HLTEN611B
Apply principles of diabetic nursing care

This competency unit describes the skills and knowledge required to apply the principles of diabetic nursing care, building upon existing skills to enable the Enrolled/Division 2 nurse to provide holistic nursing care and maintain optimal health

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. Provide diabetes care within the context of the Australian health care environment

1.1 Work with an understanding of levels of diabetes care provided in the Australian health care system

1.2 Apply an awareness of sources of funding for diabetes related services

1.3 Apply an awareness of implications of demographic changes in Australian society as they impact on diabetes related health issues across the lifespan

1.4 Recognise complementary roles of organisations and individuals involved in the support and delivery of diabetes care

1.5 Interact effectively with referring agencies and community organisations in providing diabetes care

1.6 Work with an understanding of the role of specialist services in long-term client care to achieve identified outcomes

1.7 Contribute to the multi-disciplinary health care team in the holistic management of client care

1.8 Work with an understanding of legal, ethical and health policy issues related to diabetes care delivery

2. Assess the needs of clients with diabetes

2.1 Apply an understanding of the pathophysiology of diabetes

2.2 Address common nursing needs of clients with diabetes

2.3 Use a range of contemporary assessment tools, resources and strategies relevant to client care needs, accurately and in accordance with the health unit policy

2.4 Initiate holistic nursing assessment, incorporating review of previous history, current situation and treatment regimes

2.5 Determine client understanding of their condition, self management and medications

2.6 Identify possible factor/s or significant alterations impacting on client health

2.7 Identify level of knowledge and understanding of identified significant other/s and their involvement in client's diabetes care

3. Plan diabetes care in consultation/collaboration with the health care team

3.1 Ensure nursing care plan reflects specific diabetic 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 client's function and minimise potential complications

3.3 Ensure planned care and therapeutic interventions aim to assist client/s to achieve optimal health outcomes

3.4 Discuss the plan of care with client and/or identified significant other/s, and other members of the health care team

3.5 Identify health promotion and client education sessions on the nursing care plan

3.6 Undertake ongoing case management or discharge planning in accordance with health unit policy and in consultation/collaboration with the health care team

4. Perform complex nursing interventions to assist clients in achieving and maintaining optimal diabetes health

4.1 Prioritise interventions for clients according to their needs

4.2 Reorganise priorities as required to reflect changes in nursing workload

4.3 Promote the partnership between the client and the nurse in implementing health teaching and self management

4.4 Administer medications safely based on sound knowledge of the principles of drug actions and side effects in accordance with health unit policies and procedures

4.5 Evaluate, interpret and communicate the client's blood and urine results relating to diabetes function to the health care team

4.6 Liaise with Registered Nurses and other members of the health care team about alterations in conditions and ongoing client support

5. Evaluate the plan of care for clients with acute and/or chronic presentation diabetes

5.1 Critically review the care plan and modify according to client progress toward planned outcomes in consultation/collaboration with health care team

5.2 Evaluate client understanding of their condition, ongoing management and therapies either prior to discharge or in accordance with health unit policy depending on the clinical environment responsible for care delivery

5.3 Assess client acceptance of health teaching and management of ongoing care needs

5.4 Assess and review understanding by identified significant other/s of the client's current condition and ongoing management

5.5 Ensure client and identified significant other/s are aware of available community resources and how to access them

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:

Critical thinking and problem solving

Cultural and spiritual beliefs and practices

Culturally appropriate health promotion activities for clients with diabetic issues

Factors influencing growth and development

Factors influencing self esteem

Issues relating to diabetes care delivery, including:

impact of cultural diversity in models of health care in relation to effective diabetes care delivery

political and economic issues impacting on diabetes care delivery within Australia

client-specific diabetes issues across the lifespan relating to their individual physical, psychological, social, spiritual and economic needs

Legislative requirements for practice

Medical terminology relating to diabetes

Organisation policy and procedure

Participating as a member of the health care team

Principles of health assessment

Reflective practice

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

Specialised knowledge and execution relating to emergency care of diabetic clients

Specialised knowledge in the clinical manifestations of diabetes

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

Apply relevant health unit assessment tools according to organisation policy

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 diabetes management.

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

Demonstrate accountability for personal outputs and broad client group outcomes

Undertake nursing interventions which may include:

administration of I/M or S/C glucagon

administration of S/C insulin and oral hypoglycaemic agents

assessment, observation and documentation of clinical actions relating to the nursing management of diabetes interventions and emergencies

assistance with meeting activities of daily living

blood glucose monitoring

client education

emergency medications

fundamental nursing interventions

interpretation of blood and urine results

medication administration and management

monitoring of ketone levels

pre and post procedure care

venepuncture

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

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

Use information technology systems

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.

Clients may include:

Adult

Older adult

Significant others

Child

Adolescent

Family

Health care setting may include:

Acute care facilities

Respite or rehabilitation facilities

Medical clinics or practices

Community health clinics or centres

Aged care settings

Schools

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

Diabetic conditions may include:

Type 1 Diabetes Mellitus

Type 2 Diabetes Mellitus

Gestational diabetes mellitus

Actual and potential problems may include:

Hypoglycaemia

Hyperglycaemia

Ketoacidosis

Hyper osmolar non-ketonic coma

Retinopathy

Urinary and sexual health

Infection

Psychosocial issues

Nephropathy

Neuropathy

Peripheral vascular disease

Macrovascular disease

Health promotion goals / outcomes may include:

Exercise

Nutrition

Weight loss

Smoking cessation

Foot and eye care

Body mass index or Waist to Hip Ratio, reduction or maintenance

Health screening for early detection of complications


Sectors

Not Applicable


Employability Skills

This unit contains Employability Skills


Licensing Information

Not Applicable