Latimer S, Shaw J, Hunt T, Mackrell K, Gillespie BM, et al.
Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Pall.... Date of publication 2019 Aug 1;volume 21(4):257-263.
1. J Hosp Palliat Nurs. 2019 Aug;21(4):257-263. doi: 10.1097/NJH.0000000000000563.
Kennedy Terminal Ulcers: A Scoping Review.
Latimer S(1), Shaw J, Hunt T, Mackrell K, Gillespie BM.
Author information:
(1)Sharon 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.
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.
DOI: 10.1097/NJH.0000000000000563
PMID: 30933013 [Indexed for MEDLINE]
