Application
This unit describes the skills and knowledge required to provide supportive care of a person with chronic kidney disease including advance care planning.
This unit applies to enrolled nursing work carried out in consultation and collaboration with registered nurse, and under supervisory arrangements aligned to the Nursing and Midwifery Board of Australia regulatory authority legislative requirements; and to Aboriginal and/or Torres Strait Islander health work carried out under direct or indirect supervisory arrangements of a registered nurse or medical practitioner.
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. Assess impact of chronic kidney disease (CKD) on the person and their educational needs | 1.1 Maintain current knowledge of CKD and associated pathophysiology and apply to each clinical manifestation 1.2 Identify common problems and complications associated with CKD and focus on the person’s specific contributing factors when assessing impact on that person 1.3 Discuss with the person the psychosocial impact of CKD on their activities of daily living 1.4 Ascertain and respect person person’s needs related to their lifestyle, social context and emotional and spiritual choices 1.5 Communicate effectively with the person, family or carer and members of the interdisciplinary health care team 1.6 Clarify the educational needs of the person in terms of stages of the disease, required care and self-management strategies 1.7 Provide support to the person, family or carer in an open and non-judgemental way and within scope of own work role and responsibilities, to ensure they have the freedom to discuss spiritual and cultural issues related to the impacts of CKD |
2. Contribute to providing education to the person with CKD | 2.1 Provide information and resources to the person, family or carer on the aetiology and pathophysiology of the stages of CKD, within scope of work role and responsibilities 2.2 Update own knowledge and provide the person with relevant information to assist in maintaining their health status and slowing disease progression 2.3 Provide information and support to the person to assist them to establish and maintain an appropriate diet 2.4 Provide the person with access to appropriate health education resources on CKD and renal replacement therapy 2.5 Support the person to access information about treatment options in different stages of the disease, so that they can make informed treatment choices 2.6 Communicate effectively with the person, family or carer to clarify the person’s needs related to care, including end-of-life discussion, and refer the person to appropriate members of the interdisciplinary health care team 2.7 Contribute to advance care planning or directives in consultation with the interdisciplinary health care team to identify and meet the changing needs of the person, and changes in advance care planning or directives |
3. Contribute to determining the health status of the person with CKD | 3.1 Perform holistic primary health care assessment of the person in consultation and collaboration with the registered nurse 3.2 Monitor health status of the person to identify disease progression and report changes, referring the person to others where appropriate within scope of work role and organisation policy and procedures 3.3 Identify possible psychosocial impacts of CKD in discussions with the person and, if required and within scope of work role and organisation policy and procedures, refer the person, family or carer for counselling or assistance 3.4 Assess the psychosocial impact of palliative care on the person’s family or carer 3.5 Consult with the interdisciplinary health care team to contribute to effective care planning for the person with CKD |
4. Assist the person to develop self-management strategies | 4.1 Identify opportunities for the person to self-manage various clinical manifestations and common problems and complications associated with CKD 4.2 Assist the person to adhere to care management strategies and their medical management regime for CKD to maintain optimal health |
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:
implemented nursing care plans for 3 people with chronic kidney disease (CKD) in consultation and collaboration with interdisciplinary team in the workplace
provided follow-up care or 3 people with CKD, evaluating their health status and providing relevant health information to meet individual needs in consultation and collaboration with interdisciplinary team in the workplace or in a simulated environment.
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:
applied anatomy and physiology of the renal system and clinical manifestations and associated pathophysiology of acute kidney injury (AKI) and Stages 1 to 5 of CKD
underlying environmental and social factors contributing to CKD in the general population in Australia and to the higher rates experienced within Aboriginal and/or Torres Strait Islander communities
CKD conditions including risk factors:
diabetic nephropathy
glomerulonephritis
hypertensive nephropathy
polycystic kidney disease
reflux nephropathy
kidney stones
clinical manifestations of CKD including:
hypertension
anaemia
bone disease
cardiovascular disease
impaired immunity
electrolyte imbalance
fluid imbalance
complications and impact of CKD including:
uraemic breath
unusual or metallic taste
anorexia
nausea and vomiting
lethargy
change in urination
confusion
pain
increase in depression
stages in grief and loss
sexual dysfunction
general malaise
cardiovascular events
infections
uraemic frost
pruritus
restless leg syndrome
screening and prevention of CKD
immunity and the importance of vaccinations
changing educational needs of the person as CKD progresses
assessment of renal function and diagnostic procedures including:
common pathology tests to diagnose and monitor CKD and their interpretation
interventional and investigational procedures used in the diagnosis and the management of CKD
management of CKD including:
factors that can slow the progression and changes across the continuum of CKD
management principles for various clinical manifestations of CKD and associated co-morbidities
meaning and interpretation of health check results for a person with CKD
medicines in common use in health management of a person with CKD including basic mechanism of action, precautions, contraindications and side effects
nutritional considerations for a person with CKD
treatment options (including theory, terminology, procedures, risks and benefits) for a person with CKD including renal replacement therapies such as peritoneal dialysis (PD) and haemodialysis (HD)
psychosocial impacts
social needs:
disability support
family support
transport to appointments
accommodation
relevant organisations associated with palliative care and advance care planning
self-management strategies for a person with CKD, including knowledge the person requires and ways to foster a lifelong commitment to:
healthy life style
exercise
renal diet
fluid requirements
medication regime
care of dialysis access
recognising progressive symptoms of CKD
vaccination regime
diabetes care
cardiovascular disease care
dental care
optometry and ophthalmic care
skin care.
Assessment Conditions
Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions. Where simulation is used, it must reflect real working conditions by modelling industry operating conditions and contingencies, as well as, using suitable facilities, equipment and resources.
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.