HLTANA007
Monitor medications in the anaesthetic environment


Application

This unit describes the skills and knowledge required to access and prepare medications, fluids, blood and blood products prescribed by the anaesthetist, to monitor client responses.

The unit applies to anaesthetic technicians working under the direction of, and in consultation with, an anaesthetist in any hospital or day surgery setting.

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 describe the performance needed to demonstrate achievement of the element

1. Access medications

1.1 Access medications when directed by anaesthetist or other health professional

1.2 Follow legal and organisation procedures to obtain drugs

1.3 Identify indication of medication

2. Prepare medications for administration

2.1 Read client records for information that may impact medication administration

2.2 Communicate details from client records to anaesthetist or health professional

2.3 Accurately measure, calculate and confirm medication dosages as directed by health professional and in accordance with requirements for specific medications

2.4 Aseptically prepare and correctly label intravenous drugs

2.5 Program infusion device and confirm program with second authorised person

2.6 Safely dispose of waste and sharps

3. Monitor and record client responses

3.1 Identify adverse client responses and report to anaesthetist

3.2 Recognise and respond to acute and delayed adverse reactions to drugs within role of responsibility

3.3 Accurately record responses

4. Store medications

4.1 Secure, restock and store medications according to law and health care environmental policy

4.2 Identify and dispose of date expired medications

4.3 Complete accurate drug documentation

5. Prepare for and administer intravascular fluid, blood or blood products

5.1 Access and select intravascular solution, blood or blood product according to prescription

5.2 Confirm selected solution is fit for use

5.3 Select infusion set, connectors and/or filters

5.4 Assemble equipment and materials and prime in an aseptic manner ready for use

5.5 Program equipment according to prescription and confirm client identity with another authorised person

5.6 Administer and monitor infusion and infusion site

5.7 Store infusion equipment and solutions correctly

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:

accessed, prepared and monitored medications, fluids, blood and blood products in accordance with legislation and the organisation’s medication and delegation policies and practice under the supervision of a health professional on at least 10 different occasions

administered crystalloids, colloids, blood & blood products

programmed infusion devices at least twice

set up rapid infusion device at least twice

prepared drugs for administration via each of the following routes at least twice:

inhalational

intravenous

intramuscular

oral

subcutaneous

topical


Evidence of Knowledge

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

legal and ethical considerations (national, state/territory) for the handling and administration of medications, and how these are applied in organisations:

approved drug and fluid abbreviations

Australian and New Zealand scheduling for drugs and poisons

Australian and New Zealand Society of Blood Transfusion guidelines (ANZSBT)

codes of practice

records management requirements

storage

work role boundaries – responsibilities and limitations

rights and responsibilities of workers, employers and clients

work health and safety (WHS)

pharmacology for drugs commonly used in anaesthesia, including:

sources of drugs (natural/endorphins/synthetic)

drug nomenclature (chemical/generic/brand names)

drug classifications

common abbreviations

pharmacodynamics - drug receptor interactions/dose-response relationships/therapeutic index

pharmacokinetics (ADME) absorption/distribution/metabolism/excretion

pharmacotherapeutics

adverse drug reactions and interactions

toxicity/toxicology

drug administration routes:

enteral medication – endotracheal, sublingual, buccal, rectal, vaginal, urethral

parenteral medication - intravenous, intramuscular, intraosseous, intracardiac, intraarticular, intrauterine, intrathecal, subcutaneous, intra-arterial, inhalational

topical medication - subcutaneous, transnasal, transdermal, ocular, inhalational, aural

formulations, including

wafers

tablets

lozenges

capsules

elixir

suspension

solutions

creams

major drug groups used in anaesthesia - presentation, formulation, indication, mode of action, system of delivery and administration routes, precautions, side effects, contraindications and adverse reactions, storage requirements, factors influencing drug actions, dosage variations for different types of clients for all of the following:

inhalational induction agents

intravenous induction agents

analgesics

non steroidal anti-inflammatory drugs (NSAID)

anti-emetics

muscle relaxants

respiratory medications

anticoagulants

local anaesthetics

antibiotics

cardiovascular medication, including diuretics

electrolytes

drugs used in the management of the following conditions (which may complicate or co-exist with anaesthesia):

adrenal dysfunction

anaphylaxis

angina

bronchospasm

cardiac arrest

cardiac arrhythmias

congestive heart failure

coagulopathies

deep vein thrombosis

endocrine dysfunction

hypoglycaemia

hypotension

hyperglycaemia

hypertension

pulmonary oedema/embolism

raised intracranial/intra-ocular pressure

respiratory depression/compromise

stroke

seizure

uterine atony

methods of drug preparation, including:

dilutions

reconstitutions

factors to consider when calculating medication dosages including:

calculation formulae

calculation of dosages of injectable drugs (liquid, solid, unit dosages)

flow rate drops per minute

flow rate millilitres per hour

duration of infusion

paediatric dosage calculations (body weight, surface area, age related dose reduction)

geriatric dosage calculations (body weight, surface area and age)

methods of storage and handling of medication

equipment for administration of medications, including:

volumetric pumps

syringe drivers

consumables

infusion products and equipment:

rapid infusers

warming devices

burettes

infusion sets and attachments

blood and blood products

crystalloids

colloids

massive transfusion protocol

emergency medical management of anaphylaxis and adverse drug/fluid reactions


Assessment Conditions

Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions. The following conditions must be met for this unit:

use of suitable facilities, equipment and resources, including:

manufacturer’s instructions

organisation policies and procedures

MIMS

Australian & New Zealand Society of Blood Transfusion (ANZSBT)

Australian and New Zealand College of Anaesthetists (ANZCA)

medications

modelling of industry operating conditions, including presence of situations requiring problem solving in non-routine situations

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.


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.