Assessor Resource

HLTAHW055
Provide care to clients undertaking renal dialysis in the community setting

Assessment tool

Version 1.0
Issue Date: August 2019


This unit describes the skills and knowledge required to provide health care to clients that is specific to continuous ambulatory peritoneal dialysis or home haemodialysis being undertaken in the community setting.

This unit applies to those Aboriginal and/or Torres Strait Islander Health Workers working independently and as part of a multidisciplinary team to deliver primary health care services to Aboriginal and/or Torres Strait Islander clients and communities.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

You may want to include more information here about the target group and the purpose of the assessments (eg formative, summative, recognition)



Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes.

Performance criteria specify the level of performance needed to demonstrate achievement of the element.

1. Assess peritoneal catheter exit site and client dressing technique

1.1 Identify signs of exit site infection

1.2 Elicit signs of catheter tunnel infection

1.3 Obtain exit site swab and send for microbiological analysis

1.4 Appraise client technique for dressing exit site

1.5 Instruct client on appropriate exit site care

1.6 Document condition of exit site and refer problems in accordance with organisation policies and procedures

2. Assess patency of arteriovenous (A-V) fistula

2.1 Obtain history of pain, swelling or trauma around A-V fistula

2.2 Elicit history of haemodialysis needling problems or abnormal ‘A’ and ‘V’ pressure readings

2.3 Palpate fistula for thrill and auscultate for bruit

2.4 Identify signs suggesting fistula stenosis or infection

2.5 Promptly report potential fistula problems to medical staff for assessment

2.6 Document findings of assessment in client notes

3. Identify common or serious dialysis problems

3.1 Identify clinical features suggestive of dialysis-related peritonitis and promptly refer clients

3.2 Consider causes and take note of peritoneal fluid failing to drain

3.3 Recognise clinical features of uraemia

3.4 Anticipate hazards associated with haemodialysis after a number of missed dialysis sessions and communicate risks to client

3.5 Refer identified dialysis problems to senior health staff according to organisation procedures and clinical guidelines

4. Broker supply of dialysis consumables and support use

4.1 Obtain information on client’s requirements for dialysis consumables

4.2 Order stock from supplier in accordance with client needs and organisational procedures

4.3 Support and monitor appropriate storage arrangements for dialysis consumables

4.4 Identify, document, report and resolve problems with supply or storage of dialysis consumables

4.5 Facilitate client use of their dialysis treatment protocol

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role.

There must be evidence that the candidate has:

provided care to at least three clients undertaking renal analysis in a community setting by:

assessing peritoneal catheter exit site. This includes:

identifying signs of exit site infection

identifying signs of catheter tunnel infection

swabbing exit site and sending specimen for testing

instructing client on appropriate dressing technique

documenting findings of assessment

assessing patency of arteriovenous fistula. This includes:

identifying signs suggesting fistula stenosis or infection

palpating fistula for thrill and auscultating for bruit

obtaining history of pain and haemodialysis needling problems

identifying common and serious dialysis problems

referring client to senior health staff

ordering and recording stock of dialysis consumables and storing correctly.

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role.

This includes knowledge of:

basic anatomy and physiology of the renal system

common causes of chronic renal failure (diabetes, glomerulonephritis, hypertension, urinary tract obstruction, inherited abnormalities)

underlying environmental and social factors contributing to high rates of renal disease in Aboriginal and/or Torres Strait Islander communities

management principles for common co-morbidities (including diabetes, high blood pressure, hyperlipidaemia)

factors that can slow decline of renal function (e.g. control of high blood pressure, use of angiotensin-converting-enzyme (ACE) inhibitors, avoidance of non steroidal anti-inflammatory drugs (NSAIDS)

microbiology relevant to peritoneal, blood and skin infection in renal disease

pathophysiology of chronic renal failure, including:

fluid retention and pulmonary oedema

electrolyte balance and hazards of high potassium

calcium metabolism and renal bone disease

anaemia

signs and symptoms of uraemia and fluid retention

meaning and interpretation of common pathology tests for chronic renal failure and dialysis

haemodialysis technology

peritoneal dialysis – theory, terminology, procedures, risks and benefits

different types of renal dialysis units and their function

medicines in common use in management of chronic renal failure including basic mechanisms of action, precautions and side-effects

organisation policies and procedures.

Skills must be demonstrated working:

in a health service or centre

individually or as a member of a multidisciplinary primary health care team

with Aboriginal and/or Torres Strait Islander clients and communities.

In addition, simulations and scenarios must be used where the full range of contexts and situations cannot be provided in the workplace or may occur only rarely. These are situations relating to emergency or unplanned procedures where assessment in these circumstances would be unsafe or is impractical.

Simulated assessment environments must simulate the real-life working environment where these skills and knowledge would be performed, with all the relevant equipment and resources of that working environment.

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

Assessment must be undertaken by a workplace assessor who has expertise in this unit of competency and who is:

an Aboriginal and/or Torres Strait Islander Health Worker

or:

accompanied by an Aboriginal and/or Torres Strait Islander person who is a recognised member of the community with experience in primary health care.


Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assingnment, checklist) and due date here

Assessment task 1: [title]      Due date:

(add new lines for each of the assessment tasks)


Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes.

Performance criteria specify the level of performance needed to demonstrate achievement of the element.

1. Assess peritoneal catheter exit site and client dressing technique

1.1 Identify signs of exit site infection

1.2 Elicit signs of catheter tunnel infection

1.3 Obtain exit site swab and send for microbiological analysis

1.4 Appraise client technique for dressing exit site

1.5 Instruct client on appropriate exit site care

1.6 Document condition of exit site and refer problems in accordance with organisation policies and procedures

2. Assess patency of arteriovenous (A-V) fistula

2.1 Obtain history of pain, swelling or trauma around A-V fistula

2.2 Elicit history of haemodialysis needling problems or abnormal ‘A’ and ‘V’ pressure readings

2.3 Palpate fistula for thrill and auscultate for bruit

2.4 Identify signs suggesting fistula stenosis or infection

2.5 Promptly report potential fistula problems to medical staff for assessment

2.6 Document findings of assessment in client notes

3. Identify common or serious dialysis problems

3.1 Identify clinical features suggestive of dialysis-related peritonitis and promptly refer clients

3.2 Consider causes and take note of peritoneal fluid failing to drain

3.3 Recognise clinical features of uraemia

3.4 Anticipate hazards associated with haemodialysis after a number of missed dialysis sessions and communicate risks to client

3.5 Refer identified dialysis problems to senior health staff according to organisation procedures and clinical guidelines

4. Broker supply of dialysis consumables and support use

4.1 Obtain information on client’s requirements for dialysis consumables

4.2 Order stock from supplier in accordance with client needs and organisational procedures

4.3 Support and monitor appropriate storage arrangements for dialysis consumables

4.4 Identify, document, report and resolve problems with supply or storage of dialysis consumables

4.5 Facilitate client use of their dialysis treatment protocol

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role.

There must be evidence that the candidate has:

provided care to at least three clients undertaking renal analysis in a community setting by:

assessing peritoneal catheter exit site. This includes:

identifying signs of exit site infection

identifying signs of catheter tunnel infection

swabbing exit site and sending specimen for testing

instructing client on appropriate dressing technique

documenting findings of assessment

assessing patency of arteriovenous fistula. This includes:

identifying signs suggesting fistula stenosis or infection

palpating fistula for thrill and auscultating for bruit

obtaining history of pain and haemodialysis needling problems

identifying common and serious dialysis problems

referring client to senior health staff

ordering and recording stock of dialysis consumables and storing correctly.

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role.

This includes knowledge of:

basic anatomy and physiology of the renal system

common causes of chronic renal failure (diabetes, glomerulonephritis, hypertension, urinary tract obstruction, inherited abnormalities)

underlying environmental and social factors contributing to high rates of renal disease in Aboriginal and/or Torres Strait Islander communities

management principles for common co-morbidities (including diabetes, high blood pressure, hyperlipidaemia)

factors that can slow decline of renal function (e.g. control of high blood pressure, use of angiotensin-converting-enzyme (ACE) inhibitors, avoidance of non steroidal anti-inflammatory drugs (NSAIDS)

microbiology relevant to peritoneal, blood and skin infection in renal disease

pathophysiology of chronic renal failure, including:

fluid retention and pulmonary oedema

electrolyte balance and hazards of high potassium

calcium metabolism and renal bone disease

anaemia

signs and symptoms of uraemia and fluid retention

meaning and interpretation of common pathology tests for chronic renal failure and dialysis

haemodialysis technology

peritoneal dialysis – theory, terminology, procedures, risks and benefits

different types of renal dialysis units and their function

medicines in common use in management of chronic renal failure including basic mechanisms of action, precautions and side-effects

organisation policies and procedures.

Skills must be demonstrated working:

in a health service or centre

individually or as a member of a multidisciplinary primary health care team

with Aboriginal and/or Torres Strait Islander clients and communities.

In addition, simulations and scenarios must be used where the full range of contexts and situations cannot be provided in the workplace or may occur only rarely. These are situations relating to emergency or unplanned procedures where assessment in these circumstances would be unsafe or is impractical.

Simulated assessment environments must simulate the real-life working environment where these skills and knowledge would be performed, with all the relevant equipment and resources of that working environment.

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

Assessment must be undertaken by a workplace assessor who has expertise in this unit of competency and who is:

an Aboriginal and/or Torres Strait Islander Health Worker

or:

accompanied by an Aboriginal and/or Torres Strait Islander person who is a recognised member of the community with experience in primary health care.

Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
 
Identify signs of exit site infection 
Elicit signs of catheter tunnel infection 
Obtain exit site swab and send for microbiological analysis 
Appraise client technique for dressing exit site 
Instruct client on appropriate exit site care 
Document condition of exit site and refer problems in accordance with organisation policies and procedures 
Obtain history of pain, swelling or trauma around A-V fistula 
Elicit history of haemodialysis needling problems or abnormal ‘A’ and ‘V’ pressure readings 
Palpate fistula for thrill and auscultate for bruit 
Identify signs suggesting fistula stenosis or infection 
Promptly report potential fistula problems to medical staff for assessment 
Document findings of assessment in client notes 
Identify clinical features suggestive of dialysis-related peritonitis and promptly refer clients 
Consider causes and take note of peritoneal fluid failing to drain 
Recognise clinical features of uraemia 
Anticipate hazards associated with haemodialysis after a number of missed dialysis sessions and communicate risks to client 
Refer identified dialysis problems to senior health staff according to organisation procedures and clinical guidelines 
Obtain information on client’s requirements for dialysis consumables 
Order stock from supplier in accordance with client needs and organisational procedures 
Support and monitor appropriate storage arrangements for dialysis consumables 
Identify, document, report and resolve problems with supply or storage of dialysis consumables 
Facilitate client use of their dialysis treatment protocol 

Forms

Assessment Cover Sheet

HLTAHW055 - Provide care to clients undertaking renal dialysis in the community setting
Assessment task 1: [title]

Student name:

Student ID:

I declare that the assessment tasks submitted for this unit are my own work.

Student signature:

Result: Competent Not yet competent

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Assessor name:

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Assessment Record Sheet

HLTAHW055 - Provide care to clients undertaking renal dialysis in the community setting

Student name:

Student ID:

Assessment task 1: [title] Result: Competent Not yet competent

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

Assessor name:

Signature:

Date:

Student signature:

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