1. 2016 Novice Practitioner Scholarship Entry Form Entry is open to those either who have an interest in tissue viability (for example a link-nurse) and want a dedicated tissue viability role as their next career move, or those who are twelve months or less into a tissue viability role and who would benefit from the resources provided by the Wound Academy. Resources include the skills, knowledge and experience of Academy members, and an allocated mentor to bring them together and support you in achieving your goals over the next twelve months. Please complete as fully as possible. If you would like an electronic copy of this application please go to www.molnlycke.co.uk/woundacademy. 1. Contact details Name: Job title: Length of time in post: Main contact address: Postcode: Telephone: Email: 2.Relevant qualification experience and/or education (see entry criteria above):

2. 3.In no more than 2,000 words, please outline why you would like to win the Scholarship. This should include: Why you want to pursue a career in Tissue Viability, what you have achieved so far, the tools and resources you feel you need to prepare you for a Tissue Viability role and goals and objective for the year ahead. Please attach additional sheets if required. Signature of applicant Date

3. 4.Referee (please provide the name and contact details of the manager supporting you in this work): Terms & Conditions The scholarships are open only to UK and Eire residents. Entries must follow the guidelines for the category submitted. Entries will not be returned, so please retain a copy. The purpose of the Wound Academy scholarships/awards is for professional development. Employees of Mölnlycke Health Care Ltd and other associated individuals are not permitted to enter. Winners will be asked to provide a quarterly project update for publication in the Wound Academy bulletin. The judges’ decision is final and no correspondence will be entered into. Closing date: The closing date is 14 th March 2016. All the awards will be presented in April 2016. Please submit your completed entry by: email: woundacademy@molnlycke.comwoundacademy@molnlycke.com Or Paper application / file copy to: FAO Alison Hedley, Wound Academy, Mölnlycke Health Care, Arenson Centre, Arenson Way, Dunstable, Bedfordshire, LU5 5UL. Managers Signature Date

4. Novice Practitioner support framework Month 1 post presentation 1. Mölnlycke will inform the winner’s communication department and forward a press release to the local paper. 2. Winner will inform immediate manager, director of nursing and chief executive. 3. A summary of the winner’s entry will be published in the quarterly Wound Academy Bulletin after announcement. 4. Mölnlycke Health Care namely Deborah Glover and Alison Hedley will visit the winner’s organisation and meet with the winner and their manager to discuss their plans for the Scholarship. Whilst this is largely for personal and professional development, any development must also be in line with area/organisation objectives. During this meeting, where appropriate, objectives will be refined and timescales for achievement set. Progress will be monitored against these by the practitioner, their manager and Mölnlycke Health Care on behalf of the Wound Academy. The winner will be encouraged keep a reflective diary for the course of the year. Month 2 – 3 post presentation 4. In accordance with the winner’s stated objectives for the course of the Scholarship year, they will receive ongoing support from the Academy. Their role will be to help the winner with aspects of their project where appropriate, for example, identifying who they may need to liaise with, time management, etc. They will also help the winner to monitor their objectives and adapt as necessary.

5. They will formally contact the mentee once a quarter and will be available at other times (within reason). Naturally, other appropriate members of Mölnlycke staff and/or the Scholarship Review Panel (and members of the Wound Academy) will help where possible. 5. If the winner wishes to use the prize money to fund a module/short course of study, the Wound Academy will work with them and their manager to identify an appropriate course. Months 3 -12 6. Winners will provide a quarterly update on progress for the Bulletin. This will partly cover progress against stated objectives and incorporate elements of reflective diary, outlining visits and other undertakings. Dates for copy will be provided, and help given where necessary. 7. If the organisation has an internal newsletter or similar communication vehicle, the winner will write a short piece for this on a regular basis (to be agreed with the person responsible for production and/or editor). Support from the Mölnlycke Health Care Wound Academy will be given. 8. At the end of the year, the winner will write up the results of their objectives for publication with help from Mölnlycke. Mölnlycke will facilitate visits to other organisations where possible or appropriate. This will take the form of an introduction to an identified practitioner/specific area related to objectives or suggesting relevant people/organisations to the scholarship holder.

6. Wound Academy Innovations In Care Entry Form Entrants are required to submit a comprehensive case study (template overleaf) of a patient they and the multidisciplinary team have cared for. Categories are limited to burn injury and plastic surgery, pressure ulceration or radiotherapy skin injury. The case study should include: clinical interventions, use of appropriate standards/guidelines (e.g. tools from Mölnlycke ‘knowledge base’), and where possible, any cross-over between acute and primary care settings. Patient and family involvement should be discussed. The pressure ulceration category should focus on raising patients/career awareness, innovative ways of prevention or continuing care. Name Job title Main contact address Postcode Telephone Email Other team members: name, job title SignatureDate 1. Contact details Terms & Conditions The scholarships are open only to UK and Eire residents. Entries must use the case study template provided. Entries will not be returned, so please retain a copy. The purpose of the Wound Academy scholarships/innovations in care awards is for professional development. Employees of Mölnlycke and other associated individuals are not permitted to enter. Closing date: March 14 th 2016 Please submit your completed entry by: email: info@molnlycke.co.uk paper application to Wound Academy, Mölnlycke Health Care, Arenson Centre, Arenson Way, Dunstable, Bedfordshire, LU5 5UL. The judges’ decision is final and no correspondence will be entered into.

7. Wound Academy Scholarship and Innovations In Care Awards 2016 Example Case Study Template The purpose of a case study is to tell a story by presenting information chronologically. When presenting a case study, you need to consider all aspects of care and ensure that this is done prospectively rather than retrospectively as it is often difficult to access the information once notes have been filed. Introduction Why you are reporting this case (interesting wound, considering a novel dressing or management approach) History Past medical history; social situation (if relevant); Presentation Presenting features, signs and symptoms Wound assessment which includes size, depth, type, duration, exudate, odour, presence of infection and any previous treatment Pain assessment (including scale used) Photographs where possible Investigations Why they were undertaken; results and normal ranges

8. Differential diagnosis Or diagnoses considered (is this related to diabetes, vascular insufficiency, etc.) Treatment(s)/Progress Dressing(s) used, debridement methods, rationale for use Evaluation of wound at dressing change (include dates, relevant photographs, wound description) Pain improvement both at dressing change and between dressings (if present) Did you change the original management plan at any time and why? Final outcome (healed, healed enough to discharge patient) Discussion Include literature review (search strategy may be included, particularly if this is a relatively rare case); refer to other cases is appropriate; arguments for and against treatment options; dressing(s) performance and anything you would do differently next time? Recommendations for practice Should this new intervention be used elsewhere? Is the dressing effective for that type of wound? Conclusion Summary of patient, wound, intervention, outcome References