Elements and Performance Criteria

An appropriate health professional may include:
Registered nurse
Pathologist
Medical officer
ECG technician

ECG trace requests may come from:
A registered medical practitioner
Nominated nursing staff, e.g. nurse practitioner

ECG machines may be:
Manual
Automatic

Client preparation and ECG recording may need to take into account:
Clients may be inflexible, arthritic, in pain, tense or stressed
Clients may be large or small
Difficulties in obtaining an accurate trace at the first attempt
Electrical interference may be caused by corroded electrodes or poor electrode skin contact
Skeletal muscle tremor is usually due to pain, discomfort or anxiety
Skeletal muscle activity is most commonly due to a cold environment and/or patient movement
Wandering base line interference is commonly due to loose electrodes, but may also be due to a swaying cable or an unusually heavy diaphragm action in clients

Protective clothing may include:
Gloves
Gowns

Venues for electrocardiography may include:
Centres/clinics
Hospitals
Other institutions - ie. Psychiatric institutions
Home

Critical aspects of assessment must include:
Knows boundaries of responsibilities and refers problems to supervisor
Complies with policies and procedures including those of OHS and infection control
Demonstrates ability to produce a good client ECG trace
Can identify and manage all forms of interference
Can manage clients who may have difficulties with this procedure
Can demonstrate all steps that must be taken to ensure equipment is safe
Calibration procedures for manual ECG machines

Concurrent assessment and relationship with other units:
This unit can be assessed independently, however holistic assessment practice with other general health services units of competency is encouraged

Essential knowledge required includes:
Understands that medical equipment must be listed with TGA, and that it must be accompanied by documentary evidence of that listing
Understands that medical equipment must comply with AS/NZS 3200 'Electrical Standard', which lists test specifications for medical and electrical equipment and requirements for safety testing of Electrocardiographs.
Understands that ECG Apparatus must comply with AS 3551 'Technical Management Program for Medical Devices' which specifies the minimum maintenance program
Demonstrates rationale for routine safety checks that must be performed with each use of the apparatus
Demonstrates attachment locations of all the ECG leads
Demonstrates all steps in the production of a client ECG trace
Identifies causes of the common trace interference and the appropriate remedies
Anatomy and physiology relevant for safe and accurate ECG monitoring
Knows obligations with respect to confidentiality of patient/client information

Essential skills required includes:
Provide of appropriate level of care reflecting courtesy, responsiveness and helpfulness
Follow procedure for client identification
Reassure and assist clients to feel comfortable and relaxed
Operation of ECG machine and leads
Demonstrate the attachment of all leads to a client
Can identify an ECG trace that is unsatisfactory for diagnostic purposes
Manage the known common interferences in the production of an ECG trace

Resource implications
Resource requirements include access to:
Relevant ECG equipment and leads
ECG procedure manual
Emergency response procedures
Infection control procedures
Clinical risk assessment policy and procedures
Workplace health and safety guidelines
Other organisational policies and procedures
Duties statements and/or job descriptions

Method of assessment
Assessment may include:
Observation of performance
Written tasks
Interviewing and questioning
Computer-aided assessment
Formal appraisal systems
Staff/client feedback
Portfolio/CV
Supporting statement of supervisor(s)
Authenticated evidence of relevant work experience and/or formal/informal learning
Case studies and scenarios as a basis for discussion of issues and strategies to contribute to best practice in the work environment

Context of assessment:
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of workplace conditions. Assessment may be conducted on more than one occasion to cover a variety of situations.

A diversity of assessment tasks is essential for holistic assessment.