Application
This unit describes the skills and knowledge required to practise within the critical care environment.
Enrolled nurses working in critical care nursing need to hold and apply in-depth knowledge, effectively integrate theory and practice, and make reliable clinical assessments and judgements.
This unit applies to enrolled nurses, registered with the Nursing and Midwifery Board of Australia, seeking specialisation in enrolled nurse work that is carried out in consultation and collaboration with registered nurses, and under direct or indirect supervisory arrangements aligned to the Nursing and Midwifery Board of Australia regulatory authority legislative requirements.
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 of a unit of competency. | The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. |
1. Apply theoretical concepts and principles in providing critical care nursing | 1.1 Identify the person’s current health status and limitations and their medications and therapeutic regimes in the critical care setting with the person, family or carer 1.2 Identify factors impacting the person’s health status and report to the registered nurse significant alterations in the person’s health status 1.3 Identify and respond to the psychosocial needs of the person in the critical care environment 1.4 Identify and apply a systems approach to nursing care |
2. Contribute to interdisciplinary health care team in caring for a person in the critical care environment | 2.1 Identify role of specialist nursing and medical services in care of the person in the critical care environment and work effectively with others 2.2 Collaborate with interdisciplinary health care team in partnership with the person, family or carer to maintain continuity of nursing care planning 2.3 Identify factors relevant to the person’s situation, giving consideration to physical, psychological, social and economic impacts 2.4 Review care plan and data collected, and communicate to relevant members of the interdisciplinary health care team 2.5 Recognise the person’s choices and any advance care planning, and advocate for the rights and responsibilities of the person in critical care |
3. Perform complex nursing interventions to assist a person in critical care to attain and maintain optimal health | 3.1 Manage nursing workload according to a person’s needs and re-prioritise care activities for the person rapidly when circumstances change 3.2 Undertake appropriate pre-, intra- and post-diagnostic procedures in line with scope of practice and organisation policy and procedures, and in collaboration with the registered nurse 3.3 Respond rapidly to adverse and emergency events applying knowledge of pathophysiology and using problem-solving approaches in line with organisation policy and procedures and within scope of practice 3.4 Identify when the acuity of a person’s critical care needs is beyond own skill and knowledge, and refer promptly to registered nurse and relevant interdisciplinary health care team members |
4. Develop own practice in the critical care nursing environment | 4.1 Make appropriate proposals for nursing interventions in consultation with registered nurse to promote improved outcomes for the person and their condition 4.2 Evaluate nursing interventions provided and evaluate the outcomes against evidence-based best practice in critical care nursing 4.3 Recognise symptoms of stress and professional burnout in self, peers and colleagues, and refer to appropriate services within organisation policies and procedures and scope of practice 4.4 Seek out opportunities and participate in professional development, acquiring knowledge to guide own practice and acting as a resource for colleagues |
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:
undertaken nursing work in accordance with Nursing and Midwifery Board of Australia professional practice standards, codes and guidelines
performed the following nursing care interventions on no fewer than 3 people in a critical care setting in the workplace:
care of an arterial line
care of central venous line
assessment of chest pain
monitoring of electrocardiograph readings for abnormalities
administration of (non-invasive) continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP)
care of permanent and temporary mechanical ventilation including suctioning and bagging
peripherally inserted central catheter (PICC)/midline management
under water seal drain management
in undertaking the above, use advanced communication skills and medical terminology to communicate effectively with the person, family or carer, and the registered nurse and other health professionals to record or report the person’s outcomes.
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:
advanced life support including advanced cardiopulmonary resuscitation
complex nursing procedures relevant to care of a person in a critical care environment including infusion pumps and patient controlled analgesia pumps and syringe drivers
specialised knowledge of anatomy, physiology and pathophysiology related to critical care issues
specialised knowledge and skill relating to prioritising care in an emergency situation of a person in the critical care environment
actual and potential problems in critical care including:
respiratory failure
increased intracranial pressure
deteriorating person and levels of consciousness
haemorrhage
hypercapnia
inability to clear secretions
inability to cough
aspiration
shortness of breath
electrolyte imbalance
fluid overload
hypoxia and hypoxaemia
chest pain
stroke
vessel occlusion
pneumothorax
pacemaker lead displacement
arrhythmia
allergic reaction.
Assessment Conditions
Skills must have been demonstrated in the workplace with the addition of simulations and scenarios where the full range of contexts and situations cannot be provided in the workplace. The following conditions must be met for this unit:
use of suitable facilities, equipment and resources in line with the Australian Nursing and Midwifery Accreditation Council’s Standards including:
simulation models or manikins suitable for advanced cardiopulmonary resuscitation and clinical skills
arterial lines
CPAP and BiPAP machines
PICC lines
underwater seal drains and tubes
ventilation equipment
progressive notes of a de-identified person’s medical history
infusion pumps, patient controlled analgesia pumps and syringe drivers
organisation policy and procedures on which the candidate bases the planning
modelling of industry operating conditions including access to real people for simulations and scenarios in enrolled nursing work.
Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.
In addition, assessors must hold current registration as a Registered Nurse with Nursing and Midwifery Board of Australia.
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.