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Kennedy Terminal Ulcers: A Scoping Review.

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  • 1Sharon Latimer, PhD, is research fellow (Patient Safety in Nursing), School of Nursing and Midwifery, Griffith University; and Nursing Midwifery Education and Research Unit, Gold Coast Hospital and Health Service, Southport, Queensland, Australia. Joanie Shaw, GradCert, is nurse educator, Cancer and Specialty Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia. Tracey Hunt, MSN, is clinical nurse consultant, Diagnostics and Subspecialty Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia. Kristyn Mackrell, BSc, is senior occupational therapist, Community & Palliative Care Occupational Therapy Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia. Brigid M. Gillespie, PhD, is professor (Patient Safety in Nursing), graduate certificate, School of Nursing and Midwifery, Griffith University; and Nursing Midwifery Education and Research Unit, Gold Coast Hospital and Health Service, Southport, Queensland, Australia.

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Kennedy terminal ulcers, associated with the dying process, lack defined assessment tools and have limited prevalence data. Further research is needed to improve patient care and end-of-life decisions.

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Area of Science:

  • Palliative Care
  • Dermatology
  • Nursing Research

Background:

  • Kennedy terminal ulcers are a specific type of pressure injury linked to the end of life.
  • Existing literature on these ulcers is fragmented, necessitating a comprehensive review.

Purpose of the Study:

  • To systematically identify and map the existing literature on Kennedy terminal ulcers.
  • To examine the definition, prevalence, assessment, treatment, management, costs, and quality of life related to Kennedy terminal ulcers.

Main Methods:

  • A scoping review was conducted using the Arksey and O'Malley framework.
  • Searches included major databases (Cochrane, CINAHL, EMBASE, MEDLINE, ProQuest) and guideline repositories (1983-2018).
  • Keywords included "Kennedy ulcers," "terminal ulcer," "skin failure," and "Skin Changes at Life's End."

Main Results:

  • 32 sources were included from an initial 2997, with most literature originating from the US and published by nurses.
  • Limited data exists on prevalence, and validated assessment tools are unavailable.
  • Misclassification as pressure injuries may lead to financial penalties.

Conclusions:

  • Significant gaps exist in the assessment, management, and treatment of Kennedy terminal ulcers.
  • Patient education is crucial for informed end-of-life care decisions.
  • Further research is essential to enhance clinical practice and patient outcomes.