Wound Management and Infection Control

Question 1

Why are patients in hospital especially prone to the risk of infection?

Answer 1

Diminished health entails lowers resistance to infectious microorganisms
Invasive procedures provide points of entry for malicious agents

Question 2

What’s a HAI and what are two common ways of getting them?

Answer 2

Healthcare associated infection.
Surgical site infection
Catheter associated urinary tract infection

Question 3

What are the 3 key elements of the chain of infection?

Answer 3

Source (reservoir) of infectious agent and exit and entry points out of reservoir
A mode of transmission for the pathogen
A susceptible host with a portal of entry to receive the pathogen

Question 4

What are Standard Precautions?

Answer 4

A set of procedures that aim to limit the transmission of infection which protects both the patients and the healthcare workers

Question 5

Standard Precautions should be applied when handling what?

Answer 5

Blood (including dried)
Mucous membranes
All other bodily fluids/substances
Non-intact skin

Question 6

What the 10 components of Standard Precautions?

Answer 6

Hand Hygiene
PPE
Respiratory hygiene (cough etiquette)
Sharps safety
Safe injection practices
Aseptic Non-Touch Technique
Reprocess reusable instruments
Clean and disinfect environmental surfaces routinely
Appropriate handling of linen
Waste management

Question 7

What the 3 types of transmission based precautions?

Answer 7

Droplet
Airborne
Contact

Question 8

Steps for Droplet Precautions

Answer 8

Hand hygiene
Put on surgical mask
Take off surgical mask
Hand hygiene

Question 9

Steps for Airborne Precautions

Answer 9

Hand hygiene
Put on N95 or P2 mask
Perform a fit check on mask
Dispose of mask
Hand hygiene

Question 10

Steps for Contact Precautions

Answer 10

Hand hygiene
Put on gown or apron
Put on gloves
Dispose of gloves
Hand hygiene
Dispose of gown or apron
Hand hygiene

Question 11

What is T.I.M.E.D and what is it used for?

Answer 11

Wound assessment tool

Tissue
Infection
Moisture
Edges
Depth

Question 12

What components should you look for in tissues in a wound assessment?

Answer 12

What colour is the wound? 
Granulation=red
Epithelialisation=pink
Necrotic=black
Slough=yellow
Infection=green
Pus=white

Question 13

What are the 5 signs of infection in a wound?

Answer 13

Pain
Odour
Swelling
Warmth
Redness

Question 14

What components of moisture should you look for in a wound assessment?

Answer 14

A balance between wet and dry. Shouldn’t be cracked and flaky or look like they’ve been in a bath too long (macerated)

Question 15

What should you be looking for in the edges in a wound assessment?

Answer 15

If they are raised or rolled, also looking for colour like red or a dusky appearance

Question 16

What should you be looking for when consider depth in a wound assessment?

Answer 16

Apart from measuring depth you should look for tunnels in the skin called sinuses that can be a way for the wound to spread around the body

Question 17

What are the four stages of wound healing?

Answer 17

Haemostasis
Inflammatory
Proliferative
Re-epithelialisation (Maturation)

Question 18

What happens in the Haemostasis phase?

Answer 18

The immediate reaction to the wound is capillaries retract to stop bleeding. Red blood cells and platelets are released into the wound to aggregate and form a clot

Question 19

What happens in the Inflammatory phase?

Answer 19

The capillaries re-dilate in order to let white blood cells into the wound. They differentiate in neutrophils and macrophages which are phagocytic. These then eat the dead cells in the wound

Question 20

What happens in the Proliferative phase?

Answer 20

The wound is filled from top to bottom with granulating tissue which consists of newly formed capillaries and connective tissues. Fibroblasts enter the surrounding wound and multiply. Myofibroblasts allow the wound to shrink at the final part of this stage

Question 21

What happens in the Re-Epithelialisation phase?

Answer 21

Once the granulating tissue is almost level with the surrounding skin, the epithelial cells change shape so they can locomote across the wound bed, covering it. Once the skin is connected again these cells return to their normal appearance and attach themselves to the basement membrane. The granulation tissue then matures to scar tissue with collagen fibres to maximise tensile strength

Question 22

What are the two types of wound healing?

Answer 22

Primary: When skins closes together again with minimal tissue loss

Secondary: Healing when there has been extensive tissue loss so that the skin is unable to join together again. Takes much longer and involves more scarring