Application
The knowledge and skills described in this competency unit are to be applied within jurisdictional nursing and midwifery regulatory authority legislative requirements Enrolled/Division 2 nursing work is to be carried out in consultation/collaboration with registered nurses and under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements |
Prerequisites
Not Applicable
Elements and Performance Criteria
ELEMENT | PERFORMANCE CRITERIA |
1. Apply theoretical concepts and principles in development of a nursing care plan | 1.1 Work with an understanding of the pathophysiology of presenting/underlying critical care condition 1.2 Address common nursing needs associated with clients in the critical care environment 1.3 Initiate holistic health assessment and collect accurate client information in accordance with health unit policy 1.4 Evaluate and interpret the client's nursing care needs and communicate to the health care team 1.5 Use a range of assessment tools relevant to client health care requirements 1.6 Identify significant alterations in client health status 1.7 Ascertain possible factor(s) impacting on client health status 1.8 Clarify the knowledge of client (and/or identified significant other/s) regarding client condition, self management and individual treatment regime 1.9 Work with an understanding of the psychosocial needs of clients in critical care environment |
2. Contribute to multi-disciplinary health care team in caring for clients in the critical care environment | 2.1 Interact appropriately with emergency service personnel, referring agencies and other hospital department staff 2.2 Work with an understanding of the role of specialist nursing and medical services in the care of clients in the critical care environment 2.3 Collaborate with multi-disciplinary team in partnership with the client (and identified significant other/s with client consent), to maintain continuity of care 2.4 Identify factors relevant to client situation, giving consideration to the physical, psychological, social and economic impacts 2.5 Review data collected and communicate to relevant members of the health care team |
3. Plan nursing care in consultation/collaboration with the health care team | 3.1 Ensure nursing care plan reflects specific critical care requirements in accordance with health unit policy 3.2 Ensure care plan reflects client's current nursing needs and nursing actions designed to maximise their physical function and minimise potential complications 3.3 Apply understanding of risk management principles in planning client care 3.4 Ensure planned care and therapeutic interventions aim to assist client/s to achieve optimal health outcomes 3.5 Identify client requirements for health promotion and education aspects of the nursing care plan in conjunction with client and significant other/s 3.6 Regularly review plan of care and modify to reflect changes in client condition |
4. Perform complex nursing interventions to assist clients in critical care to attain and maintain optimal health | 4.1 Prioritise nursing interventions according to client needs 4.2 Modify nursing interventions using critical thinking and problem solving approaches, to reflect changes in client condition 4.3 Perform nursing interventions, including health promotion and/or education, to assist clients and significant other/s to achieve expected outcomes 4.4 Monitor nursing interventions, review those that fail to address client needs and revise in consultation/collaboration with the health care team 4.5 Ensure appropriate pre-, intra- and post-diagnostic procedures are undertaken in line with organisation policies and procedures 4.6 Ensure medication administration is based on sound knowledge of principles of drug actions and side effects in accordance with health unit policies and procedures 4.7 Recognise the rights and responsibilities of the critical care client 4.8 Act as an advocate for the client and their family. 4.9 Respect individual culture and religious practice for the critical care client |
5. Evaluate effectiveness of nursing interventions and planned care for clients in critical care | 5.1 Evaluate responses of client and identified significant other/s to nursing interventions, and modify and document in accordance with health unit policy 5.2 Ensure client, and significant other/s where indicated, are aware of community resources available to them and how to access them 5.3 Assess client understanding of their condition, medications and therapeutic regimes prior to discharge 5.4 Evaluate client acceptance of specific health promotion initiatives prior to discharge 5.5 Assess and review understanding of identified significant other/s in relation to current condition of client and their ongoing management 5.6 Document responses to planned nursing actions 5.7 Recognise the legal and ethical issues involved in aged care practice |
Required Skills
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: Basic and advanced life support post cardiac or respiratory arrest Cardiac rehabilitation Critical thinking and problem solving Cultural and spiritual beliefs and practices Culturally appropriate health promotion activities for clients Documentation principles Factors influencing growth and development Factors influencing self esteem Infection control Legislative requirements for practice Medical terminology Nursing procedures relevant to caring for clients with life-threatening or potentially life threatening conditions Organisation policy and procedure Participating as a member of the health care team Principles of health assessment Reflective practice Specialised in-depth knowledge of anatomy, physiology and pathophysiology related to critical care issues Specialised knowledge and execution relating to emergency care of clients in critical care issues Specialised knowledge in the clinical manifestations of disease states Workplace health and safety legislation |
Essential skills: It is critical that the candidate demonstrate the ability 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 relevant admission and discharge tools according to organisation policy Appropriately undertake nursing interventions that may include: arterial line management assessment and evaluation of alteration to body system functions assistance with meeting activities of daily living blood glucose monitoring care of client Central Venous Catheter Management chest pain assessment&management cough CPR&pre-cordial thump CPAP and BiPAP (non-invasive) emergency medications fundamental nursing interventions medication administration and management modified advanced life support oxygen therapy - pulse oximetry, hand ventilation, suction pain management strategies PICC/Midline Management recording of a 12 lead ECG under water seal drain management Apply clinical nursing skills relating to the nursing management of critical care nursing interventions and emergencies, including: assessment documentation observation Apply professional standards of practice: ANMC code of conduct ANMC code of ethics ANMC national Enrolled/Division 2 nurse competency standards state/territory Nurse Regulatory Nurses Act state/territory Nursing and Midwifery Regulatory Authority standards of practice scope of nursing practice decision making framework Use language, literacy and numeracy competence required to communicate effectively with client, group, colleagues and to record or report client outcomes Use advanced communication skills |
Evidence Required
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 Observation of performance in a work context is essential for assessment of this unit Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion and be assessed by a registered nurse |
Context of and specific resources for assessment: | This unit is most appropriately assessed in the clinical workplace or in a simulated clinical work environment and under the normal range of clinical environment conditions Where, for reasons of safety, access to equipment and resources and space, assessment takes place away from the workplace, simulations should be used to represent workplace conditions as closely as possible |
Method of assessment | Observation in the work place Written assignments/projects Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice Questioning - verbal or written Role play/simulation |
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 |
Range Statement
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. | |
Multidisciplinary health care team members could include: | Medical staff Nursing staff Social workers Physiotherapists Occupational therapists Speech pathologists Dietitian Prosthetists |
Clients may include: | Adult Older adult Significant others Child Adolescent |
Actual and potential problems may include: | Respiratory failure Increased intracranial pressure Altered state of consciousness Hypercapnia Inability to clear secretions Inability to cough Aspiration Shortness of breath Electrolyte imbalance Fluid overload Reduced CO2 Hypoxia/Hypoxaemia Chest pain Cerebral Vascular Accident Vessel occlusion Pneumothorax Pacemaker lead displacement Arrhythmia Allergy |
Nursing interventions may include: | Physical assessment - Chest auscultation, Pulse oximetry, respiratory rate, pulse rate, blood pressure, sedation score, past medical history, accessory muscles Changing invasive drains Assisting with the insertion of invasive drains Administration of medication Take blood from an arterial line for blood gas analysis Instruction in and encouragement of deep breathing and coughing exercises including passive and active exercises Pain assessment and management Spirometry Administration of non-invasive ventilation - CPAP and BiPAP Oxygen administration Tracheal suction via an ETT or Tracheostomy Management of a client with a tracheostomy - tracheostomy dressing, client assessment Management of elimination (urinary and bowel) needs including - insertion of indwelling catheters, irrigation of indwelling catheters Management of permanent and temporary mechanical ventilation including suctioning and bagging |
Disease processes may include: | Alterations in sensory function Alterations in cardiac function Alterations in respiratory function Alterations in neurological function Alterations in musculoskeletal function Alteration in genitourinary function Alteration in skin integumentary function Alteration in endocrine Function Alteration in renal function |
Health promotion goals / outcomes may include: | Exercise Nutrition Weight Loss Diabetes Management Smoking Cessation Hypertension Control Stress Management Post Menopausal Alcohol&Drugs |
Plans of care may include: | Nursing care plans Clinical pathways Treatment plans Medical notes Rehabilitation Community referrals Health teaching Discharge plans Rehabilitation plans |
Legal and ethical issues include: | Rights and responsibilities Consent Power of attorney Advanced care directives Advocacy Restraint Ethical principles Legislation affecting critical care clients |
Sectors
Not Applicable
Employability Skills
This unit contains Employability Skills |
Licensing Information
Not Applicable