HLTENN006: Apply Principles of Wound Management Assignment

This assignment solution addresses various aspects of wound management, aligning with the HLTENN006 curriculum for Diploma of Nursing students. The document covers wound healing stages (hemostasis, inflammation, proliferation, maturation), and associated care strategies. It also includes complex wound management considerations, primary healthcare principles in wound care, and the National Safety and Quality Health Service Standards. The assignment further explores the chain of infection, aseptic techniques, and the rationale behind specific wound care practices. It also includes signs and symptoms of wound infection, historical events, and components of WHIA services. The solution encompasses wound pain management, wound infection examples, and detailed wound assessment techniques (photography, tracing, linear measurement). The assignment concludes with wound debridement, drainage systems, specimen types, and the relationship between hematology lab tests and wound healing. Overall, it provides a comprehensive overview of wound care principles and practices.

Running head: DIPLOMA OF NURSING 1
Diploma of Nursing
Student’s Name
Institutional Affiliation

DIPLOMA OF NURSING 2
1. Wound ManagementMatch the following terms with the different stages of wound
healing:Inflammation, Haemostasis, Epithelialization, Maturation and Proliferation,
and granulation
Stages/Physiological and biochemical actions Stages
1.1
Stage1: Vasoconstriction,
Platelet aggregation and activation of fibrin
Hemostasis
1.2
Stage 2: Vasodilation, flushing of the wound with serous
fluid, phagocytosis;
Inflammation
1.3
Stage 3: Angiogenesis, deposition of collagen, the
formation of new tissue and wound contraction
Proliferation
1.4
Stage 4: Realignment of collagen, regaining normal
tissue strength
Maturation

DIPLOMA OF NURSING 3
2. Give one example of a wound care product or strategy that helps with each stage of
wound healing.
Stages Wound care product or strategy
2.1
Hemostasis
Chitosan dressings
2.2
Inflammation
Polymeric membrane dressings
2.3
Proliferation and granulation
Collagen Dressings
2.4
Epithelialization and Maturation
Allogeneic cultured keratinocyte grafts
3. Complex Wounds
List five common problems to be considered in the management of complex wounds?
Wound size, body contours, the expense of complex wounds should be considered. Also,
poor nutrition, along with insufficient blood flow to the injury needs to be considered.

DIPLOMA OF NURSING 4
4. Primary Health care principles for Wound Management
Briefly describe how to apply below mentioned Primary Health care principles in
wound management (20-50 words)
4.1
Universal access to care
It is termed as the absence of sociocultural, economic, or gender-related barriers.
Accordingly, it is applied through enabling affordable, reachable, and acceptable treatment to
everyone in need of the service (Blumenthal, 2016).
4.2
Community participation
The community nurses are usually placed to provide care since the environment is the
patient’s own home. It usually improves patient outcomes, together with wound healing rates.
4.3
Intersectoral approaches to health
This involves using other sectors outside the health but not necessarily in collaboration
with health and can help to create awareness or take precautions on the causes and ways of
wound management (Hussey et al., 2017).
5. The National Safety and Quality Health Service Standards
Briefly describe the National Safety and Quality Health Service Standards, ( in 10-20
words each)
5.1
Governance for Safety and Quality in Health Service Organizations
It defines the quality framework needed for medical institutions to safely enact health
systems.

DIPLOMA OF NURSING 5
5.2
Partnering with Consumers
Defines the approaches to form a client-centered clinical system through the inclusion of
consumers in the health care quality design and development.
5.3
Preventing and Controlling Healthcare-Associated Infections
Describes systems to effectively control infections along with preventing patient
infections within a clinical system to reduce the consequences.
5.4
Medication Safety
It makes sure that health professionals safely prescribe, dispense, and administer the
proper treatment to patients.
5.5
Patient Identification and Procedure Matching
Identifies patients and matches the identity accurately with the appropriate medication.
5.6
Clinical Handover
It ensures effectual communication when answerability, as well as responsibility for the
care of a patient, is being transferred.
5.7
Blood and Blood Products
Defines systems for the proper, effective, and safe management of blood and blood
products for patients to receive the blood safely.
5.8

DIPLOMA OF NURSING 6
Preventing and Managing Pressure Injuries
Defines systems to avoid patients with pressure wounds. Moreover, it defines strategies
for excellent management practice in case the pressure wounds happen.
5.9
Recognizing and Responding to Clinical Deterioration in Acute Health Care
Defines the processes to be enacted by medical institutions to retaliate to patients in case
their medical situation worsens.
5.10
Preventing fall and Harm from fall
Minimizes the patient fall incidences in health service institutions and describes
strategies for best practice management if the falls occur.
6. The Chain of Infection
Briefly describe the chain of infection (10-20 words each)
6.1
Infectious Disease/Agent
It is the bacteria causing disease. Whenever a bacterium enters the body, it can cause an
infection.
6.2
Reservoir
The place in the environment where the bacteria reside and multiply. The site may be
insects, medical equipment, or people (Singh, 2018).
6.3
Portal of Exit
This is the way the pathogen causing infection leaves the reservoir.

DIPLOMA OF NURSING 7
6.4
Mode of Transmission
It is the manner in which the microorganisms can be transmitted.
6.5
Portal of Entry
The way the bacteria can enter a new host either via catheters, the respiratory tract,
broken skin or mucous membranes
6.6
Susceptible Host
A susceptible Host is any individual receiving care who is at risk of getting infected by a
disorder. This is because of being vulnerable (Singh, 2018).
7. Infection Control
List two aseptic technique practices related to infection control in wound care.
 Maintaining a sterile field
 Hand washing practices.
8. Briefly explain why: (20 -40 words each)
8.1
Shaving around a wound should be avoided?
Shaving around a wound should be avoided because it could damage the skin around the
wound area, raising infection risk (Tartari et al., 2017). For instance, a blade that has not been
sterilized risks exposing the skin near the wound to dangerous pathogens.
8.2
A wound should not be left open to facilitate drying of excess secretions?

DIPLOMA OF NURSING 8
The excess secretions provide the different immune system cells with an ideal medium to
destroy the attacking bacteria, foreign bodies, as well as necrotic tissue reducing the infection
rate hence the wound, should not be left open for drying.
8.3
It is not appropriate to do wound care without forceps even though wearing gloves
Gloves may not always be 100% sterile since they can be contaminated easily after
opening, contributing to false security. Therefore, to ensure that the sterile equipment or the
patient is not infected through direct touch, forceps are used (Rowley & Clare, 2019).
9. What are the signs and symptoms of having a wound infection? List a minimum of 3
answers.
Redness and swelling at the wound site, purulent drainage and a foul odor, hot skin near
the wound as well as persistent pain from the wound (Wu et al., 2016).
10. Describe major historical events in the development of contemporary wound care
(pressure ulcer care)( 50-100 word)
A pressure ulcer initially causes the peeling of the skin and erodes it even up to the bones
if not cared.
11. Wound Healing Institute Australia's (WHIA)
List three critical components of WHIA services
The components consist of acute and chronic wound management, health promotion, and
community awareness in wound prevention and lastly clinical skills proficiency in wound
management.

DIPLOMA OF NURSING 9
12. On examination, you notice your client has a leg ulcer which is covered with slough.
The whole lower leg is swollen and red. The client is finding it hard to move around and
is complaining of severe pain. Who could you refer this matter to?
The matter should be referred to a specialist for further vascular assessment.
13. Wound pain management
List four key points in wound pain management
i) Make sure you avoid infection
ii) You seek help immediately after the injury
iii) You should change the wound dressing on a regular basis
iv) You should apply the pain management Medication
14. When would you give analgesia in relation to dressing times? (15 to 30 words)
Analgesia is given when pain is worse. Use of analgesics significantly decreases the pain
affiliated with dressing changes (Kaheni, Sadegh Rezai, Bagheri-Nesami & Goudarzian, 2016).
For the painkillers to take effect, it should be given long enough before the dressing.
15. Wound InfectionMicro-organisms are also causative agents for the wound. Write at one example of
each of the following:
Wound Infection Example Signs and/or Symptoms
15.1
Bacterial
Pneumonia Low appetite, feeling very
tired, high fever up to 105 F
and chills leading to shaking.
15.2
Viral
Bronchitis Shortness of breath, chest
discomfort, fatigue along with
slight fever and chills.

DIPLOMA OF NURSING 10
15.3
Fungal
Ringworm Itching, patches of hair loss
along with blister-like lesions.
16. Wound Assessment
Briefly describe the following techniques and their benefits used in wound assessment
16.1
Wound photography
The use of digital photography leads to accurate assessment and documentation, which is
vital for developing an understandable care plan. The technique enhances the reliability as well
as the accuracy of wound documentation (Lozano-Platonoff, Mejía-Mendoza, Ibáñez-Doria &
Contreras-Ruiz, 2015).
16.2
Wound tracing/mapping
The method determines the size of a wound by use of wound tracing sheets. The
technique is more reliable and presents a more accurate depiction of the size of the wound.
16.3
Linear Wound measurement
This technique is used to measure wounds to provide baseline measurements. Its benefits
are assisting in differentiating among wounds that are deteriorating, static, or improving.
Furthermore, it helps in monitoring the rates of healing.
17. Wound Debridement
For sloughy and necrotic wounds, debridement is vital for healing. Answer the
following questions related to debridement (20-30 words each).
17.1

DIPLOMA OF NURSING 11
What are the indications/ purposes of wound debridement?
The indication for debridement is the removal of devitalized tissues like biofilm,
bioburden, slough, or necrotic tissue. The process cleans the dead and contaminated tissue aiding
in the healing process.
17.2
List three types of wound debridement
The three types of wound debridement are as below.
 Autolytic debridement
 Enzymatic debridement
 Surgical debridement.
18. Wound Drains
Describe in brief the closed and open wound drainage system ( in 30-50 word each)
18.1
Closed drains
They do not expose the content to the atmosphere, and the drain is always secured with
suture. They consist of non-vacuum drains like T-tube drain or vacuum drains like the Redivac®
that apply negative pressure (Khan, Smeulders & Van der Horst, 2015). The utilization of a
closed drainage system decreases the peril of possible infection for patients and minimizes the
contact of staff with body fluids.
18.2
Open drains
They enable communication with the atmosphere and are generally secured by a suture
and might have a safety pin attached close to the skin. Moreover, they are inserted directly into

DIPLOMA OF NURSING 12
the wound and drain into a dressing (Khan et al., 2015). They consist of penrose drain,
corrugated drains along with sump drains. Since they have an open end, there is a possibility for
infections.
19. Wound Specimens
Briefly describe the following types of wound specimen:
19.1
Wound Swab
It is a culture performed by collecting a sample of tissues, or cells from a wound and
placing it in a correct nutrient media. The media promotes bacteria growth, which may be
present, enabling for further testing and identification.
19.2
Wound Fluid Sample
The culture is performed by collecting the fluid or exudate from the wound bed and
placing it to a nutrient media to facilitate the growth of bacteria, which helps in the identification
of infection.
19.3
Deep tissue biopsy
It is a clinical procedure to remove a small piece of tissue from the wound for chemical
and physical examinations.
20. Hematology and Wound HealingBriefly explain the following lab tests and its relation
on wound healing( 30-50 word each)
20.1
Hemoglobin and Haematocrit

DIPLOMA OF NURSING 13
Hematocrit test measures the amount of blood containing red blood cells which have a
protein known as hemoglobin, which transports oxygen from the lungs to other parts (Goodhead
& MacMillan, 2017). Since too high or low hematocrit levels indicate anemia, wound healing is
impaired since the body’s capability to transport oxygen-rich hemoglobin to the cells is affected.
20.2
Leucocytes
The measurement of leukocytes levels is included in the complete blood cell test, and
higher leukocytes levels indicate an infection. When the levels of leukocytes are very high, the
wound will delay in its healing process.
20.3
Thrombocytes
The test determines the count of platelets in the blood sample (Kara, Emeksiz, Alioğlu &
Dallar Bilge, 2016). The platelets aid in preventing the loss of blood at the wound site.
Furthermore, they express and release substances which foster tissue repair and influence the
processes like inflammation and immune response hence fastening the wound healing.
20.4
Serum albumin
This test looks at the albumin levels in the blood (Levitt & Levitt, 2016). Its abnormal
levels indicate nutrient deficiency and a problem with kidneys or liver. Nutrition deficiency leads
to delicate tissue, which is not able to protect the granulation tissue from enabling the
epithelialization process to proceed to close the wound.
21. Doppler Assessment
what is the significance of Doppler assessment in wound management? (10-20 words)

DIPLOMA OF NURSING 14
Doppler assessment is essential in identifying the etiology of a patient's ulcer, and a
Doppler ultrasound takes part in the evaluation.
22. Compression Therapy
22.1
Briefly explain the purpose of compression therapy, e.g., TED stockings, compression
bandaging, etc.
Compression therapy aids preventing venous stasis along with impairment of venous
walls reduce venous pressure and relieves heavy and aching legs (Liu, Guo, Lao & Little, 2017).
For instance, TED stockings aid in avoiding the pool of blood in the legs, which could result in a
blood clot. Consequently, the compression bandages are best for ambulatory patients as walking
helps blood return while the bandages prevent excess blood from remaining in the lower
extremities.
22.2
What are the nursing considerations while performing compression therapy? (20-40 words)
When performing compression therapy, nurses should consider the duration and size of
the ulcer, the mobility of the patient, the tolerance of the patient to the compression, the ability of
the patient to provide personal care along with the patient’s preference (Dissemond et al., 2016).
23. Wound cleansing
Briefly describe the following wound cleansing techniques (20-40 words each)
23.1
Swabbing
Swabbing involves obtaining specimens for culture and sensitivity by needle aspirations,
tissue biopsy, or swab (Ramsay, Cowan, Davidson, Nanney & Schultz, 2016). This procedure is

DIPLOMA OF NURSING 15
used to identify the infection-causing organism along with the extent of the microbes in the
injury to determine the correct treatment.
23.2
Irrigation
It involves a steady solution flow across an open injury surface to remove deeper debris,
attain wound hydration, along with aiding with the visual analysis. The solution removes cellular
debris and surface microbes present in the exudate.
23.3
Soaking
A wounded area is soaked in warm water, or a warm, wet cloth is put on the wounded
part for twenty minutes thrice a day. It involves using a warm salt water solution to remove all
the loose scabs as well as pus.
24. Wounds Types
Fill in the table below
Type of wound Aetiology Nursing consideration
(minimum 2 each)
24.1
Skin tear
Results from friction Nurses should consider the
type of dressing based on the
wound characteristics, along
with the pin related to the
wound.
24.2 Results from cancer The nurses should prevent
dressing adherence together

DIPLOMA OF NURSING 16
Malignant wound with bleeding.
The nurses should eliminate or
reduce odor
24.3
Neuropathic ulcers
The result from peripheral
neuropathy in diabetic
persons.
The nurse should ensure that
there is no pressure on the
affected areas.
The wound has to be debrided
thoroughly to healthy and
bleeding tissues
24.4
Burns
Results from overexposure to
the sun, heat or electrical or
chemical contact.
The nurse has to ensure that
the unburnt regions are
covered in order to avoid
hypothermia.
The area of damaged tissues
has to be cooled with cool and
flowing water for about 20
minutes
24.5
Skin grafts
This condition results from a
skin infection, deep burns or
the skin cancer surgery
The nurse has to monitor the
patient strictly after surgery
and giving him/her medication

DIPLOMA OF NURSING 17
to manage the pains.
The nurse has to give the
patient painkillers after
discharge.
25. Venous and arterial ulcers
Complete the following table (10-30 words each)
Characteristics Venous ulcers Arterial ulcers
25.1
Common History
It usually affects parts below
the knee and is found on the
inner parts of the leg. It is
brown staining on the skin
This condition is generally
caused by poor perfusion to
the lower extremities. It is
Shiny, taut skin
25.2
Classic Site
Around medial malleolus in
the gaiter area
On the lateral side of the leg
25.3
Exudate level
Fluid leak from the ulcer The ulcer is dry.
25.4
Pain
Moderate to no pain and if
present it is eased by elevating
the leg.
The pain is excruciating and is
decreased by lowering the leg
to dependent position.
25.5 May leak and cause itchy skin, The ulcer is usually pale cool

DIPLOMA OF NURSING 18
Oedema
scale, maceration, and
varicose eczema.
with little or no edema.
25.6
Skin Color
More firm and reddish brown
pigmentation and dry, flaky
skin
Thin, dry, shiny skin and
becomes pale when elevated.
25.7
Local Skin Temperature
There is always an increased
local skin temperature/warm
skin temperature
There is usually cold skin
temperature
26. Describe the management of Mixed ulcers (15-30 words)
The primary purpose of therapy, in this case, is usually wound healing together with limb
salvage. In that case, the main purpose of management is to correct the causes of ulceration by
the use of wound care therapies.
27. A patient is admitted to a Coronary Care Unit following a severe myocardial infarction.
The patient has swollen edematous legs leaking copious amounts of exudate which are
macerating the patient's skin. The leg is red, hot and inflamed too.
Briefly describe nursing care? (50-100 words)
The Coronary Care Unit main purpose is to provide care to patients in conditions such as
myocardial infarction. In that case, the nursing care required in this case is as highlighted below.
The nurse should use alginates together with hydrofibre for dressing up the wound since the
patient is leaking high exudate levels (Ahmad & Khan, 2017). The nurse should also examine the
legs and other parts too.
28. What are visceral wounds?

DIPLOMA OF NURSING 19
These are wounds in the internal body organs, particularly those within the chest like the
lungs and the heart or the abdomen such as intestines, pancreas, or the liver.
29. Wound
Assessment can be summarized using the acronym MEASURE. Briefly explain what
the acronym stands for:
29.1
MEASURE
Stands for depth, width, and length in centimeters. The most extended length in a head to
toe approach, the widest width at right angles to the length along with the depth utilizing a sterile
probe at the most in-depth site is measured.
29.2
EXUDATE
It stands for the amount of exudate. The dressing is removed to assess the characteristics,
quantity along with the odor of the exudate.
29.3
APPEARANCE
It stands for the wound bed appearance where the tissue is evaluated
29.4
SUFFERING
Pain is assessed or other signs or effect on daily life activities.
29.5
UNDERMINING

DIPLOMA OF NURSING 20
The tunneling is measured to aid in ascertaining proper dressing selection and identify the
process of non-healing or healing.
29.6
RE-EVALUATE
The wound is assessed to ascertain the effectiveness of wound therapy each week.
29.7
EDGE
The edge of the injury along with the region, which is two to four centimeters from the
edge of the wound, which is the peri-wound skin, is assessed.
30. Management can be summarized using the acronym TIME. Briefly explain what the
acronym stands for:
30.1
TISSUE
The tissue in the wound is identified if it is deficient or has non-viable tissue to determine
the best debridement type appropriate for it. However, if the tissue is viable, a dressing which
maintains maximum moisture conducive for wound healing is chosen (Chamanga, 2017).
30.2
INFLAMMATION AND INFECTION CONTROL
During wound management, identification of any visible signs of infections is vital since
systemic or local infection generates a barrier to healing (Chamanga, 2017). Therefore, systemic
antimicrobials, along with local antibiotics, can assist in managing the infection once identified.
Inflammation is the result of the escalated movement of fluid, which can lead to edema and to
manage it compression can be sufficient.
30.3

DIPLOMA OF NURSING 21
MOISTURE BALANCE
Moisture balance is vital for positive results in wound healing. It is essential to add
moisture in case the wound is too dry or select a dressing designed for moderate to heavy
drainage in case the injury is too moist (Chamanga, 2017).
30.4
EDGE/ EPITHELIAL ADVANCEMENT
The wound edges are identified, whether undermined or non-advancing. If healthy, the
edges appear attached, migrating, contracting or open (Chamanga, 2017).
31. Neuropathic Ulcers
Describe briefly three strategies you could use to minimize the risk of developing
neuropathic ulcers in at-risk patients (50-100 words)
Mitigating the peril of getting neuropathic ulcers, one should consider regular pediatric
attention to remove excessive callouses and observe possible foot ulcerations. The patient should
be advised to examine feet every day for any abnormal changes in temperature, color, or the
development of ulcers. Furthermore, a patient should be advised to avert soaking feet since
insensate feet are quickly scalded without the patient knowing it (Simpson, 2018).
32. Fistula & Sinus
complete the table below with respect to fistula and sinuses (30-50 words).
Type
Desc
ripti
on
Nursing considerations

DIPLOMA OF NURSING 22
Fistula is an abnormal connection which links
two organs which do not regularly connect
(Carrison, Mavani & Fong, 2017). Nurses
should consider the education of the patient,
emotional support along with changes in
containment procedure with rationale if there is
a need for any change.
Sinus is a narrow passageway underneath the
skin which can extend in any direction via soft
tissue leading to dead space with the possibility
for formation of abscess (Kivelev, Kivisaari,
Niemelä & Hernesniemi, 2016). Nurses should
consider assessing the level of a patient's pain
and assessing their level of anxiety. Moreover,
he should consider observing the vital signs,
along with the patient's complaints.
33. List three additional assessments or reviews (not wound assessments) that enable a
holistic approach to wound care. e.g., Braden's score
Norton score, Waterlow score along with Inlow’s score.
34. Pressure Injury Prevention
Hospitalized clients are prone to the development of pressure injuries. Australian
Standards for Safety and Quality stress the importance of pressure injury prevention in

DIPLOMA OF NURSING 23
hospitalized clients.
What causes pressure injury? List down at least 4.
A poor diet may cause pressure injuries, dehydration, having a previous pressure ulcer,
moist skin due to sweating along with being not able to move around easily as a result of illness
or age.
35. What are the different stages of a pressure injury? Explain each stage briefly (10-20
words).
Stages Description
35.1
Stage I
It is the mildest phase, where the pressure
ulcers only affect the upper skin layer.
35.2
Stage II
This phase occurs when the ulcer digs deeper
below the surface of the skin.
35.3
Stage III
The pressure sores go through the second skin
layer into the fat tissue.
35.4
Stage IV
In this stage, the sores are the most severe of
which some of them may affect the ligaments
and muscles.

DIPLOMA OF NURSING 24
36. Based on the Flow chart for the prevention and management of Pressure injuries by AWMA, what
are the nursing considerations in the prevention and management of pressure injury? Use the table
to write strategies. Write a minimum of 3 strategies for each care realm.
Care realm Nursing considerations/ strategies
36.1
Mobility
Consider regular repositioning, consider
promoting independent patient movement
using assistance devices, and consider utilizing
moving support surfaces.
36.2
Nutrition
Accessibility to a range of food choices,
monitoring of weight and dietary uptake,
minimal interruptions, and considerations of
protected meal times.
36.3
Reducing friction and shear
Provision of the right positioning aids, support
surfaces, safe manual handling techniques, and
correct fitting, removal, and checking of
devices.
36.4
Relieving pressure
Use of constant low-pressure redistribution
support surfaces, provision of transfer
assistance devices, consider more frequent
repositioning
36.5 Patient education considers negative pressure

DIPLOMA OF NURSING 25
Wound management wound therapy and considers using codexomer
iodine.
36.6
Skin Moisture management
Consider support surface use which manages
the heat and humidity between the bed surface
and the skin, and considers the use of fecal
containment device to manage fecal
incontinence. Moreover, consider cleansing the
skin at routine intervals.
37. Wound Healing
Briefly describe the following factors causing delayed wound healing (10-30 words
each)
37.1
AGE
Skin gets thinner as one, and the body exhibits decreased the inflammatory response
(Gould et al., 2015). Therefore, aging makes the skin to be predisposed to injury and heals
slowly in case an injury occurs.
37.2
ISCHAEMIA
When excessive pressure is applied at the wound site blood supply to the capillary
network is interrupted, which halts the flow of blood to the surrounding tissue hence delaying
healing.
37.3
INFECTION AND INFLAMMATION

DIPLOMA OF NURSING 26
In case a pathogen invades, the wound site infection develops. During the inflammation
stage, the wound is not able to continue with the process of healing since microorganisms which
have attacked the wound compete for limited nutrients with the fibroblasts (Gould et al., 2015).

DIPLOMA OF NURSING 27
References
Ahmad, A. N., & Khan, F. (2017). Post-operative Care. In Introduction to Surgery for
Students (pp. 121-131). Springer, Cham.
Blumenthal, D. (2016). Better health care: a way forward. Jama, 315(13), 1333-1334.
Carrison, H. F., Mavani, A., & Fong, K. (2017). U.S. Patent Application No. 15/288,491.
Chamanga, E. (2017). Wound bed preparation: employing the TIME acronym. Independent
Nurse, 2017(7), 27-30.
Dissemond, J., Assenheimer, B., Bültemann, A., Gerber, V., Gretener, S., Kohler‐von
Siebenthal, E., & Münter, C. (2016). Compression therapy in patients with venous leg
ulcers. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 14(11), 1072-
1087.
Goodhead, L. K., & MacMillan, F. M. (2017). Measuring osmosis and hemolysis of red blood
cells. Advances in physiology education, 41(2), 298-305.
Gould, L., Abadir, P., Brem, H., Carter, M., Conner‐Kerr, T., Davidson, J., ... & Grice, E. (2015).
Chronic wound repair and healing in older adults: current status and future
research. Wound Repair and Regeneration, 23(1), 1-13.
Hussey, P., Corbally, M., Rodger, D., Kirwan, A., Adams, E., Kavanagh, P., & Matthews, A.
(2017, June). ICNP® R&D Centre Ireland: Defining Requirements for an Intersectoral
Digital Landscape. In Informatics (Vol. 4, No. 2, p. 7). Multidisciplinary Digital
Publishing Institute.
Kaheni, S., Sadegh Rezai, M., Bagheri-Nesami, M., & Goudarzian, A. H. (2016). The effect of
Distraction Technique on the pain of Dressing change among 3-6 year-old
children. International Journal of Pediatrics, 4(4), 1603-1610.

DIPLOMA OF NURSING 28
Kara, S., Emeksiz, Z., Alioğlu, B., & Dallar Bilge, Y. (2016). Effects of neonatal sepsis on
thrombocyte tests. The Journal of Maternal-Fetal & Neonatal Medicine, 29(9), 1406-
1408.
Khan, S. M., Smeulders, M. J., & Van der Horst, C. M. (2015). Wound drainage after plastic and
reconstructive surgery of the breast. Cochrane Database of Systematic Reviews, (10).
Kivelev, J., Kivisaari, R., Niemelä, M., & Hernesniemi, J. (2016). Muscle insertion line as a
simple landmark to identify the transverse sinus when neuronavigation is
unavailable. World neurosurgery, 94, 394-397.
Levitt, D. G., & Levitt, M. D. (2016). Human serum albumin homeostasis: a new look at the
roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value
of serum albumin measurements. International journal of general medicine, 9, 229.
Liu, R., Guo, X., Lao, T. T., & Little, T. (2017). A critical review on compression textiles for
compression therapy: Textile-based compression interventions for chronic venous
insufficiency. Textile research journal, 87(9), 1121-1141.
Lozano-Platonoff, A., Mejía-Mendoza, M. D. F., Ibáñez-Doria, M., & Contreras-Ruiz, J. (2015).
Assessment: cornerstone in wound management. Journal of the American College of
Surgeons, 221(2), 611-620.
Ramsay, S., Cowan, L., Davidson, J. M., Nanney, L., & Schultz, G. (2016). Wound samples:
moving towards a standardised method of collection and analysis. International wound
journal, 13(5), 880-891.
Rowley, S., & Clare, S. (2019). Right Asepsis with ANTT® for Infection Prevention. In Vessel
Health and Preservation: The Right Approach for Vascular Access (pp. 147-162).
Springer, Cham.

DIPLOMA OF NURSING 29
Singh, M. M. (2018). Unit-4 Introduction to Epidemiology-Epidemiological Approaches and
Processes. IGNOU.
Simpson, J. (2018). Abnormal sweating in diabetes--implications for screening for diabetic
peripheral neuropathy. Diabetic Foot Journal, 21(4).
Tartari, E., Weterings, V., Gastmeier, P. J. R. B., Baño, J. R., Widmer, A., Kluytmans, J., &
Voss, A. (2017). Patient engagement with surgical site infection prevention: an expert
panel perspective. Antimicrobial Resistance & Infection Control, 6(1), 45.
Wu, Y. C., Smith, M., Chu, A., Lindvere‐Teene, L., Starr, D., Tapang, K., & DaCosta, R. S.
(2016). Handheld fluorescence imaging device detects subclinical wound infection in an
asymptomatic patient with chronic diabetic foot ulcer: a case report. International wound
journal, 13(4), 449-453.