# PWR-037 — Wound and tissue recovery: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 30 min reading and worksheet pass Difficulty: Intermediate Equipment: Common household or practice equipment — The current written care plan and the named care-team and emergency contact numbers.; A clean observation area with good light and handwashing supplies.; Clinician-approved supplies only when the written plan explicitly directs their use.; A dated observation sheet and ruler or photograph reference only when the clinician permits measurement or photography.; Scenario A — emergency: The fictional plan says to use emergency help for bleeding that remains uncontrolled after the prescribed first-aid action or for fainting. The dressing is rapidly soaking with bright-red blood and the person feels faint.; Scenario B — same-day: Four days after lower-leg surgery, the fictional plan says to keep the dressing intact and contact the surgical service the same day for spreading redness, increased drainage, fever or worsening pain. Redness visible beyond the dressing has expanded from about 5 mm to 15 mm, pain rose from 3/10 to 6/10 and yellow drainage is visible on the outside. Space: Desk / seated Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G6; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context Wound recovery is a clinical process, not willpower or a trainable personal Power. This lesson teaches the permitted method: identify the wound and care team, follow the written dressing and hygiene plan, observe only what the plan allows, compare redness, drainage, pain, temperature and function with the prior record, recognise emergency and same-day warning signs, and contact the accountable service with a clear report. It does not teach diagnosis, debridement, closure, antibiotics, negative-pressure treatment or improvised dressings. Target outcome: Using the two supplied fictional scenario sets, the learner records only permitted observations and correctly chooses emergency, same-day, routine or continue-plan routing without opening, probing, cleaning or treating a wound. ### Authority and setup conditions - Identify the wound, procedure/injury date, responsible service and next planned review. - Read whether the dressing should stay dry/intact and whether it may be removed by the learner; if unclear, leave it in place and call. - Wash and dry hands before and after any plan-authorised contact; keep pets and shared surfaces away. - Know the emergency signs before beginning: severe bleeding, fainting/confusion, severe pain with rapidly worsening swelling, breathing difficulty or signs of severe infection. ### Required or supplied materials - The current written care plan and the named care-team and emergency contact numbers. - A clean observation area with good light and handwashing supplies. - Clinician-approved supplies only when the written plan explicitly directs their use. - A dated observation sheet and ruler or photograph reference only when the clinician permits measurement or photography. - Scenario A — emergency: The fictional plan says to use emergency help for bleeding that remains uncontrolled after the prescribed first-aid action or for fainting. The dressing is rapidly soaking with bright-red blood and the person feels faint. - Scenario B — same-day: Four days after lower-leg surgery, the fictional plan says to keep the dressing intact and contact the surgical service the same day for spreading redness, increased drainage, fever or worsening pain. Redness visible beyond the dressing has expanded from about 5 mm to 15 mm, pain rose from 3/10 to 6/10 and yellow drainage is visible on the outside. - Scenario C — routine: There is no new redness, drainage, pain, fever or function change. Only one prescribed dressing remains, the next planned change is tomorrow and the next delivery is due in three days. The fictional plan gives a routine clinic or supply contact for non-urgent supply problems. - Scenario D — continue the plan: The dressing is intact, the marked redness boundary is unchanged, pain fell from 2/10 to 1/10, there is no new drainage or fever and ordinary function is unchanged. The fictional plan says to continue the scheduled check. - Scenario E — emergency delayed card: The fictional plan says to use emergency help for uncontrolled bleeding or a cold, pale or blue hand. Prescribed pressure has not stopped the bleeding and two fingers have become pale and cold. - Scenario F — same-day delayed card: The fictional plan says to contact the team the same day if wound edges open, a drain leaks or pain worsens. The outer dressing has lifted over a newly opened edge, fluid is leaking around the drain and pain rose from 2/10 to 5/10. - Scenario G — routine delayed card: There is mild adhesive itching away from the wound, no spreading redness, swelling, breathing problem, drainage, fever, pain increase or function loss. The fictional plan says persistent non-urgent adhesive questions go to the routine clinic. - Scenario H — continue the plan delayed card: A small amount of clear drainage is unchanged and explicitly expected in the fictional plan. The dressing remains secure, pain is improving and there is no fever, spreading redness or function change. - Covered answer strip — reveal only after every decision is locked: A and E = emergency; B and F = same-day clinical contact; C and G = routine contact; D and H = continue the written plan. ## 1. Check the written plan Read today's dressing, cleaning, activity and contact instructions and confirm the responsible service. Why: The correct action depends on the wound and treatment. Success check: The learner can state what may be touched and whom to call. Accessible alternative: Complete the same research action — “Read today's dressing, cleaning, activity and contact instructions and confirm the responsible service.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The learner can state what may be touched and whom to call.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Screen emergency signs first Before moving a dressing, look for uncontrolled bleeding, collapse/confusion, rapidly spreading swelling/redness with severe illness, breathing difficulty or a limb that is cold/pale/blue. Why: Emergency problems should not wait for routine documentation. Success check: The learner routes emergency signs immediately without continuing the check. Accessible alternative: Complete the same research action — “Before moving a dressing, look for uncontrolled bleeding, collapse/confusion, rapidly spreading swelling/redness with severe illness, breathing difficulty or a limb that is cold/pale/blue.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The learner routes emergency signs immediately without continuing the check.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Prepare clean observation Wash hands, use good light and open only clinician-approved supplies. Do not place items on an unclean surface. Why: Basic contamination control matters when a plan permits handling. Success check: The workspace follows the written plan and no unapproved item is present. Accessible alternative: Complete “Wash hands, use good light and open only clinician-approved supplies. Do not place items on an unclean surface.” in shorter passes, or use keyboard input, dictation or a support person, while preserving this success check: “The workspace follows the written plan and no unapproved item is present.” Provide the care plan in large print, plain language, audio or symbols with one clearly labelled contact route. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Leave protected items protected If the plan says the dressing, steri-strips, staples, sutures, drain or negative-pressure seal stays in place, do not lift or adjust it. Observe the outside only. Why: Disturbing treatment can cause bleeding, contamination or failure. Success check: All protected items remain intact; the visible 'Leave protected items protected' check is satisfied. Accessible alternative: A supported, seated, reduced-range or slower version of “If the plan says the dressing, steri-strips, staples, sutures, drain or negative-pressure seal stays in place, do not lift or adjust it. Observe the outside only.” is equivalent only when it keeps the same trained or measured target, declared configuration and success check: “All protected items remain intact; the visible 'Leave protected items protected' check is satisfied.” If any of those change, record it as a related alternative rather than an equivalent repetition. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Observe the declared features Record visible redness boundary, swelling, warmth as noticed without risky touching, drainage amount/colour/odour, pain trend, fever reading if already advised, and ability to use the area. Why: Change over time is more useful than a vague 'looks bad'. Success check: The log uses factual descriptions and prior comparison. Accessible alternative: Complete the same research action — “Record visible redness boundary, swelling, warmth as noticed without risky touching, drainage amount/colour/odour, pain trend, fever reading if already advised, and ability to use the area.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The log uses factual descriptions and prior comparison.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Measure only if authorised If the care plan permits, use the same ruler/photo distance and include a scale without exposing private identifiers; never probe depth or remove material to see more. Why: Consistent external measurement can aid communication, while probing is clinical care. Success check: The measurement method matches the prior record. Accessible alternative: A supported, seated, reduced-range or slower version of “If the care plan permits, use the same ruler/photo distance and include a scale without exposing private identifiers; never probe depth or remove material to see more.” is equivalent only when it keeps the same trained or measured target, declared configuration and success check: “The measurement method matches the prior record.” If any of those change, record it as a related alternative rather than an equivalent repetition. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Choose the route Use the care plan: emergency services for emergency signs; same-day clinical contact for spreading redness, pus/foul drainage, fever/feeling unwell, worsening pain, opening edges or loss of function; routine contact for slower concerns. Why: Routing is the safe skill this restricted lesson teaches. Success check: The decision matches the declared warning-sign table. Accessible alternative: Complete the same research action — “Use the care plan: emergency services for emergency signs; same-day clinical contact for spreading redness, pus/foul drainage, fever/feeling unwell, worsening pain, opening edges or loss of function; routine contact for slower concerns.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The decision matches the declared warning-sign table.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Give a concise handoff State wound/procedure/date, what changed and when, measurements if authorised, pain/temperature/function, current dressing and what you have not done. Follow the service's next instruction. Why: A complete handoff helps the accountable team triage. Success check: The receiving service has the facts needed and the learner records the advice. Accessible alternative: Complete “State wound/procedure/date, what changed and when, measurements if authorised, pain/temperature/function, current dressing and what you have not done. Follow the service's next instruction.” in shorter passes, or use keyboard input, dictation or a support person, while preserving this success check: “The receiving service has the facts needed and the learner records the advice.” Use colour-independent descriptions, tactile-safe external markers or clinician-led review when vision makes wound observation unreliable. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.