Simple modifications, which do not alter the intent of the cast/splints, may be performed at the technician's discretion

Work is performed at the request of, and in consultation with, medical staff or with own discretion and requires a range of well developed skills where some discretion and judgement is required and individuals take responsibility for the quality of their outputs

Modification of casts may occur in various locations within the hospital environment eg operating theatres, emergency department, wards, and outclient departments

All activities are carried out in accordance with organisation policies, procedures and infection control guidelines

ELEMENT

PERFORMANCE CRITERIA

1. Prepare to modify cast

1.1 Assemble and check equipment and materials for modification of casts to ensure that it is in clean and in working order

1.2 Receive and confirm if in doubt requirements for modification of cast with relevant personnel

1.3 Assess client's condition and identify precautions and potential complications of modifying cast

1.4 Explain procedure to client and obtain client consent/agreement

1.5 Provide opportunities for the client to ask questions and discuss areas of concern

1.6 Meet the comfort and safety needs of the client and applicator

1.7 Review the condition of wound and pin site and refer to relevant personnel as required

2. Modify cast

2.1 Position area to which cast is to be modified in accordance with industry best practice

2.2 Meet the comfort and safety needs of the client and applicator

2.3 Identify the client's specific needs in relation to modifying the cast

2.4 Modify cast to meet client's needs according to instructions, if required

2.5 Achieve correct handling to maintain/ correct/ modify soft tissue/ fracture position in accordance with pattern and/ or condition of injury

2.6 Complete documentation

3. Undertake post modification procedures

3.1 Clean client at completion of procedure

3.2 Ensure the neurovascular status of limb is within normal limits

3.3 Check the fit and functionality of cast

3.4 Provide written and verbal advice to client and carer regarding the care of the cast and limb

3.5 Fit client with sling, heel/overshoes and ambulation aids, as required

3.6 Instruct client and ensure client is safe on correct use of ambulation aids

3.7 Arrange appropriate support for client

4. Clean working environment

4.1 Dispose of waste in accordance with waste management policies

4.2 Clean equipment in accordance with manufacturer's specifications and stored safely

4.3 Clean work surfaces in accordance with infection control guidelines

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:

Anatomical positioning in modification of casts

Anatomy and physiology relevant to cast modification

Awareness and resolution of complications e.g. pressure sores, foreign objects in casts

Confidentiality requirements of client information

Current standards and best practice relevant to cast modification

Interpretation of documentation relating to modification of casts

Medical terminology relevant to cast modification

Organisation policy and procedures, including Infection control and WHS

Precautions and complications of modification of casts

Purpose of modification of cast

Essential skills:

It is critical that the candidate demonstrate the ability to

Comply with policies and procedures including those of WHS and infection control

Select appropriate material and use correct techniques for modification of casts

Apply current standards and best practice to meet duty of care to client

Communicate effectively with clients in relation to the procedure and manage clients' anxiety level

Demonstrate all steps that must be taken in the correct and safe usage of equipment

Recognise boundaries of responsibilities and refer problems to supervisor or other appropriate health professional

In addition, the candidate must be able 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 current standards and best practice relevant to orthopaedic device application and removal

Apply general problem solving skills to adjust casts for individual client needs

Communicate with people from diverse cultural and linguistic backgrounds

Correctly and safely modify a cast

Deal with conflict

Solve problems including an ability to use available resources

Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues

Use numeracy skills ranging from the ability to complete basic arithmetic calculations, recording stock levels and statistical information

Use oral communication skills required to fulfil job roles in a safe manner and as specified by the organisation, including skills in:

asking questions

providing clear information

listening to and understanding workplace instructions

clarifying workplace instructions when necessary

competence in English or a community language, depending on client group and organisation requirements

Use effective verbal and non verbal communication skills with a range of internal and external persons

Use reading and writing skills required to fulfil job roles in a safe manner and as specified by the organisation to a level of skill required for

reading and documenting clinical information

understanding policy and procedure manuals

Work with others and display empathy with client and carers

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

Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Context of and specific resources for assessment:

Relevant organisation policy, guidelines, procedures and protocols

Method of assessment:

Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision

Observation of work activities when modifying casts

Observation of simulation and/or role play when modifying casts

Discussion of physical and/or behavioural contingency scenarios involving duty of care

Authenticated transcripts of relevant education/training courses

Recognition of relevant life/work experience

Questioning, written assessments/projects, e-learning can be used to assess knowledge

Authenticated reports of experience in modifying casts(Documentation associated with performance reviews, supervisor/co-ordinator evaluations of work performance)

Training records associated with first aid, work health and safety training, orientation/induction training, safe manual handing, universal infection control procedures

Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice

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 and/or Torres Strait Islander clients and communities

Related units:

Holistic assessment practice with other health services units of competency is encouraged

This unit should be assessed in conjunction with:

HLTAP401B Confirm physical health status

HLTCT401D Apply casts

HLTCT403D Remove casts

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.

Types of casts may include:

Fully circumferential

Hip spica

Slab

Split cast

Equipment may include:

Benders

Heat pan

Plaster trap

Saw with vacuum

Scissors

Shears

Spreaders

Vice

Materials may include:

Abduction bars

Bandages

Cast shoes

Felts/foams

Hinges

Plaster

Quadrilateral bucket

Stockinettes

Strapping

Synthetic materials

Tapes

Thermoplastic materials

Undercast padding

Relevant personnel may include:

Medical practitioners

Other health professionals

Clients may include:

Adolescents

Adults

Children

Elderly

In-clients/out-clients

Infants

Assessment of client's condition may include:

Allergies

Relevant medical history

Skin condition eg oedema, blisters, pressure areas, broken skin, fragile skin

Precautions may include:

Loss of fracture position

Loss of soft tissue position

Complications may include:

Cast breakdown

Cast migration (due to loss of tissue bulk)

Compromising related injury

Fracture blisters

Loss of movement/function

Malalignment of bone

Neurovascular complications eg pressure areas

Reduced range of movement/function of joint

Secondary infection

Wound breakdown

Clients specific needs may include:

Age

Functional requirements or restrictions

Mobilisation difficulties or restrictions

Physical anomalies

Religious and cultural beliefs

Modifications of cast may include:

Converting eg completion, addition

Reinforcing

Repad

Splitting/bi-valving

Tightening

Trimming

Wedge

Windows

Documentation may include:

Appliance hire documentation

Appointment forms and books

Cast check forms

Client records

Work log books

Advice given to clients may include:

Cast, splint and brace care

Limb care

Mobilisation exercises/routines

Oedema control

Appropriate support may include:

Arrangement of educational material

Instructions for seeking advice if required

Organisation of walking aids e.g. crutches, wheelchairs

Referral to appropriate health professional

Review client's social situation in relation to their ability to self care with a cast

This unit contains Employability Skills