Improving pressure injury management in palliative care patients
For acute palliative care patients, their critical condition and progressing illness make them vulnerable to hospital-acquired complications such as pressure injury.
Saroeun Ven is undertaking first ever research to investigate hospital-acquired pressure injury prevention in acute palliative care
Pressure injuries cause patients physical and psychological distress, and can result in prolonged healing especially in such a medically vulnerable group. Pressure injuries are predominately preventable and are considered a safety and quality priority for hospitals.
The incidence rate for hospitalised palliative care patients has been reported to be higher (11.3%) than the incidence rate for all other hospitalised patients combined (3% to 5.4%). However, the exact number of pressure injury incidence for acute palliative care patients versus end-of-life palliative care patients is not known. This is mainly because palliative care patients are not clearly defined in research.
Nurse researcher at The Prince Charles Hospital (TPCH) Saroeun Ven is exploring the development of an appropriate pressure injury risk assessment tool for use in acute palliative care patients, focusing on the identification of appropriate pressure injury preventive interventions matched to the assessed pressure injury level of risk.
Saroeun’s research is the first of its kind to look at hospital-acquired pressure injury prevention in acute palliative care, an area that has been largely under researched due to the changing nature of palliative care.
“Acute palliative care patients are vulnerable to pressure injury due to several risk factors including immobility, alternated sensory perception, and nutritional status, all of which influence their susceptibility and tolerance to pressure and shear forces,” Saroeun said.
“Disease progression and development of several comorbidities in acute palliative care patients can also lead to an increased risk of pressure injury.
“For acute palliative care patients, pressure injury may lead to further medical complications, increase hospital length of stay and, in severe cases, hasten death.
“Generally, the goal of care for acute palliative care patients on admission is to improve their quality of life and avoid aggravating their current medical condition. Therefore, hospital-acquired pressure injury prevention is a priority.”
Saroeun said that the importance of developing an appropriate pressure injury risk assessment tool is particularly relevant due to changes in acute palliative care models.
“Traditional models of palliative care primarily focus on patients nearing end of life,” she said.
“Modern palliative care now incorporates patients in the early stage of a their disease and who can be cared for at home with support and input from a specialist palliative care team.
“The needs of acute palliative care patients can vary significantly and we need to understand how these clinical differences can impact pressure injury management and prevention. Having an appropriate risk assessment tool that considers the individual clinical stages and needs of acute palliative care patients will hopefully allow us to improve patient outcomes and clinical practice.
“Our aim is to reduce complications such as pain, infection, psychological distress and functional recovery for acute palliative care patients.”
Saroeun’s research is supported by The Common Good, an initiative of TPCH Foundation.