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Follow the links below to find material targeted to the unit's elements, performance criteria, required skills and knowledge

Elements and Performance Criteria

1. Elements define the essential outcomes.
2. Assess peritoneal catheter exit site and client dressing technique
   • 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
3. Assess patency of arteriovenous (A-V) fistula
   • 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
4. Identify common or serious dialysis problems
   • 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
5. Broker supply of dialysis consumables and support use
   • 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

Range Statement

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Performance Evidence

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.

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Knowledge Evidence

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.

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