OET Writing practice · Nursing
Diabetic foot ulcer – district nurse wound care
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your discharge letter in 40 minutes, about 180–200 words in the body.
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Case notes
NURSING — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 10/09/2026 Patient: Mr Declan O'Sullivan, DOB 08/12/1967 (58 yrs) Surgical Ward 7, St Brendan's Hospital, Millbrook Admission date: 31/08/2026 Discharge date: 10/09/2026 Social background: - Long-distance lorry driver, currently on sick leave - Divorced, lives alone in first-floor flat (lift) - Smokes 10 cigarettes/day; declines cessation support at present - Alcohol approx. 20 units/week - Diet mainly takeaway meals, irregular meal times due to shift work - Brother lives nearby, can drive pt to appointments - Plays darts in local league Medical history: - Type 2 diabetes (dx 2012), poorly controlled. HbA1c 86 mmol/mol (31/08/2026) - Peripheral neuropathy both feet - Hypertension - Obesity, BMI 34 - Fractured L wrist 2018 - NKDA Nursing management and progress: 31/08 Admitted from GP: ulcer plantar surface L foot (1st metatarsal head) × 3 weeks; pt noticed blood on sock. Wound 3.0 × 2.5 cm, depth 0.8 cm, sloughy base, moderate purulent exudate, surrounding erythema 3 cm, malodorous. T 38.2°C. BGL 19.4 mmol/L - X-ray: no osteomyelitis. Wound swab: Staphylococcus aureus (MSSA) - IV flucloxacillin; IV insulin infusion 01/09 Pedal pulses palpable. ABPI 0.9 L foot. Podiatry: sharp debridement 02/09 Basal-bolus insulin commenced. Diabetes educator input 04/09 Erythema reduced to 1 cm. Afebrile 05/09 Offloading: removable knee-high walking boot fitted. Pt removes boot to walk to bathroom "because it's heavy" 07/09 Changed to oral flucloxacillin 1 g QID 08/09 Wound 2.2 × 1.8 cm, depth 0.4 cm; 70% granulation, 30% slough; small serous exudate; no odour - Dressing: cadexomer iodine + foam secondary dressing, change every 2–3 days - Self-injecting insulin competently. BGLs 7–13 mmol/L 09/09 Mild R knee pain (old sports injury), no action required - Pt asks when he can return to driving; advised to discuss with GP 10/09 Wound unchanged from 08/09. Dressing changed today Medications on discharge: - Flucloxacillin 1 g PO QID until 17/09 - Insulin glargine 24 units nocte; insulin aspart 8 units with meals - Metformin 1 g BD - Ramipril 5 mg daily; atorvastatin 40 mg nocte - Paracetamol 1 g QID PRN Discharge plan: - District nurse: dressing changes every 2–3 days (next due 12/09); measure wound weekly; monitor for infection; reinforce wearing offloading boot at all times when weight-bearing - Check BGL diary; hypoglycaemia education given - High-risk foot clinic (podiatry) 17/09 for debridement - Diabetes clinic in 4 weeks - GP review in 1 week Writing Task: Using the information in the case notes, write a letter to Mrs Joanne Pritchard, District Nurse, Millbrook District Nursing Team, 5 Cedar Court, Millbrook, who will be managing Mr O'Sullivan's wound care at home. In your answer: - Expand the relevant notes into complete sentences - Do not use note form - Use letter format The body of the letter should be approximately 180–200 words.
How to approach this discharge letter
- The reader takes over care after discharge. Open with who the patient is, why they were in hospital and that they are going home, then say what you need the reader to do.
- Give the current condition, medication changes and the follow-up plan. Summarise the hospital stay instead of retelling it day by day.
- Leave out resolved problems and background that does not change care at home.
Members also get the model answer, the note-selection table and task-specific tips for this task.