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Evidence Guide: HLTCA403D - Perform stress testing

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

 

HLTCA403D - Perform stress testing

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

Prepare equipment for use

  1. Check equipment for good working order
  2. Check materials for availability and supply
Check equipment for good working order

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Check materials for availability and supply

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare client for stress testing

  1. Receive and process the request for Holter monitor in accordance with organisation procedures
  2. Identify the client correctly following the organisation's guidelines for preventing client misidentification
  3. Reassure and provide information to the client regarding the stress testing procedure appropriately and completely
  4. Involve the client fully in discussions about their treatment using language they can understand
  5. Provide the client with the opportunity to ask questions and discuss areas of concern
  6. Record client information electronically
  7. Review client medical history and address pre-existing conditions
  8. Obtain and document consent following ethical and legal requirements
Receive and process the request for Holter monitor in accordance with organisation procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify the client correctly following the organisation's guidelines for preventing client misidentification

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Reassure and provide information to the client regarding the stress testing procedure appropriately and completely

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Involve the client fully in discussions about their treatment using language they can understand

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide the client with the opportunity to ask questions and discuss areas of concern

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Record client information electronically

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Review client medical history and address pre-existing conditions

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain and document consent following ethical and legal requirements

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Attach electrodes for stress test

  1. Maintain the client's privacy and dignity throughout procedure
  2. Complete preparation of client's skin for electrode placement as required
  3. Position the client correctly and comfortably and place electrodes in accordance with client's needs and current standards
  4. Attach blood pressure cuff correctly to the client
Maintain the client's privacy and dignity throughout procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Complete preparation of client's skin for electrode placement as required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Position the client correctly and comfortably and place electrodes in accordance with client's needs and current standards

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Attach blood pressure cuff correctly to the client

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist with stress test

  1. Record blood pressure and 12 lead ECG whilst client is supine and standing
  2. Ensure supervising medical officer is present prior to commencement of test
  3. Provide assistance to the medical officer during the stress test
  4. Record and monitor 12 lead ECG and blood pressure throughout exercise and post exercise in accordance with policies and procedures
  5. Identify and report signs of client discomfort, distress or adverse reaction to the medical officer in attendance and check equipment for true reading
  6. Suspend or stop the test in response to adverse client reaction
  7. Inform and reassure client, as appropriate, throughout the procedure
  8. Maintain communication with the client at all times throughout the procedure
Record blood pressure and 12 lead ECG whilst client is supine and standing

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure supervising medical officer is present prior to commencement of test

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide assistance to the medical officer during the stress test

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Record and monitor 12 lead ECG and blood pressure throughout exercise and post exercise in accordance with policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify and report signs of client discomfort, distress or adverse reaction to the medical officer in attendance and check equipment for true reading

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Suspend or stop the test in response to adverse client reaction

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Inform and reassure client, as appropriate, throughout the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Maintain communication with the client at all times throughout the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Complete stress test

  1. Remove stress test leads and electrodes from client
  2. Store stress test leads in accordance with manufacturer's guidelines
  3. Dispose of disposable stress test electrodes and other materials in accordance with waste management procedures
  4. Provide client with assistance as required, on completion of the procedure
  5. Complete, print and present report to cardiologist for review
Remove stress test leads and electrodes from client

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Store stress test leads in accordance with manufacturer's guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Dispose of disposable stress test electrodes and other materials in accordance with waste management procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide client with assistance as required, on completion of the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Complete, print and present report to cardiologist for review

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

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 for assessment and evidence required to demonstrate this competency unit:

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

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

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

Access and equity considerations:

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment:

Resources essential for assessment include:

Clinical risk assessment policies and procedures

Emergency response procedures

Infection control procedures

Other organisation policies and procedures

Relevant organisation policy, guidelines, procedures and protocols

Relevant stress test equipment and leads

Stress test procedure manual

Workplace health and safety guidelines

Method of assessment

Authenticated reports of experience in performing stress testing (Documentation associated with performance reviews, supervisor/coordinator evaluations of work performance)

Authenticated transcripts of relevant education/training courses

Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice

Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision

Discussion of physical and/or behavioural contingency scenarios involving duty of care

e-learning can be used to assess knowledge

Observation of simulation and/or role play when performing stress testing

Observation of work activities when performing stress testing

Recognition of relevant life/work experience

Training records associated with first aid, occupational health and safety training, orientation/induction training, safe manual handing, universal infection control procedures

Written assessments/projects, questioning,

Required Skills and Knowledge

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:

Anatomy and physiology relevant for performance of stress test

Basic pharmacology related to cardiac function relevant for performance of stress test

Cardiac rhythm disturbance

Causes of the common trace interference and the appropriate remedies

Complications and contraindications for clients undergoing stress testing

Confidentiality and privacy requirements of client information

Electrical safety requirements

Principles of function, usage, indications, limitations and care of equipment relevant for performance of a stress test

Protocols for stress testing

Purpose of stress tests eg: diagnostic, prognostic

Routine maintenance policy and procedures for equipment

Essential skills:

It is critical that the candidate demonstrate the ability to:

Communicate effectively with clients in relation to the procedure and manage clients' anxiety level

Comply with organisation policies and procedures including those of WHS and infection control.

Identify and manage all forms of interference with ECG trace

Identify and respond to contraindications before and during test

Identify steps that must be taken to ensure equipment is safe for use

Identify the equipment requirements and prepare a range of equipment for performance of stress testing

Produce a diagnostic stress test result

Recognise boundaries of responsibilities and refer problems to supervisor or other appropriate health professional

continued ...

Essential skills (contd):

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:

Apply basic cardiopulmonary resuscitation in accordance with organisation policies and procedures and current standards

Communicate with people from diverse cultural and linguistic backgrounds

Correctly operate stress equipment

Correctly prepare skin, place electrodes and anchor electrodes and leads

Deal with conflict

Identify a stress test result that is unsatisfactory for diagnostic purposes

Manage the known common interferences in the production of a stress test trace

Prepare and use equipment for performance of stress testing

Produce a stress test trace satisfactory for diagnostic purposes

Solve problems including the ability to use available resources

Take measurement of blood pressure

Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues

Use effective verbal and non verbal communication skills with a range of internal and external persons are essential
Organisation may require competence in English or a community language, depending on client group

Use numeracy skills ranging from the ability to complete basic arithmetic calculations, recording stock levels and statistical information

Use oral communication skills required to fulfil job roles in a safe manner and as specified by the organisation, including skills in asking questions, providing clear information, listening to and understanding workplace instructions, and clarifying workplace instructions when necessary

Use reading and writing skills required to fulfil job roles in a safe manner and as specified by the organisation
The level of skill required involves reading and documenting clinical information and understanding policy and procedure manuals

Work with others and display empathy with client and relatives

Range Statement

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance.

Equipment may include:

Monitoring equipment

Resuscitation equipment

Checking of equipment must include:

Cleanliness

New battery

Calibration

Settings appropriate for a 3 or 5 lead rhythm trace

Maintenance in accordance with the relevant Australian Standard

Materials may include:

Electrodes

Battery

Cassette tape

Surgical tape

Skin prep

Tissues

Clients may include:

Infants

Children

Adolescents

Adults

Elderly

Request may come from:

Registered medical practitioner

Registered nurse

Information given to clients may include:

Correct attire

Expectation/safety of test

Monitoring occurring throughout test

Client information may include:

Client symptoms

Date and time

Medical history e.g. hypertension, hypercholesteraemia, recent myocardial infarction

Medical record number

Medications

Name

Predicted heart rate

Weight

Action in response to client's medical history may include:

Providing for client's special needs

Supine may be

Lying

Sitting

Adverse client reaction mat include:

Chest pain

Client request

Hyper/hypotension

Ischaemic ECG changes

Major cardiac arrhythmia

Respiratory distress

Assistance for the client may include:

Cleaning of gel from chest and limbs

Re-arranging of clothing

Report may include:

Details of client recovery

Details of client symptoms

ECG changes

Maximum heart rate and blood pressure

Percentage of predicted maximum heart rate reached

Reason for completion of test