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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 of assessment	The individual being assessed must provide evidence of specified essential knowledge as well as skills Consistency of performance should be demonstrated over the required range of situations relevant to the workplace Where for reasons of safety space or access to equipment and resources assessment takes place away from the workplace the assessment environment should represent workplace conditions as closely as possible

Conditions of assessment	This unit includes skills and knowledge specific to Aboriginal andor Torres Strait Islander culture Assessment must therefore be undertaken by a workplace assessor who has expertise in the unit of competency or who has the current qualification being assessed and who is Aboriginal or Torres Strait Islander himherself or accompanied and advised by an Aboriginal or Torres Strait Islander person who is a recognised member of the community with experience in primary health care

Context of assessment	Competence should be demonstrated working individually under supervision or as part of a primary health care team working with Aboriginal andor Torres Strait Islander clients Assessment should replicate workplace conditions as far as possible

Related unit	This unit should be assessed in conjunction with the related unit HLTAHWB Provide care to clients undertaking renal dialysis in the community setting HLTAHW514B Provide care to clients undertaking renal dialysis in the community setting

Range Statement



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.

Cultural respect	This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples It recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social wellbeing, community capacity and governance Its application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices

Community control	Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community in this process

Supervision	Supervision must be conducted in accordance with prevailing state/territory and organisation legislative and regulatory requirements References to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionals A person at this level should only be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines

Legislative requirements	Federal, state or territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of Variables Aboriginal and/or Torres Strait Islander Health Workers may be required to operate in situations that do not constitute "usual practice" due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by "usual practice circumstances" Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework

Renal replacement therapy includes:	Haemodialysis Continuous ambulatory peritoneal dialysis Kidney transplantation

Physical signs of fluid overload include:	Dyspnoea and tachypnoea Ankle oedema Crackles on lung auscultation

Signs of exit site infection include:	Soiling of exit site dressing Blood-stained or pus discharge Exit site redness and tenderness

Signs of catheter tunnel infection include:	Expressible pus or discharge Tenderness, redness or pustules over peritoneal catheter tunnel

Appropriate exit site care includes:	Washing in shower and padding dry with gauze Application of topical antiseptic Correct placement of anchor tape Application of adhesive absorbent dressing Securing redundant tubing

Signs suggesting fistula stenosis or infection include:	Absent or reduced bruit or thrill Low 'a' or high 'v' pressure readings during haemodialysis Redness, tenderness or discharge

Routine pathology testing for dialysis clients include	Haemoglobin and blood counts Serum creatinine, potassium, calcium and phosphate Parathyroid hormone Iron studies

Medicines commonly used in dialysis care include:	Common antihypertensive medicines Common lipid lowering agents Phosphate binders (calcium salts) Erythropoetin Calcitriol

Clinical features suggestive of dialysis-related peritonitis include:	Abdominal pain/tenderness Fever Turbid or cloudy dialysate return

Causes of peritoneal fluid failing to drain include:	Fibrin plugs Constipation Dialysate not instilled

Clinical features of uraemia include:	Lethargy Nausea Confusion Uraemic smell

Hazards associated with haemodialysis after a number of missed dialysis sessions include:	Severe headache Fitting

Dialysis consumables include	Dialysate fluids Machine lines and dialysers Needles and syringes Normal saline Dressing supplies and tapes Peritoneal catheter caps Antiseptic and cleaning supplies

Appropriate storage arrangements for dialysis consumables include:	Safe from environmental hazards (sun, water, rodents) Secure from young children Accessible for stock-take, resupply and daily use

Information provided to client may include:	Normal structure and functioning of the renal system, kidneys and blood Causes of renal failure Physical symptoms of renal failure Different renal replacement treatment options and advantages/disadvantages How kidney transplantation is done and what is involved Information about self-care, including: Dietary requirements and rationale Fluid requirements Medication regime Looking after fistula sites Recognising common dialysis problems

Specific reference for work in this area:	National Guidelines for the Management of Dialysis&Kidney Transplantation in Remote Australia

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HLTAHW513B - Support renal dialysis clients in the community setting

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Elements and Performance Criteria

Required Skills

Evidence Required

Range Statement