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Elements and Performance Criteria

  1. Work as part of the multidisciplinary health care team for the client with an orthopaedic condition
  2. Clarify the impact of client's orthopaedic condition on the client and/or their family
  3. Contribute to planning appropriate care for the client with an orthopaedic condition
  4. Implement care plan for the client with an orthopaedic condition
  5. Assist to evaluate the outcomes of planned nursing actions for the client with an orthopaedic condition

Required Skills

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

Admission and discharge process

Age specific requirements eg older adult young adult paediatric client

Anatomy and physiology

Client rights and responsibilities

Clinical manifestations of orthopaedic conditions

Community and inhospital services available for medical condition clients

Critical thinking and problem solving

Diagnostic tests and their meanings

Emergency and first aid management of complications of orthopaedic conditioninjury

Emergency and first aid management of orthopaedic conditioninjuries

Health illness continuum

Legal and ethical issues related to practice

Medical terminology

Nursing management of the client with a fracture

Nursing management of the medical orthopaedic client

Nursing management of the surgical orthopaedic client

Occupational health and safety legislation

Organisation policy and procedure

Participating as a member of the health care team

Pathophysiology of clinical manifestations of orthopaedic conditions

Phases of care for orthopaedic condition clients

Philosophy underpinning orthopaedic nursing

Reflective practice

Specialised indepth knowledge of anatomy and physiology and pathophysiology of clinical manifestations of orthopaedic conditions

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 to address

acute care and intensive care needs of orthopaedic condition client

pain management needs

pressure area care needs

rehabilitative care needs of orthopaedic condition client

Apply principles of

bandaging

health assessment

plaster of paris management

rehabilitation

traction

Apply professional standards of practice

ANMC code of conduct

ANMC code of ethics

ANMC national EnrolledDivision nurse competency standards

stateterritory Nurse Regulatory Nurses Act

stateterritory Nursing and Midwifery Regulatory Authority standards of practice

scope of nursing practice decision making framework

Apply principles of documentation to document planned nursing interventions

Ensure maintenance of skin integrity

Facilitate activities of daily living

Maintain effective symptom management

Maintain evidence based practice in line with current literature and work of professional bodies associated with medical condition

Manage administration of medications as per jurisdictional and legal requirements

Recognise and address appropriately religious and cultural needs of client and significant others

Recognise and address needs of client and significant others in relation to grief and loss

Undertake health teaching to address specific needs of client and significant others

Undertake nursing management of the client with an amputation

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

Use prosthetic aids and devices appropriately

Use communication skills for

counselling

interviewing

Evidence Required

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 prior to assessment in the workplace

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 assignmentsprojects

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

Questioning verbal and writing

Role playsimulation

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 andor Torres Strait Islander clients and communities


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.

Multidisciplinary health care team members may include:

Client and their significant others

Medical staff

Nursing staff

Social workers

Physiotherapists

Occupational therapists

Speech pathologists

Dietitian

Prosthetists

Podiatrists

Drug and alcohol services

Emergency services including - ambulance, Royal Flying Doctor Service, Care Flight

Community services

Transitional rehabilitation services

Health care settings may include:

Hospital - private or public

Day clinic

Long stay centres

Short stay centres

Medical clinic

Aged care

Respite centres

Community

Paediatric environments

Orthopaedic conditions include (but are not limited to):

Musculoskeletal conditions e.g. gout, systemic lupus erythematosus, osteomyelitis, bursitis, epicondylitis, hallux valgus, avascular necrosis, compartment syndrome, thromboembolism, disseminated intravascular coagulation, delayed union, fat embolism, contractures

Congenital musculoskeletal conditions e.g. torticolis, spina bifida

Traumatic musculoskeletal conditions including - dislocations, sprains, fractures, traumatic amputations

Degenerative musculoskeletal conditions e.g. arthritis, back pain, muscle spasm, disc prolapse, osteoarthritis, osteitis deformans, osteomalacia

Surgical interventions for musculoskeletal conditions e.g. internal and external fixtures for fractures, applications of surgical braces, removal of bunions, elective surgical procedures (joint replacement surgery), laminectomy, surgical amputation

Bone tumours e.g. metastatic bone carcinoma, multiple myeloma, bone tuberculosis, osteosarcoma, chondrosarcoma

Assessment of impact of orthopaedic condition include:

Performance of activities of daily living

Loss or limitation to physical function

Assessment of musculoskeletal function

Accompanying trauma and injuries

Impact on sexuality, relationships, self image, body image

Grief and loss

Loss of vocation

Coping mechanisms

Personal and community support mechanisms

Level of communication

Maintenance/improvement of quality of life

Maintenance/improvement of lifestyle

Impact of secondary disease processes

Plans of care may include:

Nursing care plans

Clinical pathways

Treatment plans

Medical notes

Rehabilitation

Community referrals

Health teaching

Discharge plans

Rehabilitation plans

Specific nursing interventions/ clinical skills include:

Management of elimination (urinary and bowel) needs including - insertion of indwelling catheters, irrigation of indwelling catheters

Wound care

Skin care including - assessment and management of skin care

Health teaching in relation to client care needs

Pain management

Manual handling

Co ordination of clinical care

Application of specific prosthetic devices

Assessment of oxygen saturation levels

Peak flow

Electrocardiography

Management of intravenous therapy

Management of blood product infusions

Rehabilitative care practices

Emergency resuscitation skills

Evaluation of planned care includes:

Level of independence in performance of activities of daily living

Access and use of community support services

Participation in rehabilitation programs

Self management of symptoms of musculoskeletal injury including muscle spasm, pressure care, elimination management