Kennedy Terminal Ulcers: A Scoping Review

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Latimer, Sharon
Shaw, Joanie
Hunt, Tracey
Mackrell, Kristyn
Gillespie, Brigid M
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2019
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Abstract

Kennedy terminal ulcers, a subset of pressure injuries, are associated with the dying process. This scoping review aimed to identify and map the published literature on Kennedy terminal ulcers in terms of its definition, prevalence, assessment, treatment, management, health care costs, and quality of life for patients in all health care settings. Using the Arksey and O’Malley scoping review framework, we systematically searched the Cochrane Library, CINAHL, EMBASE, MEDLINE, and ProQuest databases and 5 guideline repositories between 1983 and 2018. The following search terms were used: Kennedy ulcers, Kennedy terminal ulcers, terminal ulcer, skin failure, and Skin Changes at Life’s End. Data were extracted using a purposely developed data collection tool. Initial searches yielded 2997 sources, with 32 included in this review. Most Kennedy terminal ulcer literature was published by nurses in the United States. Kennedy terminal ulcer prevalence data are limited, with no validated assessment tools available. Kennedy terminal ulcers may be misclassified as pressure injuries, potentially resulting in financial penalties to the institution. This scoping review revealed significant knowledge and clinical practice gaps in patient assessment, management, and treatment of Kennedy terminal ulcers. Timely patient education may help them to make informed care and quality end-of-life decisions. Further research is needed to inform clinical practice to improve patient care.

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Journal of Hospice & Palliative Nursing

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21

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4

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© 2019 Lippincott Williams & Wilkins. This is a non-final version of an article published in final form in The Journal of Hospice & Palliative Nursing, August 2019, Volume 21, Issue 4, p 257–263. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal link for access to the definitive, published version.

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Nursing

Acute care

Health services and systems

Public health

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