The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects of assessment:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Conditions of assessment:

This unit includes skills and knowledge specific to Aboriginal and/or Torres Strait Islander culture

Assessment must therefore be undertaken by a workplace assessor who has expertise in the unit of competency or who has the current qualification being assessed and who is:

Aboriginal or Torres Strait Islander him/herself

or:

accompanied and advised by an Aboriginal or Torres Strait Islander person who is a recognised member of the community with experience in primary health care

Context of assessment:

Competence should be demonstrated working individually, under supervision or as part of a primary health care team working with Aboriginal and/or Torres Strait Islander clients

Assessment should replicate workplace conditions as far as possible

Related units:

This unit should be assessed in conjunction with:

HLTAHW517B Prepare for and manage childbirth

HLTAHW518B Provide postnatal and infant health care

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

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:

Organisation policies and procedures relating to client confidentiality

Role of the Aboriginal Health Worker in counselling and health education

Anatomy/physiology, pharmacology, pathology and basic microbiology relevant to pregnancy

Knowledge of microbiology relevant to antenatal health and prevention of infection or cross infection

Nutritional needs of pregnant women

Health conditions, obstetric problems and associated issues related to pregnancy

Strategies to:

improve antenatal health in the community

address clients presenting with antenatal problems

coordinate provision of optimum level of maternal health service delivery

Medical problems occurring in pregnancy requiring referral

Relevant assessment methods and use of associated equipment, testing procedures

Relevant treatments, medicines and associated care services available

Risks and contraindications associated with relevant treatments and medication

Realistic expectation of client condition during monitoring of progress

Relevant evaluation criteria for monitoring effectiveness of specific antenatal health management program

Essential skills:

It is critical that the candidate demonstrate the ability to:

Undertake comprehensive health checks related to antenatal health

Provide information, guidance and support to clients and their families with antenatal health issues

Monitor the outcomes of antenatal health care services and make any required revisions to services, care plans or information provided

In addition, the candidate must be able 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 the ability to:

Take and document a general, social and obstetric health history

Perform an antenatal physical assessment

Recognise situations requiring immediate or urgent action

Work with other members of multi-disciplinary team to ensure actions determined in the client's care plan are carried out and documented

Provide treatment, medicine and other health care services appropriate to antenatal health in a safe and effective manner and within guidelines

Prepare and implement an antenatal plan

Communicate effectively with client to obtain information and ensure understanding of information provided

Liaise between service providers, individuals, families and community groups

Holistically evaluate impact of treatment on client's physical, mental and emotional condition and behaviour

Monitor outcomes of treatment / medication regimes

Evaluate outcome of client's prescribed treatment/ care plan

Evaluate overall effectiveness of care plan

Make timely and appropriate referrals, providing accurate and relevant details to clients and referral agencies

Manage community education on antenatal health

Reflect on and improve own level and application of skills and knowledge to achieve desirable outcomes and maintain own capabilities

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Cultural Respect

This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples

It recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social well being, community capacity and governance

Its application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices

Community Control

Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community in this process

Supervision

Supervision must be conducted in accordance with prevailing State/Territory and organisation legislative and regulatory requirements

References to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionals

A person at this level should only be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines

Legislative Requirements

Federal, State or Territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of Variables

Aboriginal and/or Torres Strait Islander Health Workers may be required to operate in situations that do not constitute "usual practice" due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by "usual practice circumstances"

Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework

Potential impact of risk factors includes:

Lifestyle and other risk factors identified from a health history

Potential effects of risk factors on the foetus, including:

alcohol consumption

tobacco use

nutrition

prescription and non prescription drugs

illegal drugs

environmental hazards

Potential impact of compliance or non-compliance with antenatal care plan

Presence or absence of family, financial and social support systems

Environmental and housing issues affecting pregnancy, child care and family health

Potentially serious complications of pregnancy requiring referral may include:

Vaginal bleeding (painful and painless) - threatened miscarriage, incomplete miscarriage, placenta praevia, placental abruption

Abdominal pain in early pregnancy -ectopic pregnancy

Premature labour and premature rupture of membranes

Proteinuria / hypertension - pregnancy-induced hypertension

Signs and symptoms of gestational diabetes and pregnancy induced hypertension

Other urinary abnormalities - UTI, glycosuria

Reduced foetal movements and/or signs of poor foetal growth

Symptoms such as:

shortness of breath

a rise in BP

rapid weight gain

poor weight gain

oedema

abnormal fundal heights for dates

reduced or lack of foetal movement

absence of foetal health sound

abnormal urinalysis

pain on micturition

shortness of stature

anaemia

Antenatal physical assessment includes:

Abdominal palpation to identify foetal lie and presentation

Measurement of fundal height and estimation of expected progression of pregnancy

Perform venepuncture to collect blood for antenatal tests as per procedure manual

Perform an antenatal assessment

Identify all signs/evidence of pregnancy

Documentation of findings from a physical assessment and follow up as per policy and procedures manual

Issues relating to nutrition may include:

Nutrients required in pregnancy and their food sources

Identifying women 'at risk' for nutritional problems in pregnancy

Possible effects for the mother and foetus if diet is inadequate during pregnancy

Obstetric problems to be identified and managed include:

Antepartum haemorrhage

Vaginal discharges

Importance of a 'show' before 38 weeks of pregnancy

Fluid loss from the vagina

Ruptured membranes (including onset of labour, prolapsed cord, infection)

Abdominal pain in pregnancy (including braxton hicks contractions and labour contractions)

Incompetent cervix

Information provided includes:

Normal and abnormal vaginal discharge

Care of the perineum

Episiotomy or caesarean wound and breasts

Resumption of sexual relations

Obtaining baby clothes and nappies

Sources of advice and support

Welfare payments and other financial assistance