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iRubric: Wound Care Rubric

iRubric: Wound Care Rubric

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Wound Care Rubric Wound Care Rubric Wound Care Performance Evaluation N336 Rubric Code: SX98528 By prettymica Ready to use Public Rubric Subject: Nursing Type: Assessment Grade Levels: Undergraduate

Wound Care
	Non-performance Fail this performance if any of the boxes below are checked. 0 pts	Below Expectations Fail this performance if any of the boxes below are checked. 0 pts	Basic 3 pts	Proficient 4 pts	Distinguished 5 pts
KWIPES K=Knock W=Wash hands I= Identify self & patient P=Privacy E= Explain S= Safety	Non-performance The learner did not use KWIPES method	Below Expectations The learner is unable to identify and use acronym without continuous prompting	Basic The learner uses every letter of the acronym with two prompts. Two patient identifiers must be used.	Proficient The learner uses every letter of the acronym with one prompt. Two patient identifiers must be used.	Distinguished The learner uses every letter of the acronym appropriately with zero prompting. Two patient identifiers must be used
Gather Supplies PPE, wound care kit, sterile gloves to fit, NS, biohazard bag, other sterile supplies as needed per physician order	Non-performance Learner exhibits unsafe patient care.	Below Expectations The learner is unable to gather supplies and provide safe care to pt.	Basic Learner gathers supplies for procedure PPE, wound care kit, sterile gloves to fit, NS, biohazard bag, other sterile supplies as needed per physician order with 2 prompts from faculty	Proficient Learner gathers supplies for procedure PPE, wound care kit, sterile gloves to fit, NS, biohazard bag, other sterile supplies as needed per physician order Learner is able to self correct errors/omissions.	Distinguished Learner gathers supplies for procedure PPE, wound care kit, sterile gloves to fit, NS, biohazard bag, other sterile supplies as needed per physician order without prompts
Remove dressing Have pt rate pain. Administer pain medication as needed prior to procedure. Apply clean gloves Remove old dressing using proper technique (dons gloves, remove layers one at a time, removes tape parallel to skin and toward drsg) Properly disposes of old drsg in biohazard bag Removes soiled gloves and performs hand hygiene.	Non-performance Learner exhibits unsafe patient care.	Below Expectations The learner is unable to remove dressing and administer pain medications appropriately, or one of these two steps are not completed.	Basic Learner has pt rate pain. Administer pain medication as needed prior to procedure. Apply clean gloves Remove old dressing using proper technique (dons gloves, remove layers one at a time, removes tape parallel to skin and toward drsg) Properly disposes of old drsg in biohazard bag *Removes soiled gloves and performs hand hygiene with 2 prompts from faculty.	Proficient Learner has pt rate pain. Administer pain medication as needed prior to procedure. Apply clean gloves Remove old dressing using proper technique (dons gloves, remove layers one at a time, removes tape parallel to skin and toward drsg) Properly disposes of old drsg in biohazard bag *Removes soiled gloves and performs hand hygiene. Learner is able to self correct errors/omissions.	Distinguished Learner has pt rate pain. Administer pain medication as needed prior to procedure. Apply clean gloves Remove old dressing using proper technique (dons gloves, remove layers one at a time, removes tape parallel to skin and toward drsg) Properly disposes of old drsg in biohazard bag *Removes soiled gloves and performs hand hygiene. Learner performs all steps without prompts.
Assessment Assessment of wound, size, color exudate, odor, and closure, palpate as necessary. Measure length, width, and depth. *Patient’s response, to procedure.	Non-performance Learner exhibits unsafe patient care.	Below Expectations The learner is unable to complete full assessment without continuous prompting. Or NO assessment completed.	Basic Learner Assessment of wound, size, color exudate, odor, and closure, palpate as necessary. Measure length, width, and depth. *Patient’s response, to procedure. Performs assessment listed above accurately with 2 prompts	Proficient Learner Assessment of wound, size, color exudate, odor, and closure, palpate as necessary. Measure length, width, and depth. *Patient’s response, to procedure. Performs assessment listed above with self correction.	Distinguished Learner Assessment of wound, size, color exudate, odor, and closure, palpate as necessary. Measure length, width, and depth. *Patient’s response, to procedure. Performs assessment listed above accurately without prompts.
Moist to Dry Dressing Application Old Dressing is removed per above criteria. Hand hygiene Uses aseptic technique Sterile wound kit, sterile gloves used. Cleanse wound, surrounding tissue Apply moist drsg (remove excess solution) Fill wound bed without touching surrounding skin. Apply sterile gauze pad over wet gauze. Cover the wound with sterile ABD pad. Secure appropriately, initial & date. Remove gloves, wash hands, discard soiled items biohazard	Non-performance The learner does not follow the indicated steps and exhibits unsafe patient care.	Below Expectations The learner follows some, but not all of the steps. Does not provide safe, aseptic care to the patient. Example: Dressing dripping wet and applied to wound, telfa pad applied over damp dressing.	Basic The learner attempts to follow each step but makes several mistakes and corrects with prompting from faculty (up to 2 times). Provides aseptic, safe patient care.	Proficient The learner follows each step self-correcting any mistakes in the process. Provides aseptic, safe patient care.	Distinguished The learner follows each step exactly as described making zero mistakes or self-corrections. Provides aseptic, safe patient care.
Surgical Wound Dressing Old dressing is removed per above criteria. Performs hand hygiene Uses aseptic technique/sterile gloves Cleanse wound and surrounding tissue appropriately. If drain is present, use split gauze to cover. Important to face drain to not drain on wound bed). Non stick dressing over suture/staple line. Cover wound and drain site with sterile dressing. Tape, label with time, date, initials. Remove gloves, discard soiled items, wash hands	Non-performance The learner does not follow the indicated steps. Exhibits unsafe patient care.	Below Expectations The learner follows some, but not all of the steps. Does not provide safe care to the patient. Example: does not use aseptic technique, places drain over wound opening while dressing wound.	Basic The learner attempts to follow each step but makes several mistakes and corrects with prompting from faculty (up to 2 times).	Proficient The learner follows each step self-correcting any mistakes in the process.	Distinguished The learner follows each step exactly as described making zero mistakes or self-corrections
Documentation is accurate Patient name, date, time, how patient tolerated procedure. Document assessment: size, color, edema, closures (staples/sutures intact/missing), exudate, odor.	Non-performance Documentation is not completed	Below Expectations Documentation is completed erroneously	Basic The learner attempts to document appropriately but makes up to 2 mistakes and corrects with faculty prompting.	Proficient The learner documents appropriately self correcting any omissions.	Distinguished The learner documents appropriately with zero omissions or self corrections.

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