Application
This unit describes the skills and knowledge required to provide health care to clients that is specific to continuous ambulatory peritoneal dialysis or home haemodialysis being undertaken in the community setting.
This unit applies to those Aboriginal and/or Torres Strait Islander Health Workers working independently and as part of a multidisciplinary team to deliver primary health care services to Aboriginal and/or Torres Strait Islander clients and communities.
The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.
Elements and Performance Criteria
ELEMENT | PERFORMANCE CRITERIA |
Elements define the essential outcomes. | Performance criteria specify the level of performance needed to demonstrate achievement of the element. |
1. Assess peritoneal catheter exit site and client dressing technique | 1.1 Identify signs of exit site infection 1.2 Elicit signs of catheter tunnel infection 1.3 Obtain exit site swab and send for microbiological analysis 1.4 Appraise client technique for dressing exit site 1.5 Instruct client on appropriate exit site care 1.6 Document condition of exit site and refer problems in accordance with organisation policies and procedures |
2. Assess patency of arteriovenous (A-V) fistula | 2.1 Obtain history of pain, swelling or trauma around A-V fistula 2.2 Elicit history of haemodialysis needling problems or abnormal ‘A’ and ‘V’ pressure readings 2.3 Palpate fistula for thrill and auscultate for bruit 2.4 Identify signs suggesting fistula stenosis or infection 2.5 Promptly report potential fistula problems to medical staff for assessment 2.6 Document findings of assessment in client notes |
3. Identify common or serious dialysis problems | 3.1 Identify clinical features suggestive of dialysis-related peritonitis and promptly refer clients 3.2 Consider causes and take note of peritoneal fluid failing to drain 3.3 Recognise clinical features of uraemia 3.4 Anticipate hazards associated with haemodialysis after a number of missed dialysis sessions and communicate risks to client 3.5 Refer identified dialysis problems to senior health staff according to organisation procedures and clinical guidelines |
4. Broker supply of dialysis consumables and support use | 4.1 Obtain information on client’s requirements for dialysis consumables 4.2 Order stock from supplier in accordance with client needs and organisational procedures 4.3 Support and monitor appropriate storage arrangements for dialysis consumables 4.4 Identify, document, report and resolve problems with supply or storage of dialysis consumables 4.5 Facilitate client use of their dialysis treatment protocol |
Evidence of Performance
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role.
There must be evidence that the candidate has:
provided care to at least three clients undertaking renal analysis in a community setting by:
assessing peritoneal catheter exit site. This includes:
identifying signs of exit site infection
identifying signs of catheter tunnel infection
swabbing exit site and sending specimen for testing
instructing client on appropriate dressing technique
documenting findings of assessment
assessing patency of arteriovenous fistula. This includes:
identifying signs suggesting fistula stenosis or infection
palpating fistula for thrill and auscultating for bruit
obtaining history of pain and haemodialysis needling problems
identifying common and serious dialysis problems
referring client to senior health staff
ordering and recording stock of dialysis consumables and storing correctly.
Evidence of 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:
basic anatomy and physiology of the renal system
common causes of chronic renal failure (diabetes, glomerulonephritis, hypertension, urinary tract obstruction, inherited abnormalities)
underlying environmental and social factors contributing to high rates of renal disease in Aboriginal and/or Torres Strait Islander communities
management principles for common co-morbidities (including diabetes, high blood pressure, hyperlipidaemia)
factors that can slow decline of renal function (e.g. control of high blood pressure, use of angiotensin-converting-enzyme (ACE) inhibitors, avoidance of non steroidal anti-inflammatory drugs (NSAIDS)
microbiology relevant to peritoneal, blood and skin infection in renal disease
pathophysiology of chronic renal failure, including:
fluid retention and pulmonary oedema
electrolyte balance and hazards of high potassium
calcium metabolism and renal bone disease
anaemia
signs and symptoms of uraemia and fluid retention
meaning and interpretation of common pathology tests for chronic renal failure and dialysis
haemodialysis technology
peritoneal dialysis – theory, terminology, procedures, risks and benefits
different types of renal dialysis units and their function
medicines in common use in management of chronic renal failure including basic mechanisms of action, precautions and side-effects
organisation policies and procedures.
Assessment Conditions
Skills must be demonstrated working:
in a health service or centre
individually or as a member of a multidisciplinary primary health care team
with Aboriginal and/or Torres Strait Islander clients and communities.
In addition, simulations and scenarios must be used where the full range of contexts and situations cannot be provided in the workplace or may occur only rarely. These are situations relating to emergency or unplanned procedures where assessment in these circumstances would be unsafe or is impractical.
Simulated assessment environments must simulate the real-life working environment where these skills and knowledge would be performed, with all the relevant equipment and resources of that working environment.
Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.
Assessment must be undertaken by a workplace assessor who has expertise in this unit of competency and who is:
an Aboriginal and/or Torres Strait Islander Health Worker
or:
accompanied by an Aboriginal and/or Torres Strait Islander person who is a recognised member of the community with experience in primary health care.
Foundation Skills
The Foundation Skills describe those required skills (language, literacy, numeracy and employment skills) that are essential to performance. |
Foundation skills essential to performance are explicit in the performance criteria of this unit of competency. |