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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 units	This unit should be assessed in conjunction with HLTAHWB Prepare for and manage childbirth HLTAHW517B Prepare for and manage childbirth HLTAHWB Provide postnatal and infant health care HLTAHW518B Provide postnatal and infant health care

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 well being, 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

Potential impact of risk factors includes:	Lifestyle and other risk factors identified from a health history Potential effects of risk factors on the foetus, including: alcohol consumption tobacco use nutrition prescription and non prescription drugs illegal drugs environmental hazards Potential impact of compliance or non-compliance with antenatal care plan Presence or absence of family, financial and social support systems Environmental and housing issues affecting pregnancy, child care and family health

Potentially serious complications of pregnancy requiring referral may include:	Vaginal bleeding (painful and painless) - threatened miscarriage, incomplete miscarriage, placenta praevia, placental abruption Abdominal pain in early pregnancy -ectopic pregnancy Premature labour and premature rupture of membranes Proteinuria / hypertension - pregnancy-induced hypertension Signs and symptoms of gestational diabetes and pregnancy induced hypertension Other urinary abnormalities - UTI, glycosuria Reduced foetal movements and/or signs of poor foetal growth Symptoms such as: shortness of breath a rise in BP rapid weight gain poor weight gain oedema abnormal fundal heights for dates reduced or lack of foetal movement absence of foetal health sound abnormal urinalysis pain on micturition shortness of stature anaemia

Antenatal physical assessment includes:	Abdominal palpation to identify foetal lie and presentation Measurement of fundal height and estimation of expected progression of pregnancy Perform venepuncture to collect blood for antenatal tests as per procedure manual Perform an antenatal assessment Identify all signs/evidence of pregnancy Documentation of findings from a physical assessment and follow up as per policy and procedures manual

Issues relating to nutrition may include:	Nutrients required in pregnancy and their food sources Identifying women 'at risk' for nutritional problems in pregnancy Possible effects for the mother and foetus if diet is inadequate during pregnancy

Obstetric problems to be identified and managed include:	Antepartum haemorrhage Vaginal discharges Importance of a 'show' before 38 weeks of pregnancy Fluid loss from the vagina Ruptured membranes (including onset of labour, prolapsed cord, infection) Abdominal pain in pregnancy (including braxton hicks contractions and labour contractions) Incompetent cervix

Information provided includes:	Normal and abnormal vaginal discharge Care of the perineum Episiotomy or caesarean wound and breasts Resumption of sexual relations Obtaining baby clothes and nappies Sources of advice and support Welfare payments and other financial assistance

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HLTAHW516B - Provide antenatal health care

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Elements and Performance Criteria

Required Skills

Evidence Required

Range Statement