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Elements and Performance Criteria

  1. Contribute to multi-disciplinary health care team in caring for the client with a stoma
  2. Assess health care needs of client with a stoma
  3. Plan holistic care for the client with a stoma
  4. Provide comprehensive care for client with a stoma
  5. Evaluate progress toward expected outcomes of care

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

Age specific requirements

Clients rights and responsibilities

Cultural and spiritual beliefs and practices

Culturally appropriate health promotion activities for clients with stoma issues

Diagnostic tests and their meaning

Factors influencing growth and development

Factors influencing self esteem

Legislative requirements for practice

Medical terminology

Nursing management of the stoma client undergoing surgery

Occupational health and safety legislation

Organisation policy and procedure

Participating as a member of the health care team

Principles of health assessment

Reflective practice

Specialised indepth knowledge of anatomy physiology and pathophysiology related to stoma issues

Specialised knowledge and execution relating to emergency care of stomas

Specialised knowledge of clinical manifestations of chronic disease states

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 include

facilitation of activities of daily living

fundamental and complex nursing interventions

physical assessment

medication administration as per jurisdictional and legal requirements

assessment observation and documentation of

nutritional status

hydration

digestive function

skin integrity

pain management

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

Apply relevant admission and discharge tools according to organisation policy

Apply relevant health unit assessment tools according to organisation policy

Apply cognitive processes to reflect problem solving and analysis in the planning implementation and evaluation of care to clients

Apply organisation policy and procedure relating to stoma management

Demonstrate accountability for personal outputs and broad client group outcomes

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 nursing management of the stoma client

Use advanced communication skills interviewing and counselling

Use education and teaching strategies relating to health promotion and practical task applications for stoma conditions

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

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

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 or written

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.

Clients may include:

Children

Adolescents

Adults

Older adults

Significant others

Health care setting may include:

Hospitals (private or public)

Aged care facility

Respite centre

Clinics (medical, day or outpatient)

Community or General Practice settings

Rehabilitation hospitals

Paediatric settings, childcare or schools

Multidisciplinary health care team members may include:

Nurses

Doctors

Allied health professionals

Community or volunteer staff

Administration staff from a variety of organisations

Clients and their families

Professional and associated organisations include:

Australian Association of Stomal Therapy Nurses

World Council of Enterostomal Therapists

Colostomy Associations

Ileostomy Associations

Crohns and Colitis Association

GISS

Stoma management may include:

Pre-operative and pre-procedure bowel preparation

Wound care specific to stoma operation i.e. perineal wounds

Supporting bridge site care

Appliance and product selection and management

Management of skin and peristomal skin conditions

Management of feeding and drainage tubes

Management of urinary incontinence

Faecal incontinence - types, causes, assessment and management

Skin care and products to assist in the management of incontinence

Making long bags

Management of constipation, diarrhoea, constipation and flatus

Care of high output stomas

Odour control

Knowledge of available resources

Stoma care may include issues relating to:

Altered fluid and electrolyte states

Nutrition/hydration

Body image and sexuality

Psychological and psycho-social considerations

Activities of daily living

Jejunostomy

Gastrotomy

Caecostomy

Gastrointestinal and Genito-urinary fistula care

Health promotion goals/ outcomes may include:

Effective gas exchange

Protection of own airway

Re-inflation of lungs