Elements and Performance Criteria

RANGE STATEMENT

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.


Cultural respect
This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples
It recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social wellbeing, community capacity and governance
Its application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices


Community control
Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community in this process


Supervision
Supervision must be conducted in accordance with prevailing state/territory and organisation legislative and regulatory requirements
References to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionals
A person at this level should only be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines


Legislative requirements
Federal, state or territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of Variables
Aboriginal and/or Torres Strait Islander Health Workers may be required to operate in situations that do not constitute 'usual practice' due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by 'usual practice circumstances'
Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework


Renal replacement therapy includes:
Haemodialysis
Continuous ambulatory peritoneal dialysis
Kidney transplantation


Physical signs of fluid overload include:
Dyspnoea and tachypnoea
Ankle oedema
Crackles on lung auscultation


Signs of exit site infection include:
Soiling of exit site dressing
Blood-stained or pus discharge
Exit site redness and tenderness


Signs of catheter tunnel infection include:
Expressible pus or discharge
Tenderness, redness or pustules over peritoneal catheter tunnel


Appropriate exit site care includes:
Washing in shower and padding dry with gauze
Application of topical antiseptic
Correct placement of anchor tape
Application of adhesive absorbent dressing
Securing redundant tubing


Signs suggesting fistula stenosis or infection include:
Absent or reduced bruit or thrill
Low 'a' or high 'v' pressure readings during haemodialysis
Redness, tenderness or discharge


Routine pathology testing for dialysis clients include
Haemoglobin and blood counts
Serum creatinine, potassium, calcium and phosphate
Parathyroid hormone
Iron studies


Medicines commonly used in dialysis care include:
Common antihypertensive medicines
Common lipid lowering agents
Phosphate binders (calcium salts)
Erythropoietin
Calcitriol


Clinical features suggestive of dialysis-related peritonitis include:
Abdominal pain/tenderness
Fever
Turbid or cloudy dialysate return


Causes of peritoneal fluid failing to drain include:
Fibrin plugs
Constipation
Dialysate not instilled


Clinical features of uraemia include:
Lethargy
Nausea
Confusion
Uraemic smell


Hazards associated with haemodialysis after a number of missed dialysis sessions include:
Severe headache
Fitting


Dialysis consumables include
Dialysate fluids
Machine lines and dialysers
Needles and syringes
Normal saline
Dressing supplies and tapes
Peritoneal catheter caps
Antiseptic and cleaning supplies


Appropriate storage arrangements for dialysis consumables include:
Safe from environmental hazards (sun, water, rodents)
Secure from young children
Accessible for stock-take, resupply and daily use


Information provided to client may include:
Normal structure and functioning of the renal system, kidneys and blood.
Causes of renal failure
Physical symptoms of renal failure
Different renal replacement treatment options and advantages/disadvantages
How kidney transplantation is done and what is involved
Information about self-care, including:
dietary requirements and rationale
fluid requirements
medication regime
looking after fistula sites
recognising common dialysis problems


Specific reference for work in this area:
National Guidelines for the Management of Dialysis&Kidney Transplantation in Remote Australia

EVIDENCE GUIDE

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects of assessment:
The individual being assessed must provide evidence of specified essential knowledge as well as skills
Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible


Conditions of assessment:
This unit includes skills and knowledge specific to Aboriginal and/or Torres Strait Islander culture
Assessment must therefore be undertaken by a workplace assessor who has expertise in the unit of competency or who has the current qualification being assessed and who is:
Aboriginal or Torres Strait Islander him/herself
or:
accompanied and advised by an Aboriginal or Torres Strait Islander person who is a recognised member of the community with experience in primary health care


Context of assessment:
Competence should be demonstrated working individually, under supervision or as part of a primary health care team working with Aboriginal and/or Torres Strait Islander clients
Assessment should replicate workplace conditions as far as possible


Related unit:
This unit should be assessed in conjunction with the related unit:
HLTAHW513A Support renal dialysis clients in the community setting