Sample assessment tool -- Observation and demonstration checklist Knowledge questions 1. Define the following wound management terminologies in your own words (in at least a sentence each): Acute...

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Sample assessment tool -- Observation and demonstration checklist Knowledge questions 1. Define the following wound management terminologies in your own words (in at least a sentence each): Acute wound Chronic wound Dermis Exudate Purulent Epithelialisation Granulation Erythema Macerated Cellulitis SatisfactoryNot Yet Satisfactory 2. Explore and briefly describe the historical development of contemporary wound management strategies in your own words. SatisfactoryNot Yet Satisfactory 3. Explore and describe in your own words the National Safety and Quality Health Service (NSQHS) Standard relevant to wound management. How can compliance with this Standard be ensured and monitored? SatisfactoryNot Yet Satisfactory ( Document: HLTENN006 Candidate Assessment Guide Date created: 14 December 2018 Version: 2.1 Date implemented: 14 December 2018 Next review: 14 December 2021 Responsibility: Academic Manager (VET) ) ( Page 13 of 75 ) 4. Discuss various causes of internal and external wounds in your own words. SatisfactoryNot Yet Satisfactory 5. Discuss the pathophysiology and management of fungal infections. Your answer should include: · What it is · How it is detected · How it is managed – consider PPE, medications, wound dressing etcetera. · List three (3) different types of fungal infection. SatisfactoryNot Yet Satisfactory 6. Discuss the pathophysiology and management of viruses which cause wound infections. Your answer should include: · what it is · how it is detected · how it is managed · list two (2) different types of viral infections SatisfactoryNot Yet Satisfactory ( Document: HLTENN006 Candidate Assessment Guide Date created: 14 December 2018 Version: 2.1 Date implemented: 14 December 2018 Next review: 14 December 2021 Responsibility: Academic Manager (VET) ) ( Page 14 of 75 ) 7. Discuss the pathophysiology and management of two (2) bacteria which may can cause wound infections. Your answer should include: · what it is · how it is detected · how it is managed · list two (2) different types of bacterial infections SatisfactoryNot Yet Satisfactory 8. What are the classifications of surgical wound? Provide two (2) examples of each of the classifications of surgical wound (Class I - IV). SatisfactoryNot Yet Satisfactory 9. Identify and briefly describe the stages of pressure ulcers. SatisfactoryNot Yet Satisfactory 10. What are venous ulcers? Briefly describe the risk factors for venous leg ulcers. SatisfactoryNot Yet Satisfactory 11. Research and summarise predisposing factors and diagnostic measures for arterial ulcers. SatisfactoryNot Yet Satisfactory 12. Briefly describe what mixed ulcers are. SatisfactoryNot Yet Satisfactory 13. There are different types of exudates commonly seen in wounds. Identify and briefly describe four (4) types of discharges from wounds. SatisfactoryNot Yet Satisfactory 14. Briefly explain malignant wound. List three (3) principles underpinning malignant wound management. SatisfactoryNot Yet Satisfactory 15. Briefly explain the important characteristics of a neuropathic ulceration. SatisfactoryNot Yet Satisfactory 16. What is the difference between a topical wound infection and sepsis resulting from a wound? Outline general signs of wound infection. SatisfactoryNot Yet Satisfactory 17. Identify and briefly describe the classification of burns. SatisfactoryNot Yet Satisfactory 18. Briefly describe the strategies that are crucial in prevention and control of burn wound infection. SatisfactoryNot Yet Satisfactory 19. What is a fistula? Briefly describe the difference between blind and complete fistulas. SatisfactoryNot Yet Satisfactory 20. What is a sinus? Discuss the management of discharging sinuses. SatisfactoryNot Yet Satisfactory 21. Briefly describe the difference between split thickness and full thickness skin grafts. · Split thickness skin graft: · Full thickness skin graft: SatisfactoryNot Yet Satisfactory 22. What are visceral wounds? Outline the major causes, management and prognosis of visceral injuries. SatisfactoryNot Yet Satisfactory 23. Briefly describe the principles of wound management. SatisfactoryNot Yet Satisfactory 24. Briefly describe strategies that can be used in preventing pressure sores. SatisfactoryNot Yet Satisfactory 25. Briefly describe the action of pressure relieving devices. Provide two (2) examples each of high-tech and low-tech pressure relieving devices. SatisfactoryNot Yet Satisfactory 26. How could nurses working with elderly and frail clients benefit from a wound prevention program? SatisfactoryNot Yet Satisfactory 27. Briefly describe how to apply the following primary health care principles in wound management. · Community participation: · Intersectoral approaches to health: SatisfactoryNot Yet Satisfactory ( Document: HLTENN006 Candidate Assessment Guide Date created: 14 December 2018 Version: 2.1 Date implemented: 14 December 2018 Next review: 14 December 2021 Responsibility: Academic Manager (VET) ) ( Page 19 of 75 ) 28. Briefly explain the components of chain of infection (pathogens, reservoir, portal of exit, modes of transmission, portal of entry, and susceptible host) that you might discuss with the person, family or carer in relation to a wound. SatisfactoryNot Yet Satisfactory 29. Briefly describe the three (3) lines of defence against pathogens. SatisfactoryNot Yet Satisfactory 30. Describe, with the help of an example, how the following factors affect the susceptibility to infection: a. Immune status: SatisfactoryNot Yet Satisfactory b. Medications: ( Document: HLTENN006 Candidate Assessment Guide Date created: 14 December 2018 Version: 2.1 Date implemented: 14 December 2018 Next review: 14 December 2021 Responsibility: Academic Manager (VET) ) ( Page 20 of 75 ) Satisfactory . c. Comorbidities: Not Yet Satisfactory SatisfactoryNot Yet Satisfactory d. Age: Satisfactory . Not Yet Satisfactory 31. Identify and explain two (2) community resources and two (2) educational resources associated with wound management in Australia. Community resources associated with wound management in Australia: Educational resources: SatisfactoryNot Yet Satisfactory 32. Discuss the roles of Wounds Australia and Wound Innovations. SatisfactoryNot Yet Satisfactory 33. When is it most appropriate for a nurse to assess the person’s pain and administer analgesics when implementing wound management? Identify two (2) examples of classes of analgesics that could be administered to a person when providing wound care management. SatisfactoryNot Yet Satisfactory 34. Define wound debridement. Identify and briefly describe two (2) types of wound debridement. SatisfactoryNot Yet Satisfactory 35. Briefly explain open and closed wound drainage systems and provide an example for each. · Open drainage system · Closed drainage system SatisfactoryNot Yet Satisfactory 36. Why is it important to assess and interpret albumin and glucose values in a person with a wound? Provide three (3) examples of personnel you could collaborate with in interpreting laboratory results relating to wound care management. SatisfactoryNot Yet Satisfactory 37. Briefly describe the significance of Doppler assessment in wound management. Identify two (2) conditions where Doppler assessment of the wound is contraindicated. SatisfactoryNot Yet Satisfactory 38. What is the golden standard for the treatment of venous ulcers? Briefly describe this therapy and outline its benefits. SatisfactoryNot Yet Satisfactory 39. Briefly describe the benefits of clinical photography of a pressure ulcer of a person at the time of admission. SatisfactoryNot Yet Satisfactory 40. Briefly explain the process of wound tracing. SatisfactoryNot Yet Satisfactory 41. Outline the factors to be included in the holistic assessment of a person with a complex wound. Include in your response detailed information on skin assessment and various risk assessments a nurse must perform for a person with a wound. SatisfactoryNot Yet Satisfactory 42. What factors need to be considered when choosing a wound dressing? Describe the difference between a primary and secondary wound dressing, listing examples of each. SatisfactoryNot Yet Satisfactory 43. A film dressing was applied on a Stage 1 pressure injury. However, the injury progressed to Stage II due to mismanagement of the person at home. a. Identify two (2) goals you should set for this person. SatisfactoryNot Yet Satisfactory b. Which wound care product is most appropriate for this stage of pressure injury. SatisfactoryNot Yet Satisfactory ( Document: HLTENN006 Candidate Assessment Guide Date created: 14 December 2018 Version: 2.1 Date implemented: 14 December 2018 Next review: 14 December 2021 Responsibility: Academic Manager (VET) ) ( Page 24 of 75 ) 44. Read the case study excerpt and answer the discussion questions. Elder abuse inquiry: Man dies in hospital after Gold Coast nursing home staff fail to properly treat wounds RN Exclusive by David Lewis for Background Briefing Updated Tue 27 Sep 2016, 8:35am An elderly man developed gangrene and later died in hospital after staff at a Gold Coast nursing home failed to properly monitor and treat pressure wounds on his buttocks and feet, according to the Aged Care Complaints Commissioner. Zdenek Selir, who was known to friends and family as Danny, moved into the Leamington nursing home in Southportin June 2015 after suffering a stroke. The 88-year-old had minor pressure wounds when he arrived, but the operator of the facility acknowledges his condition deteriorated during his stay. A family member was first alerted to the situation when she visited the home and noticed a foul odour. "She could smell something in the room and she couldn't work out what it was and she pulled the covers up because she thought maybe he needed changing or something," said Mr Selir's daughter-in-law, Yvonne Selir. It turns out the situation was much more serious than that. "He had pressure wounds to the lower buttocks and his back and it had eaten into his skin and it was actually going to go gangrene," she said. "The other pressure sore he had was on his heel and his heel was that badly affected it had already gone to gangrene." Ms Selir claims the visiting family member asked nursing home staff to call for an ambulance but they instead insisted his wounds were manageable. The operator of the facility disputes this. (Full article available here: http://www.abc.net.au/news/2016-09-27/man-dies-after-nursing- home-staff-fail-to-properly-treat-wounds/7877820) ( Document: HLTENN006 Candidate Assessment Guide Date created: 14 December 2018 Version: 2.1 Date implemented: 14 December 2018 Next review: 14 December 2021 Responsibility: Academic Manager (VET) ) ( Page 25 of 75 ) a. Discuss the preventative steps which should be taken in caring for the skin of a patient who has had a stroke. Consider the whole person. SatisfactoryNot Yet Satisfactory b. What is gangrene? Discuss who is at risk of developing gangrene and how it is managed. SatisfactoryNot Yet Satisfactory c. Discuss sepsis and the impact that this may have on a patient with gangrene. Consider what changes may be noticed on the patient’s observation chart and what action you need to take as an Enrolled Nurse. SatisfactoryNot Yet Satisfactory 45. Research and describe the common wound cleansing techniques used in various healthcare facilities. SatisfactoryNot Yet Satisfactory 46. Explain the best practice for collecting a wound swab for analysis. SatisfactoryNot Yet Satisfactory 47. Research and briefly describe the wound measurement techniques used in healthcare settings. SatisfactoryNot Yet Satisfactory 48. Briefly describe the principles and advantages of moist wound healing. SatisfactoryNot Yet Satisfactory 49. Briefly describe the significance of developing individualised wound management plans. What should be considered and included in the plan for each person? SatisfactoryNot Yet Satisfactory 50. Briefly describe the steps a nurse should consider when implementing a problem solving framework when managing wounds (i.e. problem solving approach to wound care). SatisfactoryNot Yet Satisfactory 51. Briefly describe the importance of observing the following wound characteristics: · Wound location · Temperature · Presence of necrotic tissue · Wound hydration