1318 IMPROVING PERFORMANCE OF MEDICATION REVIEW AND ASSESSMENT OF BONE HEALTH IN GERIATRIC ADMISSIONS: A QUALITY IMPROVEMENT PROJECT

Abstract

Abstract 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. Method Data were collected from documentation of the initial review of admissions under the acute COTE team, over a two-week period pre- and post- intervention. A new patient assessment document was produced for the initial COTE review with prompts for medication review, vitamin D levels and FRAX scoring. Results The sample included 38 admissions pre- and 32 admissions post- intervention. Implementation of the new patient assessment document resulted in an increase in medication review from 37% to 84% overall, and 91% in instances where the document was used. In patients with falls, we observed an increase in vitamin D level testing from 50% to 65% overall, and 83% where the document was used, and an increase in FRAX scoring from 22% to 47% overall, and 67% in cases where the document was used. Conclusion A standardised patient assessment document is a simple intervention that can be introduced easily on a departmental basis to act as an aide memoire for important aspects of the CGA. In this project the new patient assessment document produced an increase in performance of medication review and assessment of bone health. Future work will aim to improve utilisation of the assessment document and evaluate changes in prescribing practice as a result of its implementation.