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

ELEMENT

PERFORMANCE CRITERIA

1. Determine health status of clients with acute and/or chronic cardiovascular conditions

1.1 Apply understanding of the pathophysiology of the presenting/underlying cardiovascular condition

1.2 Identify client nursing care needs commonly associated with cardiovascular impairment

1.3 Initiate holistic health assessment and collect accurate client information in accordance with health unit policy

1.4 Evaluate and interpret client's cardiac function 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 Identify client (and/or identified significant other/s) knowledge regarding cardiovascular conditions, self management and individual treatment regime

2. Contribute to multi-disciplinary health care team in caring for client/s with cardiovascular impairment

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 with chronic cardiovascular conditions

2.3 Collaborate with community agencies 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 for clients with acute and/or chronic cardiovascular conditions

3.1 Ensure nursing care plan reflects specific cardiovascular 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 cardiovascular 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 to attain and maintain optimal cardiovascular 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 Update nursing interventions, including health promotion and/or education, to assist client and identified 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 Implement health teaching plans for the client experiencing cardiovascular impairment (and identified significant other/s) with health care team support

4.6 Ensure appropriate pre-, intra- and post- cardiovascular diagnostic procedures are undertaken in line with organisation policies and procedures

4.7 Ensure medication administration is based on sound knowledge of principles of drug actions and side effects in accordance with health unit policies and procedures

5. Evaluate effectiveness of nursing interventions and planned care for clients with acute and/or chronic cardiovascular conditions

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

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:

Critical thinking and problem solving

Cultural and spiritual beliefs and practices

Culturally appropriate health promotion activities for clients with cardiovascular issues

Factors influencing growth and development

Factors influencing self esteem

Legislative requirements for practice

Medical terminology

Occupational health and safety legislation

Organisation policy and procedure

Participating as a member of the health care team

Principles of health assessment

Professional standards of practice

ANMC code of conduct

ANMC code of ethics

ANMC national Enrolled/Division 2 nurse competencies

Scope of nursing practice decision making framework

Reflective practice

Specialised in-depth knowledge in anatomy, physiology and pathophysiology related to cardiovascular issues

Specialised knowledge and execution relating to emergency care of cardiovascular issues.

Specialised knowledge in the clinical manifestations of chronic disease states

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 clinical nursing skills, including assessment, observation and documentation relating to the nursing management of cardiovascular interventions and emergencies

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

Apply cognitive processes to reflect problem solving and analysis in the planning implementation and evaluation of care to clients

Apply organisation policy and procedure relating to cardiovascular management

Apply relevant admission and discharge tools according to organisation policy

Apply relevant health unit assessment tools according to organisation policy

Demonstrate accountability for personal outputs and broad client group outcomes

Use advanced communication skills

Use education and teaching strategies relating to health promotion and practical task applications for cardiovascular conditions

Use information technology systems

Use language, literacy and numeracy competence required to communicate effectively with client, group, colleagues and to record or report client outcomes

Undertake nursing interventions which may include:

arterial line management

assistance with meeting activities of daily living

Central Venous Catheter Management

chest pain assessment and management

cough CPR and pre-cordial thump

CPAP and BiPAP (non-invasive)

emergency medications

fundamental nursing interventions

medication administration and management

modified advanced life support

PICC/Midline Management

under water seal drain management

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

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.

Clients may include:

Adult

Older adult

Significant others

Child

Adolescent

Health care setting may include:

Acute care facilities

Respite or rehabilitation facilities

Private or public hospitals

Medical clinics or practices

Community health clinics or centres

Aged care settings

Multidisciplinary health care team members could include:

Nurses

Doctors

Allied health professionals

Community or volunteer staff

Administration staff from a variety of organisations

Clients and their families

Cardiovascular conditions may include:

Congestive Cardiac Failure

Acute Pulmonary Oedema

Pulmonary Embolism

Arrhythmia - VT, VF, Asystole, Symptomatic brady and tachycardia, AF

Congenital Heart Defects - accessory pathways, septal defects, tetralogy of Fallot, dextracardia

Ischaemic Heart Disease - Angina and Myocardial Infarction

Heart Valve Dysfunction

Sub-Acute Bacterial Endocarditis

Pericarditis

Acute Chest Pain

Cardiomyopathy

Carotid Stenosis

Abdominal Aortic Aneurysm

Peripheral Vascular Disease

Deep Vein Thrombosis

Cardiovascular procedures may include

R and L Heart Catheters

PTCA (with or without stent)

Pacemaker (temporary or permanent)

CAVG

Mitral Valvotomy

Electrophysiology studies (with or without ablation)

ICD

Cardioversion

Heart Transplant Care

Echocardiogram

Exercise stress test

Nuclear medicine scans

TOE

Hyper/Hypo tension

Pericardiocentesis

AAA repair

Varicose veins

Amputations

Actual and potential problems may include:

Electrolyte imbalance

Fluid overload

Reduced CO2

Hypoxia/Hypoxaemia

Chest pain

Structural heart damage

Sepsis

Haemorrhage

Neurovascular damage

Cerebral Vascular Accident

Vessel occlusion

Pneumothorax

Pacemaker lead displacement

Arrhythmia

Allergy

Exercise Intolerance

Health promotion goals / outcomes may include:

Exercise

Nutrition

Weight Loss

Diabetes Management

Smoking Cessation

Hypertension Control

Stress Management

Post Menopausal

Alcohol and Drugs

This unit contains Employability Skills