Ms Saroeun Ven1,2, Dr Michael Steele1,2, Associate Professor Adam Burston1,2, Professor Paul Fulbrook1,2, Dr Josephine Lovegrove3,4, Dr Sandra Miles1,2, Ms Susan Prince1
1The Prince Charles Hospital, Chermside, Australia, 2Australian Catholic University, Banyo, Australia, 3National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Griffith University, Gold Coast, Australia, 4School of Nursing, Midwifery and Social Work, The University of Queensland and UQ Centre for Clinical Research, Herston, Australia
Biography:
Saroeun Ven is a PhD candidate at the Australian Catholic University and nurse at The Prince Charles Hospital, Queensland, Australia. Her doctoral research focuses on improving pressure injury risk assessment in acute palliative care settings, aiming to optimise patient safety and comfort across all phases of palliative care. With a strong background in clinical nursing, Saroeun’s work bridges research and practice by integrating evidence-based strategies into decision-making. Her research interests include pressure injury prevention, palliative care quality improvement, and evidence translation. Through her work, she seeks to enhance holistic patient outcomes and support healthcare teams in delivering compassionate, safe care.
Abstract:
Background:
Pressure injury prevention is a cornerstone of nursing care in acute palliative settings, where patients experience complex symptoms and functional decline. Despite this, hospital-acquired pressure injuries (HAPIs) in acute-phase palliative care are under-researched, limiting evidence-based prevention strategies.
Aim:
To describe the incidence, risk factors, risk level, and characteristics of HAPIs in adult acute-phase palliative care inpatients in a hospital setting between 2019 and 2022.
Methods:
A secondary analysis of HAPI data was conducted using four hospital databases and patient records from a Palliative Care Unit in Queensland, Australia. All adult acute-phase palliative inpatients (stable, unstable, deteriorating) admitted between 2019 and 2022 were included. Measures included pressure injury risk (Waterlow Score), symptom severity (Problem Severity Score [PSS], Symptom Assessment Scale [SAS]), functional dependence (Resource Utilisation Group–Activities of Daily Living [RUG-ADL]), and performance status (Australia-modified Karnofsky Performance Status [AKPS]). Patients with and without HAPI were compared, and regression analysis identified significant predictors of injury development.
Results:
Over the study period, 78 patients (3.9%) developed 95 HAPIs. Most were male (mean age 74-years), with 85% occurring in patients classified in the deteriorating palliative phase. Over half (51%) were classified as very high risk using the Waterlow Score. Injuries were mostly Stage 1 (40%) [early stage, non-blanching], with common sites including the sacrum, heels, and genitals. Patients with HAPI had significantly higher symptom severity and functional dependence scores (p < 0.001). High PSS on admission was a significant predictor of HAPI development.
Conclusions:
While HAPI incidence was modest, injuries occurred across acute palliative phases, including patients with escalating symptoms and functional decline. Findings underscore the pivotal role of nurses in integrating symptom management with proactive pressure injury prevention. Embedding palliative-specific risk assessments (e.g., PSS, RUG-ADL, AKPS) into routine nursing practice can strengthen bedside care, enhance comfort, and preserve dignity in acute palliative patients.
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