Unit of competency Outline
Date retreived
22/07/2026 10:17 PM AWST
22/07/2026 10:17 PM AWST
Whilst all efforts are made to provide accurate and timely information from the relevant source/documentation, please be aware that the information supplied may not be the most current version. The accuracy of the detail has not been confirmed by the Department and therefore should not be relied upon without first confirming the contents.
Provide support and management of the client undergoing haemodialysis therapy
Provide support and management of the client undergoing haemodialysis therapy
Unit of competency
National Code
HLTRNL604B
HLTRNL604B
State Code
D8491
D8491
TGA Status
Replaced
Replaced
DTWD Status
Replaced
Replaced
State Implementation and Classification
Approved Date
02/08/2011
Field of Education
060301 - General Nursing
Original Release Date
02/08/2011
Nominal Hours
80
Description
DescriptorThis unit of competency describes the knowledge and skills required to support the client undertaking haemodialysis and to use current technologies in haemodialysis including the safe administration of medications via dialysis
Notes
Elements and Performance Criteria
1. Establish therapeutic relationship with client
- 1.1 Provide the client with the opportunity to ask questions and discuss areas of concern
- 1.2 Ask the client questions clearly and in an appropriate manner, level and pace, and in a way that encourages the client to provide full answers
- 1.3 Provide accurate feedback and education, appropriate to the client's needs and concerns, within scope of role and responsibilities
- 1.4 Encourage client independence throughout the procedure according to their level of capability
2. Assessphysicalhealth status of client in preparation for haemodialysis
- 2.1 Complete pre-dialysis assessment of the client through observation and interview and report to other members of the health care team as required within scope of work role and organisation guidelines
- 2.2 Review pathology results, identify significant variations, and report to other members of the health care team according to organisation policies and procedures
- 2.3 Examine the vascular access site to determine suitable sites for cannulation and to identify any problems
- 2.4 Identify any significant physical health issues in relation to dialysis prescription and requirement for adjustments and report to other members of the health care team as required within scope of work role and organisation guidelines
- 2.5 Recognise and refer actual and potential problems that vary from the client's normal health status to other members of the health care team as required in consultation with registered nurse and within scope of work role and organisation guidelines
3. Prepare equipment and the client for haemodialysis treatment
- 3.1 Explain procedure to the client in accordance with legal requirements and organisation policies and procedures
- 3.2 Prepare the client for treatment and make comfortable
- 3.3 Prepare machine according to organisation policies and procedures
- 3.4 Determine dialysis settings according to the client's dialysis prescription within scope of work role and organisation guidelines
- 3.5 Prepare other interventions, including medications, under the direct supervision of, and as delegated by, the registered nurse within scope of work role and organisation guidelines
- 3.6 Prepare consumables for cannulation of the client and connection to machine
- 3.7 Wash hands and use personal protective equipment in accordance with standard and additional precautions
- 3.8 Prepare the client's access for cannulation according to organisation policies and procedures
- 3.9 Determine appropriate site for cannulation in consultation with registered nurse
- 3.10 Perform cannulation according to organisation policies and procedures
4. Perform dialysis
- 4.1 Connect the client to haemodialysis machine according to organisation policies and procedures and infection control guidelines
- 4.2 Monitor the client during treatment within scope of work role and refer to other members of the health care team according to organisation policies and procedures
- 4.3 Recognise and respond appropriately to machine alarms and actual and potential problems of haemodialysis
- 4.4 Assess the client's response to treatment within scope of work role and confer with supervising registered nurse
- 4.5 Assess the client's response to other interventions as administered within scope of work role
- 4.6 Recognise acute and delayed adverse reactions to other interventions and respond within scope of work role
- 4.7 Disconnect the client from haemodialysis machine in accordance with organisation policies and procedures
- 4.8 Clean equipment, dry and store in accordance with infection control and manufacturer's guidelines
- 4.9 Examine vascular access site to identify any problems
5. Assess physical health status of client at completion of haemodialysis
- 5.1 Complete the post-dialysis assessment of the client
- 5.2 Evaluate the client'sresponse to treatment and report to other members of the health care team as required within scope of work role and organisation guidelines
- 5.3 Document and report outcomes to the appropriate members of the health care team
- 5.4 Provide feedback to the client on physical health assessment in order to maintain optimal health status within scope of work role
- 5.5 Encourage the client to voice concerns and respond appropriately
- 5.6 Incorporate referral to community services into advanced care planning strategies in consultation/collaboration with registered nurse and other members of the health care team
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.
Clients are limited to:
Adolescent
Adult
Assessment of physical health status may include:
Blood pressure pulse and respiration
Weight
Hydration status
Evidence of uraemia and electrolyte imbalance e.g. lethargy, confusion, anorexia, nausea and vomiting
Signs of fluid overload e.g. dyspnoea, tachypnoea ankle oedema, weight gain over a short period of time and high blood pressure readings
Signs of dehydration e.g. dry mouth, dizzy, postural drop in blood pressure, low blood pressure and weight loss over short period of time
Blood sugar levels
Pathology results from routine testing for dialysis clients
Haemodialysis vascular access site status
Members of the health care team may include:
Enrolled/Division 2 nurse
Registered nurse
Nurse practitioner
General practitioner
Renal physician
Chronic disease management team
Dietitian
Social worker
Pharmacist
Podiatrist
Aboriginal and/or Torres Strait Islander health worker
Scope of work role refers to:
Enrolled/Division 2 nurses
Aboriginal and/or Torres Strait Islander health workers
Pathology resultsmay include:
Haematological tests:
haemoglobin
iron studies
Biochemical tests:
urea
creatinine
calcium
phosphate
Dialysis adequacy tests:
Kt/Vs
urea reduction ratio
fraction reduction urea
Examine the vascular access site includes:
Palpate fistula for thrill
Auscultate fistula for bruit
Observe for signs of infection
Check last needle sites
Vascular access site problems may include:
Decreased thrill
High pitched bruit
Difficulty in needling fistula
Abnormal arterial and venous pressure readings
Pain, swelling, redness or trauma
False aneurysms
Leaking around cannulation site
Actual and potential problems of haemodialysis may include:
Blown needle
Hypotension
Blood leak within dialyser
Blood leak from cannulation sites
Clotted dialyser within the circuit
Rapid or excess fluid removal
Rapid or excess electrolyte removal
Prepare other interventions including medications must include:
Identification of contraindications of medications
Confirmation of client identity and check for known allergies
Identification of the purpose and function of prescribed medication
100% accurate calculation of medication doses for administration as prescribed
Contributing to the provision of information provided to clients and carers on side effects of medication administration
Other interventions may include:
Antibiotics
Iron
Erythropoiesis stimulating agents
Anticoagulation
Blood products e.g. concentrated albumin, packed cells
Delegation refers to:
Conferring of authority to perform specific medication administration activities to a worker not usually authorised but who has been determined as appropriate for the task by the delegating health professional
Delegation is within the context of a care plan or other written instruction
Where delegation is provided verbally it must be confirmed as soon as practicable according to organisation procedures in writing and incorporated in the care plan
The authority is specific to an individual client within a specific care context and is not transferable
Delegation instructions must include:
medication and its purpose
dosage and related instructions
route
contraindications
any other relevant instructions or information, especially information specific to the client
Consumables may include:
Blood lines
Dialyser
Dialysate
Priming solution
Syringe/needles
Anti-coagulant
Tourniquet
Antiseptic solution and alcohol swabs
AV needles x 2
Gauze and tape
Local anaesthetic cream or subcutaneous lignocaine
Flushing equipment - normal saline and syringes
Infection control guidelines may include:
Standard and additional precautions
Aseptic technique
Access site preparation
Waste handling and disposal
Client's response to treatment may include:
Hypotension
Headache
Yawning
Cramps
Not achieving ideal weight
Documentation may include:
Record of test procedures
Complete and sign request form
Medical record notation
Labelling specimens and documentation
Data entry on paper and electronically
Client's response to treatment
Strategies to manage client's response to treatment
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.
Clients are limited to:
Adolescent
Adult
Assessment of physical health status may include:
Blood pressure pulse and respiration
Weight
Hydration status
Evidence of uraemia and electrolyte imbalance e.g. lethargy, confusion, anorexia, nausea and vomiting
Signs of fluid overload e.g. dyspnoea, tachypnoea ankle oedema, weight gain over a short period of time and high blood pressure readings
Signs of dehydration e.g. dry mouth, dizzy, postural drop in blood pressure, low blood pressure and weight loss over short period of time
Blood sugar levels
Pathology results from routine testing for dialysis clients
Haemodialysis vascular access site status
Members of the health care team may include:
Enrolled/Division 2 nurse
Registered nurse
Nurse practitioner
General practitioner
Renal physician
Chronic disease management team
Dietitian
Social worker
Pharmacist
Podiatrist
Aboriginal and/or Torres Strait Islander health worker
Scope of work role refers to:
Enrolled/Division 2 nurses
Aboriginal and/or Torres Strait Islander health workers
Pathology resultsmay include:
Haematological tests:
haemoglobin
iron studies
Biochemical tests:
urea
creatinine
calcium
phosphate
Dialysis adequacy tests:
Kt/Vs
urea reduction ratio
fraction reduction urea
Examine the vascular access site includes:
Palpate fistula for thrill
Auscultate fistula for bruit
Observe for signs of infection
Check last needle sites
Vascular access site problems may include:
Decreased thrill
High pitched bruit
Difficulty in needling fistula
Abnormal arterial and venous pressure readings
Pain, swelling, redness or trauma
False aneurysms
Leaking around cannulation site
Actual and potential problems of haemodialysis may include:
Blown needle
Hypotension
Blood leak within dialyser
Blood leak from cannulation sites
Clotted dialyser within the circuit
Rapid or excess fluid removal
Rapid or excess electrolyte removal
Prepare other interventions including medications must include:
Identification of contraindications of medications
Confirmation of client identity and check for known allergies
Identification of the purpose and function of prescribed medication
100% accurate calculation of medication doses for administration as prescribed
Contributing to the provision of information provided to clients and carers on side effects of medication administration
Other interventions may include:
Antibiotics
Iron
Erythropoiesis stimulating agents
Anticoagulation
Blood products e.g. concentrated albumin, packed cells
Delegation refers to:
Conferring of authority to perform specific medication administration activities to a worker not usually authorised but who has been determined as appropriate for the task by the delegating health professional
Delegation is within the context of a care plan or other written instruction
Where delegation is provided verbally it must be confirmed as soon as practicable according to organisation procedures in writing and incorporated in the care plan
The authority is specific to an individual client within a specific care context and is not transferable
Delegation instructions must include:
medication and its purpose
dosage and related instructions
route
contraindications
any other relevant instructions or information, especially information specific to the client
Consumables may include:
Blood lines
Dialyser
Dialysate
Priming solution
Syringe/needles
Anti-coagulant
Tourniquet
Antiseptic solution and alcohol swabs
AV needles x 2
Gauze and tape
Local anaesthetic cream or subcutaneous lignocaine
Flushing equipment - normal saline and syringes
Infection control guidelines may include:
Standard and additional precautions
Aseptic technique
Access site preparation
Waste handling and disposal
Client's response to treatment may include:
Hypotension
Headache
Yawning
Cramps
Not achieving ideal weight
Documentation may include:
Record of test procedures
Complete and sign request form
Medical record notation
Labelling specimens and documentation
Data entry on paper and electronically
Client's response to treatment
Strategies to manage client's response to treatment
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 for assessment and evidence required to demonstrate competency in this unit
Candidates must demonstrate their ability to apply essential knowledge identified for this unit of competency before undertaking workplace application
Observation of performance in a work context is essential for assessment of this unit of competency
Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion
Assessment of medication administration must include a written calculation test with 100% mastery
Context of and specific resources for assessment
This unit of competency is most appropriately assessed in the clinical workplace and under the normal range of clinical environment conditions
Method of assessment
Observation in the workplace
Written assignments/projects
Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice
Questioning - verbal and written
Role play
Access and equity considerations
All workers in the health industry should be aware of access and equity issues in relation to their own area of work
All workers should develop their ability to work in a culturally diverse environment
In recognition of particular health issues facing Aboriginal and/or Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and/or Torres Strait Islander people
Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities
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 for assessment and evidence required to demonstrate competency in this unit
Candidates must demonstrate their ability to apply essential knowledge identified for this unit of competency before undertaking workplace application
Observation of performance in a work context is essential for assessment of this unit of competency
Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion
Assessment of medication administration must include a written calculation test with 100% mastery
Context of and specific resources for assessment
This unit of competency is most appropriately assessed in the clinical workplace and under the normal range of clinical environment conditions
Method of assessment
Observation in the workplace
Written assignments/projects
Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice
Questioning - verbal and written
Role play
Access and equity considerations
All workers in the health industry should be aware of access and equity issues in relation to their own area of work
All workers should develop their ability to work in a culturally diverse environment
In recognition of particular health issues facing Aboriginal and/or Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and/or Torres Strait Islander people
Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities
Replaces
| State Code | National Code | Title | Type |
|---|---|---|---|
| WA861 | HLTRNL604A | Provide support and management of the client undergoing haemodialysis therapy | Unit of competency |
Replaced By
| State Code | National Code | Title | Type |
|---|---|---|---|
| WD281 | HLTRNL604C | Provide support and management of the client undergoing haemodialysis therapy | Unit of competency |
