Assessor Resource

HLTRNL603B
Provide care and support to client in renal replacement therapy in community setting

Assessment tool

Version 1.0
Issue Date: May 2024


The unit involves application of specialised skills and knowledge by Enrolled/Division 2 nurses or Aboriginal and/or Torres Strait Islander health workers, for clinical assessment and follow up of client care plans under direct or indirect supervisory arrangements in line with jurisdictional and regulatory requirements.

For Enrolled/Division 2 nurses the knowledge and skills described in this unit of competency are to be applied within jurisdictional nursing and midwifery regulatory authority legislative requirements.

Enrolled 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.

For Aboriginal and/or Torres Strait Islander health workers, this unit of competency addresses the delivery of renal health care services in Aboriginal and/or Torres Strait Islander communities.

Work performed by Aboriginal and/or Torres Strait Islander health workers is to be carried out in consultation/collaboration with registered nurses and/or medical practitioners under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements.

This unit describes the skills and knowledge required to provide care and support to clients with renal disease who are undertaking renal replacement therapy in the community setting

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

Prerequisites

Pre-requisites

This unit must be assessed after successful achievement of the following related units of competency:

HLTRNL601B Support the client with chronic kidney disease

HLTRNL602B Provide support and management of the client undergoing peritoneal dialysis therapy

AND one of the following units:

HLTEN519B Administer and monitor intravenous medication in the nursing environment

OR

HLTAHW606B Manage medicines in Aboriginal and/or Torres Strait Islander health care

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 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

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

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:

Application of infection control principles to the management of clients who undergo renal replacement therapies including:

importance of good hygiene and adequate nutrition in prevention of infection

maintaining cleanliness of exit site or fistula arm

monitoring and maintaining integrity of skin to prevent infection

no touch technique

Common pathology tests to diagnose and monitor CKD and their interpretation

Fluid, electrolyte and acid base balance

Health status monitoring

Immunity and the importance of vaccinations

Knowledge of disinfection procedures for dialysis equipment and machine according to organisation policies and procedures and infection control guidelines

Management principles for different types of renal replacement therapy including:

haemodialysis

kidney transplant

peritoneal dialysis

Medicines in common use in management of clients with Stage 5 CKD including basic mechanism of action, precautions and side effects

Organisation policies, procedures and protocols relating to renal replacement therapy

Pathophysiology of Stage 5 CKD

Primary health care assessment and its interpretation

Reportable limits for patients vital signs and biochemical and haematological results for clients undergoing renal replacement therapy

Resources available to support the client

Self-care principles, and commitment required and the potential impact of Stage 5 CKD and renal replacement therapy has on quality of life and self-esteem

Signs and symptoms of actual and potential problems of renal replacement therapy and the appropriate response

Structure and function of the urinary, cardiovascular, lymphatic and immune systems

Understanding of own role and responsibilities and those of other health care team members in the delivery of care to clients with CKD

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 interpersonal skills, including working with others, using sensitivity when dealing with people and relating to persons from differing cultural, social and religious backgrounds

Assess patency of vascular access

Deliver effective education

Demonstrate accountability for personal outputs and client group outcomes

Demonstrate an understanding of self-care principles, education resources and long term commitment required to support the client to achieve self-care

In consultation with the health care team, contribute to effective plans of care to meet the needs of the client undergoing renal replacement therapy

Monitor the client in the preparation of dialysis equipment

Monitor the client's ability to assess the effectiveness of their current renal replacement therapy

Perform a health status assessment within scope of practice to monitor the health status of the client undergoing renal replacement therapy

Recognise actual and potential problems of renal replacement therapy and respond appropriately

Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues, including appropriate practices to ensure efficient use of resources

Use appropriate communication skills (non-verbal, openness, sensitivity, non-judgemental attitudes)

Use oral communication skills (language competence) required to fulfil job roles as specified by the organisation/service, including:

interviewing techniques

asking questions

active listening

asking for clarification

Use written communication skills (literacy competence) required to fulfil job roles as specified by organisation/service at a level of skill that may range from reading and understanding client documentation to completion of written reports

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

Significant others may include:

Family

Carer

Friend

Assessment of health status mayinclude:

Blood pressure, pulse and respiration

Weight

Evidence of uraemia and electrolyte imbalance e.g. lethargy, anorexia, confusion, 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

Pathology results from routine testing for dialysis clients

Peritoneal dialysis exit site and/or fistula

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 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

Renal replacement therapy includes:

Peritoneal dialysis

Haemodialysis

Kidney transplant

Actual and potential problemsmay include:

Hypertension/hypotension

Hyperglycaemia/hypoglycaemia

Cardiovascular abnormalities

Fluid imbalance

Electrolyte imbalance

Malnutrition

Haemodialysis problems

haemolysis

vascular access problems

infection

clotted or stenosed vascular access

prolonged bleeding

Peritoneal dialysis problems

infection

peritonitis

exit site infection

blocked or split Tenckhoff catheter

accidental break in sterile pathway

hernia

leak

obesity

Psychosocial issues

Dietary management

Self-care principles include:

Fluid balance management

Nutritional management

Prevention of infection

Care of dialysis access

Care of transplanted kidney

Administration of medications and identification of their side effects

Provide effective education include:

Develop lesson plan

Time management of education session

Evaluating education session

Evaluating client learning

Recognising teachable moments

Assessing teaching and learning resources

Management ofdialysis equipment and consumables may include:

Stock management principles

stocktake

ordering cycle

count stock on hand

ordering supplies

method of ordering

check expiry dates

Delivery mode

Timeframes

Storage requirements

Requirement to rotate stock

Check equipment

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

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
Provide the client and significant others with the opportunity to ask questions and discuss areas of concern 
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 
Provide accurate feedback and education, appropriate to the client's, and their significant others', needs and concerns, within scope of role and responsibilities 
Encourage client independence according to their level of capability 
Complete a health 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 
Review pathology results, identify significant variations and refer to other health care team members according to organisation policies and procedures 
Identify any significant physical health status issues in relation to current renal replacement therapy 
Assist the client to determine if changes to current renal replacement therapy are required and report to other members of the health care team as required within scope of work role and organisation guidelines 
Document client assessment and refer actual and potential problems in accordance with organisation policies and procedures 
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 within scope of work role and organisation guidelines 
Provide feedback to the client on physical health assessment in order to maintain optimal health status 
Encourage the client to voice concerns, respond within scope of work role and organisation guidelines and report to other members of the health care team as required 
Assist the client adhere to self-care principles 
Observe the client manage their renal replacement therapy and provide effective education as required 
Assist and empower the client to self-manage the dialysis equipment and consumables 
Recognise and respond appropriately to actual and potential problems of renal replacement therapy and report to other members of the health care team as required within scope of work role in consultation with registered nurse and organisation guidelines 
Document and report outcomes to the appropriate members of the health care team 
Identify situations when the client is not coping with the renal replacement therapy and report to other members of the health care team in consultation with registered nurse 
Incorporate referral to community services into advanced care planning strategies in consultation/collaboration with registered nurse and other members of the health care team 

Forms

Assessment Cover Sheet

HLTRNL603B - Provide care and support to client in renal replacement therapy in community setting
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

HLTRNL603B - Provide care and support to client in renal replacement therapy in community setting

Student name:

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

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

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