Prevention of pressure ulcers in palliative care: Simplified HoRT Tool Scale developed to identify palliative clients at risk of pressure ulcers

Introduction
Prevention of pressure ulcers in palliative care is of utmost importance and critical to providing good basic nursing care. The aim is to promote comfort and or improve the quality of life for the client

Method
Clinical nurse consultants sought the Information from the technology department of Eastern Palliative Care to provide a report from PaLcare [a computer-based program] on client's pressure ulcer status presented over the previous 6 months. The report found there were 6 [six] clients with impaired skin integrity [unable to establish if the pressure ulcers were present prior to coming onto the palliative care program].

Clinical nurse consultants researched journals and best practice articles and after much discussion and collaboration a simple tool for pressure area assessment was adopted.

Results
A hospice pressure ulcer risk assessment scale tool [HoRT Scale] was selected to be utilised by Eastern Palliative Care clinical staff [Massage therapists and specialist palliative nurses] in order to identify clients at risk of development of pressure areas.

A laminated tool was designed and given to the clinical staff concerned. Guidelines and policy process maps were also developed. Staff has been educated as to how to incorporate the HoRT Scale into their clinical practice.

Evaluation
This project commenced in December 2009. The HoRT Scale is being currently evaluated by accessing the Palcare [computer-based program]. Preliminary evaluation is revealing positive results on the implementation of this tool.