Elements and Performance Criteria
- Elements define the essential outcomes
- Establish therapeutic relationship with the person to support self-management of renal replacement therapy
- Perform an assessment of the person to establish their cognitive ability to support self-management of renal replacement therapy
- Provide the person, family or carer with the opportunity to ask questions and discuss areas of concern
- Ask the person questions clearly in an appropriate manner, level and pace, and in a way that encourages the person to provide full answers
- Assist and empower the person to self-manage their renal replacement therapy, and provide feedback and education as required
- Recognise and respond appropriately within scope of work role to identified actual and potential problems of the person’s proposed renal replacement therapy, and report outcomes to interdisciplinary health care team
- Incorporate referral to community services into advance care planning strategies in consultation and collaboration with interdisciplinary health care team
- Assess physical health status of a person undergoing dialysis
- Perform a pre-dialysis assessment of the person and report outcomes to interdisciplinary health care team in accordance with scope of work role and organisation policies and procedures
- Examine the person’s vascular access for haemodialysis or catheter and exit site for peritoneal dialysis to identify actual and potential problems
- Obtain specimen swab from the person’s vascular access site or catheter site if necessary, according to organisation policies and procedures, and send specimen for microbiological analysis
- Identify any significant physical health issues for the person in relation to dialysis prescription and any requirement for adjustments, and report to other members of the interdisciplinary health care team
- Recognise and refer actual and potential problems related to variations from the person’s normal health status to interdisciplinary health care team
- Assist the person in self-care management of peritoneal dialysis treatment
- Review the person’s understanding of the procedure in accordance with legal requirements and organisation policies and procedures
- Assess the person’s self-care strategies
- Appraise the person’s technique for dressing exit site and provide effective education as required
- Assist the person as necessary with their peritoneal dialysis exchange technique in accordance with organisation policies and procedures and infection control guidelines
- Monitor the person during treatment within scope of work role and within organisation policies and procedures
- Recognise and respond appropriately to actual and potential problems of peritoneal dialysis treatment
- Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis
- Assess the person’s response to treatment, and document and report outcomes to interdisciplinary health care team
- Assist the person to self-manage peritoneal dialysis consumables using waste minimisation and sustainable practice
- Perform peritoneal dialysis exchange for the person unable to undertake procedure
- Examine the peritoneal dialysis catheter exit site and perform exit site dressing as required
- Prepare peritoneal dialysis additives for dialysis bag in line with delegation, and consider and identify causes of peritoneal fluid failure to drain
- Perform peritoneal exchange according to prescribed treatment order, organisation policy and procedures
- Monitor person during treatment within scope of work role and within organisation policy and procedures and refer to interdisciplinary health care team
- Identify clinical features suggestive of dialysis-related peritonitis and promptly refer a person to interdisciplinary health care team
- Assess the person’s response to dialysis additives and treatment as administered within scope of work role
- Recognise acute and delayed adverse reactions to dialysis additives and respond within scope of work role
- Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis
- Document and report treatment outcomes to interdisciplinary health care team
- Prepare equipment and the person for haemodialysis treatment
- Explain procedure and prepare the person for treatment and make comfortable
- Prepare machine according to organisation policy and procedures
- Determine dialysis settings according to the person’s dialysis prescription within scope of work role and organisation policies and procedures
- Prepare other interventions, including medications, under the direct supervision of, and as delegated by interdisciplinary health care team within scope of work role and organisation policies and procedures
- Prepare consumables for cannulation of the person and connection to machine
- Wash hands and use personal protective equipment in accordance with infection prevention and control guidelines
- Prepare the person’s access for cannulation according to organisation policies and procedures
- Identify appropriate site for cannulation, and check for signs suggesting fistula stenosis or infection and consult with interdisciplinary health care team.
- Perform cannulation according to organisation policies and procedures
- Perform haemodialysis
- Connect the person to haemodialysis machine according to organisation policies and procedures and infection control guidelines
- Monitor the person and refer variations in health status to the interdisciplinary health care team according to organisation policies and procedures
- Recognise and respond appropriately to machine alarms and actual and potential problems of haemodialysis
- Assess the person’s response to treatment and other interventions as administered within scope of work role and consult with interdisciplinary health care team
- Recognise acute and delayed adverse reactions to other interventions and respond within scope of work role
- Disconnect the person from haemodialysis machine in accordance with organisation policy and procedures
- Clean and dry and store equipment in accordance with infection control and manufacturers’ instructions
- Examine vascular access site to identify any actual or potential problems and refer to interdisciplinary health care team
- Evaluate health status of the person at completion of dialysis
- Complete the post-dialysis assessment of the person and document and report outcomes
- Evaluate the person’s response to treatment and report to interdisciplinary health care team as required within scope of work role and organisation policy and procedures
- Provide feedback to the person on physical health assessment in order to maintain optimal health status
- Identify opportunities to encourage the person to voice concerns, and respond appropriately