HLTENN024
Apply nursing practice in the cardiovascular care setting


Application

This unit describes the skills and knowledge required to apply the principles of cardiovascular nursing care to provide holistic nursing care and maintain a person’s optimal cardiovascular health.

Enrolled nurses working in cardiovascular nursing 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 for a person with cardiovascular condition

1.1 Contribute information to nursing care plan that reflects the person’s nursing needs, and include nursing actions to maximise cardiovascular function and minimise potential complications

1.2 Identify the role of specialist nursing and medical services in the care of the person with cardiovascular condition, and work within that context

1.3 Collaborate with community service agencies in partnership with the person, family or carer to maintain continuity of care

1.4 Identify factors relevant to the person’s situation, including physical, psychological, social and economic impacts

1.5 Monitor and review data collected about the person and communicate to relevant interdisciplinary health care team members

2. Perform complex nursing interventions in the cardiovascular healthcare setting

2.1 Prioritise nursing interventions according to the person’s needs and in consultation with registered nurse

2.2 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

2.3 Participate in risk assessment identification and risk management processes for the person with cardiovascular condition

2.4 Apply complex decision-making processes to modify nursing interventions and use problem-solving approaches in response to changes in the person’s condition

2.5 Identify when the acuity of a person’s cardiovascular health is beyond own skill and knowledge, and refer promptly to registered nurse and relevant interdisciplinary health care team

2.6 Administer prescribed emergency medication based on sound knowledge of principles of drug actions and in accordance with organisation policies and procedures

2.7 Make appropriate proposals for nursing interventions in consultation with registered nurse to promote improved outcomes for the person and their condition

3. Evaluate effectiveness of nursing interventions and planned care, and support continuing self-care

3.1 Evaluate nursing interventions provided and consider identified outcomes against evidence-based best practice in cardiovascular nursing care

3.2 Identify responses of the person, family or carer to nursing interventions and their understanding of ongoing management of the cardiovascular impairment

3.3 Identify opportunities where indicated, to provide the person, family or carer with information on available community resources and how to access them

3.4 Assess, prior to discharge, the person’s understanding of their cardiovascular condition, medications and therapeutic regimes

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 with a cardiovascular condition in the workplace:

administration of (non-invasive) continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP)

peripherally inserted central catheter (PICC)/midline management

monitoring of electrocardiograph readings for abnormalities

under water seal drain management

in undertaking the above, used 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:

the following issues and manifestation, sufficiently in-depth and specialised to make considered judgements and to make professional contributions to cardiovascular nursing care:

physiology and pathophysiology related to cardiovascular issues

emergency care of cardiovascular issues (knowledge and execution)

clinical manifestations of chronic disease states

cardiovascular conditions including:

congestive heart failure

acute pulmonary oedema

pulmonary embolism

arrhythmia:

ventricular tachycardia

ventricular fibrillation

asystole

symptomatic brady and tachycardia

atrial fibrillation

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

actual and potential problems relating to cardiovascular conditions including:

electrolyte imbalance

fluid overload

hypoxia, hypoxaemia

chest pain

structural heart damage

sepsis

haemorrhage

neurovascular damage including cerebral vascular accident

vessel occlusion

pneumothorax

pacemaker lead displacement

arrhythmia

exercise intolerance

cardiovascular procedures including:

cardiac stents

percutaneous transluminal coronary angioplasty (PTCA) with or without stent

pacemaker (temporary or permanent)

cardiac access vascular graft (CAVG)

mitral valvotomy

electrophysiology studies, with or without ablation

implantable cardioverter defibrillator(ICD)

cardioversion

echocardiogram

exercise stress test

nuclear medicine scans

transoesophageal echocardiogram (TOE)

hyper and hypo tension

pericardiocentesis

abdominal aortic aneurysm (AAA) repair

varicose veins

amputations

actions designed to maximise cardiovascular function and minimise potential complications

reflective practice and evidence-based best practice for cardiovascular nursing.


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

CPAP and BiPAP (non-invasive) devices

PICC lines and CVC lines

underwater seal 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 a 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.