits = 60,381)
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1. M Fisher, 2. C Culyer, 3. F Ali, 4. S Shubber
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Introduction: It is important to identify delirium on admission as delirium increases patient mortality and also is linked to an increased length of hospital admission (1). Delirium is identified through a scoring system such as 4AT (2) and should be done on all patients over 65, with new confusion, or reduced mobility (3) as per NICE guidelines. The aim of the QIP is therefore to bring the department in line with NICE guidelines and increase the number of patients in the over 65 cohort having a cognitive assessment, and in particular looking at those with confusion and falls as these can be
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H Alexander, M Fincher, P Simpson
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Introduction The UCNH model is being implemented across Sussex to reduce ED pressures. Based at the Polegate Make Ready Centre, the UCNH launched in mid-November 2024 to provide alternative pathways for 999 callers. The UCNH operates as a multidisciplinary team of up to eight clinicians, including an Urgent Community Response Trainee Advanced Care Practitioner and a Consultant in Frailty, two Advanced Paramedic Practitioners, two Computer-Aided Dispatch drivers, and two remote consultation paramedics. Method The team triages calls, manages acute cases, and works collaboratively with ambulance
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Ayesha Masood, Jeremy Pluess, Donal Fitzpatrick, Cian O’Caheny
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Introduction: Polypharmacy, multimorbidity, and frailty are closely interlinked. The STOPPFrail (Screening Tool of Older Person’s Prescriptions) criteria offer a structured approach to identifying potentially inappropriate medications (PIMs) in very frail older adults with limited life expectancy. This study evaluates the application of these criteria before and after admission to a specialist geriatric ward in a tertiary care hospital. Methodology: Medications were assessed against the STOPPFrail (Version 2) criteria before and after admission. Patients aged ≥65 years were included if they
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N. Davey 1,2, G. Harte 1,5, A. Boran 3,4, P. Mc Elwaine 1, 2, S P Kennelly 1,2,4
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Introduction Gait speed, often referred to as the 'sixth vital sign,' is an important health indicator in older adults, predicting morbidity and functional status. This study evaluated GaitKeeper, a novel artificial intelligence (AI)-enabled mobile technology that integrates augmented reality (AR). GaitKeeper is designed to standardise the measurement of gait speed and address inconsistencies commonly encountered in traditional clinical settings due to varied assessment techniques. Methods This study was conducted in two phases to validate GaitKeeper against Vicon and GaitRite, two established

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Tan Sze Yang, Gordon Pang Hwa Mang
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Introduction Malaysia is transitioning from an ageing to an aged nation. According to the Department of Statistics Malaysia (DOSM), 7.4% of Malaysia's population was aged 65 years or older in 2023, projected to exceed 15% by 2030. Frailty is increasingly prevalent, affecting 11% of adults aged 50–59 years and escalating to 51% among those aged 90 years or older, based on global data. A local pilot study in March 2024 in general medical wards highlighted common frailty-related issues, including deconditioning (36%), delirium (17%), and a 12-month readmission rate of 46%. Objectives To introduce
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C Bennie1; J Burton1; A Falconer1; H Gilmour2; H Morgan1; C Ritchie2
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Introduction Early access to specialist care is recognised to be beneficial for older adults living with frailty. Decision-making around assessing function and mobility to facilitate safe discharge can be challenging for staff in an Emergency Department environment. This can result in patients being admitted to await specialist review. The aim of this test of change was to explore the role and contribution of a Specialist Frailty Allied Health Professional (AHP) within the ED and to evaluate the impact on the care of patients living with frailty. Methods For a 12-month period, the ED has had a
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Nathan Leung
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Neck of Femur Fractures (NOFF) - Educational QIP on Medication Management to Reduce Avoidable Hypotension and Acute Kidney Injury (AKI) Introduction Hip fractures prevalence increases with age. Patients aged ≥80 years have high morbidity and mortality risk following a hip fracture (hazard ratio for men [HR] 7.95, 95% CI 6.13-10.30 and HR women 5.75, 95% CI 4.94-6.67, respectively). Intraoperative hypotension is a risk factor for Acute Kidney Injury (AKI) after Neck of Femur Fracture (NOFF) surgery. The National NCEPOD AKI Report found a third of AKI is predictable and avoidable. Sodium-Glucose
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L Duffy 1; J Cassidy 2; S Le Sommer 2; K McArthur 2; P Murray 2; J Queen 2; E Walker 2
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Introduction: Older people living with frailty are core users of health and social care. Services attuned to their needs afford better outcomes, help avoid harm and improve the experience for people living with frailty and their carers. These services may also help with flow and capacity. The Glasgow Royal Infirmary (GRI) Team aimed to advance services in order to enhance the quality and provision of care for older people with frailty. Methods: As part of the Health Improvement Scotland Focus on Frailty Programme, the GRI Team developed processes for early identification of people living with
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Kerry Lyons
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Title: An overview of the Dementia UK Consultant Admiral Nurse service supporting families affected by frailty and dementia Authors: K Lyons1. Provenances: 1. Dementia UK Introduction: Emerging and increasing frailty often goes unidentified, and families living with dementia and frailty are missing vital opportunities to receive the right support at the right time. People living with frailty are less able to adapt to stress factors such as acute illness, injury, or changes in their environment, personal or social circumstances, leading to adverse health outcomes and an earlier loss of
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P Crawford1,2; R Plumb2,3; P Burns1; S Flanagan1; M Devlin1; C McParland1; M Smyth1; C Crawley1; A McGrath1; L Dolan1; C Conroy1; C Morris1; C Gallen1; C Fannin1; A Glass1; J Barrett1; C Marner1; M McFarland1; C Parsons2.
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Introduction: World Guidelines for Falls Prevention & Management for Older Adults[1] recommends medication review as part of multifactorial risk assessment for those at high risk of falling. Use of Falls Risk Increasing Drugs (FRIDs) [2], polypharmacy and anticholinergic burden are known to increase risk of falls in older people [3]. This prospective observational study was conducted to assess if polypharmacy, prescription of FRIDs and anticholinergic burden [4] improve after hospitalisation with a fall. Method: Data gathered from electronic medication records once necessary ethical approvals
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ZAID AL-DEERAWI; DON SIMS
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Introduction . DVT is a common complication post stroke. Clinically evident DVT can occur in 2-10% after an acute stroke. DVT can develop as early as Day 2 after acute stroke; Risk peaks between Days 2 and 7. Untreated proximal DVT has a 6-15% mortality risk. Intermittent pneumatic compression (IPC) of the legs is recommended to reduce the risk of DVT in non-ambulatory stroke patients. Methods Criteria = All new stroke admissions to Stroke ward should have IPC applied by the time they were seen by the consultant on the post-take ward round – Unless contraindicated. Initial Audit = 100
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K Edwards 1; C Brighton 2.
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Background: The Gold Standard Framework (GSF) was first introduced to General Practice in 2000. It is recognised a third of hospital inpatients may be in their last year of life and over the past 25 years there has been evidence to show the GSF reduces hospitalisation and allows more people to live and die in their preferred place of care. Teams undertaking GSF find admissions and lengths of stay are significantly reduced. Our inpatient ward did not have processes to identify those appropriate for the GSF therefore a process to identify and code patients for the community to follow up on
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A Chandani : C Cunanan; S Ragavan
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Aim: We aimed to improve the assessment, documentation, and management of inpatient falls by introducing a memorable CARE poster and promoting the use of a digital falls proforma for both nurses and doctors. This initiative aims to standardize practices and enhance patient safety. Method: Cycle 1: Initial data revealed poor documentation of falls, with missing elements such as Clinical Frailty Scale (CFS) scoring, medication review, pain management, and lying/standing blood pressure (LSBP) measurement. These critical aspects were incorporated into the CARE poster. Cycle 2: The CARE poster and
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Catherine Crisp
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Introduction: With an aging population of major trauma patients admitted to the Southwest Major Trauma Centre, a dedicated team of medics, nurses, and therapists launched a pilot aimed at enhancing the care of frail major trauma patients in a Major Trauma Centre (MTC). This initiative - the Frailty and Trauma Liaison Team (FTLT), focuses on ensuring continuity and quality of care for this vulnerable population in major trauma. Methods: It targeted the completion of comprehensive geriatric assessments (CGA) within 72 hours for patients with a Clinical Frailty Scale (CFS) score greater than 4
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