Application
This unit describes the skills and knowledge required to provide nursing care to a person with respiratory impairment in settings such as hospitals, community settings, hospices and long term care facilities.
Enrolled nurses providing respiratory nursing care need to hold and apply specialised 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 | Performance criteria describe the performance needed to demonstrate achievement of the element. |
1. Contribute to the interdisciplinary health care team in caring a person with respiratory impairment | 1.1 Work with the health care team, consulting with the registered nurse and team members in providing nursing care to the person with respiratory impairment 1.2 Evaluate, interpret and communicate person’s respiratory function to relevant members of the health care team 1.3 Identify physical, psychological, social and economic factors relevant to the person’s health care status, and the outcomes of planned care |
2. Assist a person in maintaining optimal respiratory health | 2.1 Identify factors impacting a person’s respiratory status and re-prioritise care activities for the person rapidly when circumstances change 2.2 Participate in risk assessment identification and risk management processes for the person with complex respiratory impairment 2.3 Support the person, and family or carer as required, during pre-, intra- and post-diagnostic procedures, providing accurate information on the procedures 2.4 Identify responses of the person, family or carer to nursing interventions and their understanding of how to manage the respiratory impairment after discharge 2.5 Provide the person, family or carer with information about available community resources, and how to access them 2.6 Identify when the acuity of a person is beyond own skills and knowledge and promptly consult with registered nurse and relevant interdisciplinary health care team |
3. Actively promote improvement and advancement of respiratory nursing care | 3.1 Make appropriate proposals for nursing interventions in consultation with registered nurse to promote improved outcomes for the person and their condition 3.2 Evaluate nursing interventions provided and consider identified outcomes against evidence-based best practice in respiratory care nursing 3.3 Evaluate responses of the person, family or carer to health promotion and education resources, and continuously improve promotions and resources based on feedback 3.4 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 respiratory care setting in the workplace:
care of an arterial line
positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP)
care of permanent and temporary mechanical ventilation including suctioning and bagging
tracheal suction via an endotracheal tube (ETT)
assisted with the insertion or removal of pleural and intercostal drains
administered oxygen based on interpretation of oximetry readings or blood gas analysis in consultation with registered nurse
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:
respiratory anatomy, physiology and pathology, sufficiently in-depth and specialised to make considered judgements and to make a professional contribution to respiratory nursing care
respiratory conditions including:
acute respiratory distress syndrome
asthma
bronchitis, bronchiolitis, bronchiectasis (acute and chronic)
chronic obstructive airway disease
cystic fibrosis
emphysema
heamothorax
lung cancer
pulmonary oedema
pneumonia
pulmonary Embolism (PE)
pnuemothorax
sleep Apnoea
tuberculosis (TB)
actual and potential problems from respiratory conditions including:
aspiration
hypoxia
hypercapnia
inability to clear secretions
inability to cough
inability to protect airway
respiratory failure
shortness of breath
potential nursing interventions related to respiratory conditions including:
administration of non-invasive ventilation, CPAP and BiPAP
assisting with insertion and removal of pleural drains
care of an arterial line and interpretation of blood gas analysis
care of a person with a tracheostomy
tracheostomy dressing
tracheal suction via an endotracheal tube (ETT) or tracheostomy
interpreting the results of oximetry readings
respiratory assessment:
chest auscultation
inspection
pulse oximetry
respiratory rate
pulse rate
blood pressure
sedation score
past medical history
accessory muscles in use when breathing
degree of shortness of breath (SOB)
interpreting results of spirometry testing
surgical procedures for respiratory conditions.
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:
simulated learning environment with simulation manikins suitable for advanced clinical nursing skills
arterial lines
CPAP and BiPAP (non-invasive) devices
oxygen therapy equipment
pleural drains
suctioning equipment
vital sign monitoring equipment
progressive notes of a de-identified person’s medical history
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.