Assessor Resource

HLTEN609B
Practise in the respiratory nursing environment

Assessment tool

Version 1.0
Issue Date: May 2024


The knowledge and skills described in this competency unit are to be applied within jurisdictional nursing and midwifery regulatory authority legislative requirements

Enrolled/Division 2 nursing work is to be carried out in consultation/collaboration with registered nurses and under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements

This unit addresses the principles of respiratory nursing care, building upon existing skills to enable the Enrolled/Division 2 nurse to provide holistic nursing care to a group of clients with respiratory impairment

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

Prerequisites

Not Applicable

Employability Skills

This unit contains Employability Skills



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.

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 this competency unit:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Observation of performance in a work context is essential for assessment of this unit

Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion and be assessed by a registered nurse

Context of and specific resources for assessment:

This unit is most appropriately assessed in the clinical workplace or in a simulated clinical work environment and under the normal range of clinical environment conditions

Where, for reasons of safety, access to equipment and resources and space, assessment takes place away from the workplace, simulations should be used to represent workplace conditions as closely as possible

Method of assessment

Observation in the work place

Written assignments/projects

Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice

Questioning - verbal or written

Role play/simulation

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 Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and 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

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.

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

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:

Critical thinking and problem solving

Cultural and spiritual beliefs and practices

Culturally appropriate health promotion activities for clients with respiratory problems

Factors influencing growth and development

Factors influencing self esteem

Legal standards for practice

Medical terminology

Organisation policy and procedure

Participating as a member of the health care team

Principles of health assessment

Reflective practice

Specialised in-depth knowledge of in respiratory anatomy, physiology and pathology

Specialised knowledge and execution relating to emergency care of respiratory

Specialised knowledge of clinical manifestations of chronic respiratory disease states

Workplace health and safety legislation

Essential skills:

It is critical that the candidate demonstrate the ability 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 the ability to:

Apply clinical nursing skills, including:

facilitation of activities of daily living

fundamental nursing interventions

complex nursing interventions

physical assessment skills

neurological function

assistance with meeting activities of daily living

medication administration

assessment of physical reflexes

assessment, observation and documentation of:

nutritional status

hydration

respiratory function

Apply professional standards of practice:

ANMC code of conduct

ANMC code of ethics

ANMC national Enrolled/Division 2 nurse competency standards

state/territory Nurse Regulatory Nurses Act

state/territory Nursing and Midwifery Regulatory Authority standards of practice

scope of nursing practice decision making framework

Apply cognitive processes to reflect problem solving and analysis in the planning implementation and evaluation of care to clients

Apply organisation policy and procedure relating to respiratory management

Apply relevant admission and discharge tools according to organisation policy

Apply relevant health unit assessment tools according to organisation policy

Appropriate use advanced terminology relating to respiratory issues

Demonstrate accountability for personal outputs and broad client group outcomes

Use advanced communication skills

Use education and teaching strategies relating to health promotion and practical task applications for respiratory conditions

Use language, literacy and numeracy competence required to communicate effectively with client, group, colleagues and to record or report client outcomes

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.

Multidisciplinary health care team members could include:

Medical staff

Nursing staff

Social workers

Physiotherapists

Occupational therapists

Speech pathologists

Dietitian

Prosthetists

Special health requirements include:

Nutritional disorders

Health perceptions

Separation from family

Psychomotor dysfunction

Respiratory conditions may include:

Asthma

COAD

Pulmonary oedema

Pneumonia

Emphysema/bronchiotisis

Bronchitis (acute and chronic)

Asthma

Adult Respiratory Distress Syndrome

Lung cancer

Cystic fibrosis

Heamo/pnuemothorax

Surgical procedures

TB

PE

Sleep Apnoea

Actual and potential problems may include:

Hypoxia

Respiratory failure

Hypercapnia

Inability to clear secretions

Inability to cough

Inability to protect airway

Aspiration

Shortness of breath

Nursing interventions may include:

Respiratory assessment - Chest auscultation, Inspection, Pulse oximetry, respiratory rate, pulse rate, blood pressure, sedation score, past medical history, accessory muscles, SOB degree

Changing pleural drains

Assisting with the insertion of pleural drains

Administration of respiratory medication - nebulised, oral

Take blood from an arterial line for blood gas analysis

Instruction in and encouragement of deep breathing and coughing exercises

Pain assessment and management

Spirometry

Administration of non-invasive ventilation - CPAP and BiPAP

Oxygen administration

Tracheal suction via an ETT or Tracheostomy

Management of a client with a tracheostomy - tracheostomy dressing, client assessment

Health promotion goals / outcomes may include:

Effective gas exchange

Protection of own airway

Re-inflation of lungs

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
Apply understanding of the pathophysiology of the presenting/underlying respiratory condition 
Identify client nursing care needs commonly associated with respiratory impairment 
Initiate holistic health assessment and collect accurate client information in accordance with health unit policy 
Evaluate, interpret and communicate client respiratory function to the health care team 
Use a range of assessment tools relevant to client care requirements 
Identify significant alterations in client health status 
Ascertain possible factor(s) impacting on client health status 
Identify client (and/or identified significant other/s) knowledge regarding respiratory conditions, self management and individual treatment regime 
Interact appropriately with emergency service personnel, referring agencies and other hospital department staff 
Work with an understanding of the role of specialist nursing and medical services in the care of clients with chronic respiratory conditions 
Collaborate with multi-disciplinary team in partnership with the client (and identified significant other/s with client consent), to maintain continuity of care 
Identify factors relevant to client situation, giving consideration to the physical, psychological, social and economic impacts 
Review data collected and communicate to relevant members of the health care team 
Ensure nursing care plan reflects specific respiratory care requirements in accordance with health unit policy 
Ensure care plan reflects client's current nursing needs and nursing actions designed to maximise respiratory function and minimise potential complications 
Apply understanding of risk management principles in planning client care 
Ensure planned care and therapeutic interventions aim to assist client/s to achieve optimal health outcomes 
Identify client requirements for health promotion and education aspects of the nursing care plan in conjunction with client and significant other/s 
Regularly review plan of care and modify to reflect changes in client condition 
Prioritise nursing interventions according to client needs 
Modify nursing interventions using critical thinking and problem solving approaches, to reflect changes in client condition 
Update nursing interventions, including health promotion and/or education, to assist client and identified significant other/s to achieve expected outcomes 
Monitor nursing interventions, review those that fail to address client needs and revise in consultation/collaboration with the health care team 
Implement health teaching plans for the client experiencing respiratory problems (and identified significant other/s) with health care team support 
Ensure appropriate pre-, intra- and post-diagnostic procedures are undertaken in line with organisation policies and procedures 
Ensure medication administration is based on sound knowledge of principles of drug actions and side effects in accordance with health unit policies and procedures 
Evaluate responses of client and identified significant other/s to nursing interventions, and modify and document in accordance with health unit policy 
Evaluate responses of client and identified significant other/s to health promotion and education and modify and document in accordance with health unit policy 
Ensure client, and significant other/s where indicated, are aware of community resources available to them and how to access them 
Assess client understanding of their condition, medications and therapeutic regimes prior to discharge 
Evaluate client acceptance of specific health promotion initiatives prior to discharge 
Assess and review understanding of identified significant other/s in relation to current condition of client and their ongoing management 

Forms

Assessment Cover Sheet

HLTEN609B - Practise in the respiratory nursing environment
Assessment task 1: [title]

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

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Result: Competent Not yet competent

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Assessment Record Sheet

HLTEN609B - Practise in the respiratory nursing environment

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

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Overall assessment result: Competent Not yet competent

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