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Evidence Guide: HLTAHW055 - Provide care to clients undertaking renal dialysis in the community setting

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

HLTAHW055 - Provide care to clients undertaking renal dialysis in the community setting

What evidence can you provide to prove your understanding of each of the following citeria?

Elements define the essential outcomes.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess peritoneal catheter exit site and client dressing technique

  1. Identify signs of exit site infection
  2. Elicit signs of catheter tunnel infection
  3. Obtain exit site swab and send for microbiological analysis
  4. Appraise client technique for dressing exit site
  5. Instruct client on appropriate exit site care
  6. Document condition of exit site and refer problems in accordance with organisation policies and procedures
Identify signs of exit site infection

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Elicit signs of catheter tunnel infection

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain exit site swab and send for microbiological analysis

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Appraise client technique for dressing exit site

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Instruct client on appropriate exit site care

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Document condition of exit site and refer problems in accordance with organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess patency of arteriovenous (A-V) fistula

  1. Obtain history of pain, swelling or trauma around A-V fistula
  2. Elicit history of haemodialysis needling problems or abnormal ‘A’ and ‘V’ pressure readings
  3. Palpate fistula for thrill and auscultate for bruit
  4. Identify signs suggesting fistula stenosis or infection
  5. Promptly report potential fistula problems to medical staff for assessment
  6. Document findings of assessment in client notes
Obtain history of pain, swelling or trauma around A-V fistula

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Elicit history of haemodialysis needling problems or abnormal ‘A’ and ‘V’ pressure readings

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Palpate fistula for thrill and auscultate for bruit

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify signs suggesting fistula stenosis or infection

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Promptly report potential fistula problems to medical staff for assessment

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Document findings of assessment in client notes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify common or serious dialysis problems

  1. Identify clinical features suggestive of dialysis-related peritonitis and promptly refer clients
  2. Consider causes and take note of peritoneal fluid failing to drain
  3. Recognise clinical features of uraemia
  4. Anticipate hazards associated with haemodialysis after a number of missed dialysis sessions and communicate risks to client
  5. Refer identified dialysis problems to senior health staff according to organisation procedures and clinical guidelines
Identify clinical features suggestive of dialysis-related peritonitis and promptly refer clients

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Consider causes and take note of peritoneal fluid failing to drain

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise clinical features of uraemia

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Anticipate hazards associated with haemodialysis after a number of missed dialysis sessions and communicate risks to client

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Refer identified dialysis problems to senior health staff according to organisation procedures and clinical guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Broker supply of dialysis consumables and support use

  1. Obtain information on client’s requirements for dialysis consumables
  2. Order stock from supplier in accordance with client needs and organisational procedures
  3. Support and monitor appropriate storage arrangements for dialysis consumables
  4. Identify, document, report and resolve problems with supply or storage of dialysis consumables
  5. Facilitate client use of their dialysis treatment protocol
Obtain information on client’s requirements for dialysis consumables

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Order stock from supplier in accordance with client needs and organisational procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Support and monitor appropriate storage arrangements for dialysis consumables

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify, document, report and resolve problems with supply or storage of dialysis consumables

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Facilitate client use of their dialysis treatment protocol

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes.

Performance criteria specify the level of performance needed to demonstrate achievement of the element.

1. Assess peritoneal catheter exit site and client dressing technique

1.1 Identify signs of exit site infection

1.2 Elicit signs of catheter tunnel infection

1.3 Obtain exit site swab and send for microbiological analysis

1.4 Appraise client technique for dressing exit site

1.5 Instruct client on appropriate exit site care

1.6 Document condition of exit site and refer problems in accordance with organisation policies and procedures

2. Assess patency of arteriovenous (A-V) fistula

2.1 Obtain history of pain, swelling or trauma around A-V fistula

2.2 Elicit history of haemodialysis needling problems or abnormal ‘A’ and ‘V’ pressure readings

2.3 Palpate fistula for thrill and auscultate for bruit

2.4 Identify signs suggesting fistula stenosis or infection

2.5 Promptly report potential fistula problems to medical staff for assessment

2.6 Document findings of assessment in client notes

3. Identify common or serious dialysis problems

3.1 Identify clinical features suggestive of dialysis-related peritonitis and promptly refer clients

3.2 Consider causes and take note of peritoneal fluid failing to drain

3.3 Recognise clinical features of uraemia

3.4 Anticipate hazards associated with haemodialysis after a number of missed dialysis sessions and communicate risks to client

3.5 Refer identified dialysis problems to senior health staff according to organisation procedures and clinical guidelines

4. Broker supply of dialysis consumables and support use

4.1 Obtain information on client’s requirements for dialysis consumables

4.2 Order stock from supplier in accordance with client needs and organisational procedures

4.3 Support and monitor appropriate storage arrangements for dialysis consumables

4.4 Identify, document, report and resolve problems with supply or storage of dialysis consumables

4.5 Facilitate client use of their dialysis treatment protocol

Required Skills and Knowledge

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes.

Performance criteria specify the level of performance needed to demonstrate achievement of the element.

1. Assess peritoneal catheter exit site and client dressing technique

1.1 Identify signs of exit site infection

1.2 Elicit signs of catheter tunnel infection

1.3 Obtain exit site swab and send for microbiological analysis

1.4 Appraise client technique for dressing exit site

1.5 Instruct client on appropriate exit site care

1.6 Document condition of exit site and refer problems in accordance with organisation policies and procedures

2. Assess patency of arteriovenous (A-V) fistula

2.1 Obtain history of pain, swelling or trauma around A-V fistula

2.2 Elicit history of haemodialysis needling problems or abnormal ‘A’ and ‘V’ pressure readings

2.3 Palpate fistula for thrill and auscultate for bruit

2.4 Identify signs suggesting fistula stenosis or infection

2.5 Promptly report potential fistula problems to medical staff for assessment

2.6 Document findings of assessment in client notes

3. Identify common or serious dialysis problems

3.1 Identify clinical features suggestive of dialysis-related peritonitis and promptly refer clients

3.2 Consider causes and take note of peritoneal fluid failing to drain

3.3 Recognise clinical features of uraemia

3.4 Anticipate hazards associated with haemodialysis after a number of missed dialysis sessions and communicate risks to client

3.5 Refer identified dialysis problems to senior health staff according to organisation procedures and clinical guidelines

4. Broker supply of dialysis consumables and support use

4.1 Obtain information on client’s requirements for dialysis consumables

4.2 Order stock from supplier in accordance with client needs and organisational procedures

4.3 Support and monitor appropriate storage arrangements for dialysis consumables

4.4 Identify, document, report and resolve problems with supply or storage of dialysis consumables

4.5 Facilitate client use of their dialysis treatment protocol

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:

provided care to at least three clients undertaking renal analysis in a community setting by:

assessing peritoneal catheter exit site. This includes:

identifying signs of exit site infection

identifying signs of catheter tunnel infection

swabbing exit site and sending specimen for testing

instructing client on appropriate dressing technique

documenting findings of assessment

assessing patency of arteriovenous fistula. This includes:

identifying signs suggesting fistula stenosis or infection

palpating fistula for thrill and auscultating for bruit

obtaining history of pain and haemodialysis needling problems

identifying common and serious dialysis problems

referring client to senior health staff

ordering and recording stock of dialysis consumables and storing correctly.

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:

basic anatomy and physiology of the renal system

common causes of chronic renal failure (diabetes, glomerulonephritis, hypertension, urinary tract obstruction, inherited abnormalities)

underlying environmental and social factors contributing to high rates of renal disease in Aboriginal and/or Torres Strait Islander communities

management principles for common co-morbidities (including diabetes, high blood pressure, hyperlipidaemia)

factors that can slow decline of renal function (e.g. control of high blood pressure, use of angiotensin-converting-enzyme (ACE) inhibitors, avoidance of non steroidal anti-inflammatory drugs (NSAIDS)

microbiology relevant to peritoneal, blood and skin infection in renal disease

pathophysiology of chronic renal failure, including:

fluid retention and pulmonary oedema

electrolyte balance and hazards of high potassium

calcium metabolism and renal bone disease

anaemia

signs and symptoms of uraemia and fluid retention

meaning and interpretation of common pathology tests for chronic renal failure and dialysis

haemodialysis technology

peritoneal dialysis – theory, terminology, procedures, risks and benefits

different types of renal dialysis units and their function

medicines in common use in management of chronic renal failure including basic mechanisms of action, precautions and side-effects

organisation policies and procedures.

Range Statement