Background Symptom control of malodour in patients with Malignant Fungating Wounds (MFW) can be challenging as there is little evidence or guidelines. Malodour can be a taboo in society. Human response to smell is complex. A literature review showed that malodour is a major concern to patients, families and staff. As a nurse working in a hospice, I wanted to look at how we could develop a standard for assessing malodour.

Aim My presentation shares my experience in setting a standard for auditing the assessment of the symptom of malodour for patients with MFWs in a UK hospice. I chose this area because malodour from MFWs is a challenge in practice.

Methods I carried out a literature search to see what evidence and guidelines there were to inform my audit standard. I analysed the information and reflected on my 11 years’ experience as a hospice nurse.

Results Patients with the symptom of malodour from MFW are affected physically, emotionally and socially. The symptom also affects their family and friends and can be distressing for other patients and staff. I felt the practice of assessing malodour at the hospice could improve so would start a clinical audit with my standard that;

‘All patients that are admitted to the hospice with a malignant fungating wound will have the symptom of malodour holistically assessed to support the development of a patient- centred plan of care aimed at improving quality of life.’

Conclusions I was then able to audit the assessment of malodour as a basis for change in our practice aims at improving the management of this distressing symptom. The results have informed my leading a multidisciplinary group to devise a holistic assessment tool for assessing the symptoms of malignant fungating wounds.