Application
This unit describes advanced skills and knowledge required to support Aboriginal and/or Torres Strait Islander women during childbirth and support of childbirth in a culturally safe environment.
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. Plan and support culturally safe birthing for women and their families | 1.1 Identify local birthing practices and cultural beliefs and discuss with women in planning and advocating for culturally appropriate and safe birthing options 1.2 Discuss roles, relationships and responsibilities to support culturally safe birthing, including the role of the Aboriginal and/or Torres Strait Islander Health Worker as an advocate for women and families 1.3 Discuss and identify signs of onset of labour and support women to attend the planned place of birth as required 1.4 Provide physical and emotional support to women as appropriate during childbirth and the immediate post-partum period 1.5 Support women and their families to take a self-care approach in line with individual needs to organisation and community requirements 1.6 Maintain referral and communication networks with medical staff, specialist obstetricians, midwives, allied health staff, birthing facilities and female community Elders regarding culturally safe birthing options and services |
2. Prepare and deliver safe birthing | 2.1 Maintain emergency delivery bundles and instructions in isolated community settings 2.2 Identify signs and symptoms of imminent unexpected childbirth 2.3 Seek urgent professional assistance and advice with birthing as necessary 2.4 Prepare to manage untimely birth in a community or home setting using the best available resources 2.5 Identify helpers and allocate tasks as appropriate based on experience and knowledge 2.6 Prepare appropriate equipment and medication 2.7 Institute basic management of second and third stages of labour, if needed 2.8 Undertake initial management of post-partum haemorrhage according to emergency care guidelines and organisational protocols, as well as other common birthing emergencies 2.9 Arrange safe evacuation in consultation with medical or midwifery staff if required and as per organisation procedures |
3. Monitor and evaluate care | 3.1 Monitor care of individual women after birth according to organisation procedures 3.2 Regularly update client files with birthing and postnatal details according to organisation procedures and policies 3.3 Review progress and outcomes in consultation with pregnant woman 3.4 Maintain registers of women undergoing postnatal care according to organisation policies and procedures 3.5 Keep schedules of participation in antenatal care and use to organise continuing care according to woman’s needs 3.6 Organise transport and other assistance as required to women post-birth 3.7 Supervise other staff participating in provision of birthing practices 3.8 Maintain referral and communication networks with medical staff, specialist obstetricians, midwives, allied health staff, birthing facility staff and female community Elders 3.9 Keep statistics for birthing outcomes and use to evaluate maternal health programs |
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:
prepared for and supported at least five women during the pregnancy and birthing process, including:
communicating effectively with each client and family if available to obtain information and ensure understanding of information provided
providing treatment, medicine and other health care services appropriate to interpartum health in a safe and effective manner and within guidelines
liaising between service providers, individuals, families and community groups
holistically evaluating the impact of treatment on client’s physical, mental and emotional condition and behaviour
performing all required assessments to determine health of the client and baby
interpreting assessment outcomes to determine course of action for health care, including issues requiring immediate action
utilising referral services as necessary
recognising situations requiring immediate or urgent action and taking appropriate action as required within current job role, legislative requirements and organisation procedures
supporting the client to attend appointments for monitoring of own and baby’s health.
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:
birthing practices suitable for culturally safe and positive birth outcomes
organisation policies and procedures relating to client confidentiality
anatomy/physiology, pharmacology, pathology and basic microbiology relevant to pregnancy, maternal and/or infant health
knowledge of microbiology relevant to maternal and/or infant health and prevention of infection or cross infection
health conditions, obstetric problems and associated issues related to pregnancy, maternal and infant health
medical problems occurring in pregnancy requiring referral and follow-up
relevant assessment methods and use of associated equipment and testing procedures
relevant treatments, medicines and associated care services available
risks and contraindications associated with relevant treatments and medication
realistic expectation of client condition during monitoring of progress
obstetric problems, including:
antepartum haemorrhage
vaginal discharges
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)
pre-term labour
breech presentation
post-partum or intrapartum haemorrhage
shoulder dystocia
retained placenta
obstructed labour
eclampsia
vital signs during childbirth or delivery, including:
TPR
blood pressure
auscultation of foetal heart rate
blood glucose level
foetal palpation
fundal height measurements
urinalysis
weight
monitoring progress of labour
bloods
rate of contractions
baseline observations including, but not limited to:
temperature, pulse, respiration
blood pressure
blood loss per vaginum
condition of fundus
rate of contractions
progress of labour
documentation of findings from a physical assessment and follow-up as per policy and procedures manual
pain assessment
blood sugar levels
pulse oximetry
recognition of significant abnormalities in cardiotocograph (CTG) reading
immediate care required for newborns, including:
use of humidicribs
intravenous infusions
blood sugar levels
skin-to-skin contact and breastfeeding in the first hour after birth
weight, length and head circumference measurements
temperature
respiratory rate
APGAR scoring and assessment
resuscitation
oxygen administration.
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 (such as unplanned or emergency births) 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. | |
Numeracy | in order to measure and interpret vital signs during labour, including temperature, pulse and respiration (TPR), blood pressure, rate of contractions and foetal heart beat detected using foetal stethoscope and Doppler |
Learning | in order to draw selectively on past experience and learning and adapt to new context |
Other foundation skills essential to performance are explicit in the performance criteria of this unit.