Mrs Grace Edwards1,2, Dr Caroline Phelan2
1Sydney Local Health District, Camperdown, Australia, 2Flinders University, Bedford Park, Australia
Biography:
Grace Edwards is the End-of-Life Care Coordinator at SLHD, with extensive experience in acute care, clinical education, and service development. She leads initiatives to improve compassionate, culturally responsive care, advance care planning, and consumer engagement. Grace is currently involved in research on Kennedy Terminal Ulcers, Not-for-Resuscitation policy reviews, and evaluating the quality of end-of-life care in acute settings. She has presented on calciphylaxis, JMO ACP education initiatives and quality end of life care in the acute care setting. Grace is passionate about improving death literacy across consumers and clinicians, building workforce capability and embedding public health approaches into palliative care.
]Abstract:
Background:
Kennedy Terminal Ulcers (KTUs) were first described in 1989 and are hypothesized to result from skin changes during the dying process. KTUs remain under-recognised, with limited guidance on management and prognostic implications. Understanding their prevalence may support recognition of skin failure as part of the dying process and help prioritise comfort-focused care over burdensome interventions.
Aim:
This study aims to assess the prevalence of KTUs in adult patients at a metropolitan tertiary and quaternary referral hospital. Findings may inform nursing practice around end-of-life skin care, reducing unnecessary wound therapies and pressure-relieving strategies.
Method:
A retrospective chart review will be conducted for patients aged ≥18 years who died between 01/01/2024 and 30/06/2024. Records will be screened for pressure injuries occurring within 7 days of death. Eligible cases will be assessed using the End-of-Life Wound Assessment Tool (Latimer et al., 2023) to identify KTUs.
Results:
Data collected from the audit will be presented. Previous studies report KTU prevalence ranging from 4.7% to 12.4% in palliative care settings. However, prevalence remains difficult to determine due to limited large-scale studies, highlighting the need for further research into end-of-life wounds and their clinical implications.
Conclusion:
Exploring KTU prevalence in acute care will expand the evidence base and support nursing decision-making in terminal care. Improved understanding may prevent unnecessary treatments and promote comfort-focused care, aligning with best practice in end-of-life skin management.