Background Skin integrity is key to ongoing care and comfort of patients towards end of life (Langemo, 2006). Palliative care aims to ease suffering with the raising prevalence of pressure area deterioration (EPUANPUAP, 2009). As patients’ function and nutritional state declines, understanding early the risk of developing a pressure ulcer is pivotal. Prevention is key (NICE, 2015).

Funding, for a year-long project, was awarded by the Queen’s Nursing Institute to a group of hospice community palliative nurses.

Project aims

• Explore early detection of risk factors in the development of pressure ulcers

• Understand the needs of patients and carers in the awareness of pressure ulcer risks

• Develop collaboration and sharing of knowledge with the Hospice multi-disciplinary team and develop relationships with primary care agencies.

Methods Three focus group meetings with patients and carers to discuss their pressure ulcer risk awareness and information needs.

Palliative care community nurses attended training. Meetings with external collaborative services, including community nurses, care agencies and care commissioning groups.

To compare the recording of Waterlow score before and after project implementation (Waterlow, 2005).

Results 94% of patients referred to the hospice by October 2015, had a Waterlow recording. Providing evidence for appropriate and timely pressure ulcer prevention interventions.

The focus group developed an information leaflet, ‘Skin Awareness’ advocating self-care as ‘Awareness is Key’.

100% of community based registered nurses received Waterlow Assessment training.

Awareness has been raised throughout the hospice multi-disciplinary team and external services (GPs, community curse, and occupational therapists) of pressure ulcer risks for community palliative care patients.

Conclusion The project has been vital in reducing the discomfort palliative care patients’ experience towards end-of-life.

Further research is being developed, as there is a paucity of evidence in understanding the skin care of community palliative care patients, towards end-of life.