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Evidence Guide: HLTEN515B - Implement and monitor nursing care for older clients

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

 

HLTEN515B - Implement and monitor nursing care for older clients

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

Respond to the special health requirements of the older adult

  1. Work within the scope of practice for the Enrolled/Division 2 nurse with the aged care client within any health care setting
  2. Work with an understanding of physical changes that take place as part of the ageing process, associated age-related adjustments and transitions and psychosocial needs of the older persons and their families
  3. Allow for the fact that drugs and medicines have different effects in the older person
  4. Reflect an understanding of pathophysiological disorders and how they may affect older persons and their family
  5. Communicate effectively with older person experiencing sensory loss
  6. Perform preventive health checks in consultation/collaboration with a registered nurse
  7. Assist the older person to maintain health lifestyle practices
  8. Work with an awareness of own values, attitudes and beliefs towards ageing and the aged person
  9. Work with an awareness of common stereotypes associated with ageing and the influences they can have on the care of the older adult
  10. In planning and implementing care for the older person, use work practices that reflect an understanding of theories of aging and best practice care guidelines
  11. Take action to manage factors which may tend to segregate and disadvantage the older adult
Work within the scope of practice for the Enrolled/Division 2 nurse with the aged care client within any health care setting

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work with an understanding of physical changes that take place as part of the ageing process, associated age-related adjustments and transitions and psychosocial needs of the older persons and their families

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Allow for the fact that drugs and medicines have different effects in the older person

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Reflect an understanding of pathophysiological disorders and how they may affect older persons and their family

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Communicate effectively with older person experiencing sensory loss

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Perform preventive health checks in consultation/collaboration with a registered nurse

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the older person to maintain health lifestyle practices

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work with an awareness of own values, attitudes and beliefs towards ageing and the aged person

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work with an awareness of common stereotypes associated with ageing and the influences they can have on the care of the older adult

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

In planning and implementing care for the older person, use work practices that reflect an understanding of theories of aging and best practice care guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Take action to manage factors which may tend to segregate and disadvantage the older adult

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Contribute to care plan development for the older person

  1. Assess the older client to determine their health status in consultation/collaboration with registered nurse
  2. Complete appropriate health assessment tools used specifically in the aged care environment
  3. Assist the older client to identify self-care abilities and disabilities
  4. Develop the nursing care plan within the context of the health care setting using organisation policies and procedures
  5. Ensure client, family and/or significant other understand the implications of their admission to the health care setting
  6. Discuss with older client or their family representative psychological, social and/or physical needs
  7. Discuss with older person or their family representative the impact of the ageing process and/or pathophysiological disorders on the performance of activities of daily living
  8. Share information regarding older person's health status with other members of health care team
  9. Implement care as per nursing care plan and monitor work allocated to others
  10. Provide support, comfort for grieving family/client
  11. Take into account the impact of complex issues involved in aged care on carer(s)
Assess the older client to determine their health status in consultation/collaboration with registered nurse

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Complete appropriate health assessment tools used specifically in the aged care environment

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the older client to identify self-care abilities and disabilities

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Develop the nursing care plan within the context of the health care setting using organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure client, family and/or significant other understand the implications of their admission to the health care setting

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Discuss with older client or their family representative psychological, social and/or physical needs

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Discuss with older person or their family representative the impact of the ageing process and/or pathophysiological disorders on the performance of activities of daily living

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Share information regarding older person's health status with other members of health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Implement care as per nursing care plan and monitor work allocated to others

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide support, comfort for grieving family/client

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Take into account the impact of complex issues involved in aged care on carer(s)

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist to evaluate outcomes of planned nursing care of the older client

  1. Document responses of older client to nursing actions
  2. Report changes in older client response to nursing actions to registered nurse
  3. Convey information clearly and accurately to appropriate staff member
  4. Take in account complex and dual diagnosis issues in addressing aged care
  5. Provide information on community services available to older person and their family
Document responses of older client to nursing actions

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Report changes in older client response to nursing actions to registered nurse

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Convey information clearly and accurately to appropriate staff member

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Take in account complex and dual diagnosis issues in addressing aged care

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide information on community services available to older person and their family

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Practise within the aged care environment

  1. Work with an understanding of the funding mechanisms impacting on aged care provision
  2. Take into account the variety of areas of practice within the aged care environment
  3. Take into account the changes and impacts of those changes to the delivery of health care for the older person
  4. Work with an understanding of the changing demographics of the aging population
  5. Work with an awareness of own values, attitudes and beliefs towards ageing and the aged person
  6. Promote health maintenance for older person and their family
  7. Provide information on community services available to older person and their family
  8. Provide care of deceased person
  9. Provide support, comfort for grieving family/client
  10. Take into account the impact of complex issues involved in aged care on carer(s)
Work with an understanding of the funding mechanisms impacting on aged care provision

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Take into account the variety of areas of practice within the aged care environment

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Take into account the changes and impacts of those changes to the delivery of health care for the older person

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work with an understanding of the changing demographics of the aging population

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work with an awareness of own values, attitudes and beliefs towards ageing and the aged person

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Promote health maintenance for older person and their family

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide information on community services available to older person and their family

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide care of deceased person

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide support, comfort for grieving family/client

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Take into account the impact of complex issues involved in aged care on carer(s)

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Address contemporary issues in aged care practice

  1. Work with an awareness of the current legal and ethical issues involved in aged care practice
  2. Work with accurate knowledge of the role of guardianship, advanced health directives and legislation in aged care practice
  3. Recognise and support the rights and responsibilities of the older person
  4. Work with an awareness of elder abuse as a significant contemporary issue for older persons
  5. Act as an advocate for the client and their family
  6. Demonstrate respect for individual culture, spiritual and religious practice for the older person
  7. Observe and respond appropriately to physical, emotional and mental signs of stress in the older adult
Work with an awareness of the current legal and ethical issues involved in aged care practice

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work with accurate knowledge of the role of guardianship, advanced health directives and legislation in aged care practice

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise and support the rights and responsibilities of the older person

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work with an awareness of elder abuse as a significant contemporary issue for older persons

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Act as an advocate for the client and their family

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Demonstrate respect for individual culture, spiritual and religious practice for the older person

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Observe and respond appropriately to physical, emotional and mental signs of stress in the older adult

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use strategies which relate to the progressive and variable nature of dementia

  1. Work with an awareness of dementia as a neurological condition
  2. Provide activities appropriate for gender, culture and age reflecting likes and dislikes of the individual
  3. Design activities that provide the client with opportunities for autonomy and risk-taking where they can maintain safety, dignity and comfort
  4. Use a range of validation strategies to relieve distress and agitation in clients
Work with an awareness of dementia as a neurological condition

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide activities appropriate for gender, culture and age reflecting likes and dislikes of the individual

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Design activities that provide the client with opportunities for autonomy and risk-taking where they can maintain safety, dignity and comfort

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use a range of validation strategies to relieve distress and agitation in clients

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Develop and implement strategies to minimise impact of challenging behaviours

  1. Observe and document behaviours to determine triggers which may be related to: physical and emotional health; environment; tasks; and communication
  2. Consider the potential impact of the behaviours on the person or other persons in determining an appropriate response
  3. Consider a range of options when developing effective responses for inclusion in the person's care plan
  4. Implement best practice strategies which minimise the impact of behaviours
  5. Regularly review strategies that are implemented to ensure maximum effectiveness
Observe and document behaviours to determine triggers which may be related to: physical and emotional health; environment; tasks; and communication

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Consider the potential impact of the behaviours on the person or other persons in determining an appropriate response

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Consider a range of options when developing effective responses for inclusion in the person's care plan

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Implement best practice strategies which minimise the impact of behaviours

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Regularly review strategies that are implemented to ensure maximum effectiveness

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

Observation of performance in a work context is essential for assessment of this unit

Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion and be assessed by a registered nurse

Observation must include:

care of the older person in both acute care and residential aged care facility

communication with older people, family and carers

clinical performance

assessment of the older person

Context of and specific resources for assessment:

This unit is most appropriately assessed in the clinical workplace or in a simulated clinical work environment and under the normal range of clinical environment conditions

Assessment should replicate workplace conditions as far as possible

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

Method of assessment

Observation in the workplace

Written assignments/projects

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

Questioning - verbal and writing

Role play/simulation

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

Related units:

This unit is recommended to be assessed in conjunction with the following related units:

HLTAP501B Analyse health information

HLTEN509B Apply legal and ethical parameters to nursing practice

This competency unit incorporates the content of:

HLTEN414B Deliver nursing care to older clients

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:

Acute health problems with older person

An understanding of the potential impacts of dual/multiple diagnosis on identifying and prioritising needs

Basic knowledge of current research or dementia including relevant statistics

Best practice guidelines to address complex and/or special needs

Chronic health problems with older person

Common indicators and symptoms of dementia

Complex nursing interventions

Confidentiality and privacy

Continence management

Counseling resources within environment and community

Documentation principles

Effective communication skills

Environment policy and procedures

Fundamental nursing interventions

Infection control principles

Legal frameworks/requirements e.g. RCS documentation, Aged Care Act.

Limitations and legal ramifications of physical, chemical and psychological restraint

Medication administration principles

Nature of dementia as a neurological condition which is progressive

Occupational health and safety

Organisation protocols and policies related to own area of work

Pain management

Plan of care for the client

Principles and practices of assessment of individuals with complex and/or special needs

Range of appropriate strategies when working with people with dementia

Relevant activities and communication in working with people with dementia

Stereotypes and influences on ageing

Support services available

The importance of a physical, social and emotional environment for people with dementia

The importance of a safe, physical environment for people with dementia

Understanding of anatomy, physiology and pathophysiology

Understanding of physiology of ageing process

Essential skills:

It is critical that the candidate demonstrate the ability 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 problem solving skills, including use of tools and techniques to solve problems, analyse information and make decisions that require discretion and confidentiality

Apply clinical skills related to activities of daily living:

dressing

elimination

fluid intake

grooming

hygiene

nutrition

oral hygiene

Apply professional standards of practice:

ANMC code of conduct

ANMC code of ethics

ANMC national Enrolled/Division 2 nurse competency standards

state/territory Nurse Regulatory Nurses Act

state/territory Nursing and Midwifery Regulatory Authority standards of practice

scope of nursing practice decision making framework

Prioritise and address changing service needs of clients with complex and special care needs

Undertake admission and discharge activities

Use interpersonal skills, including working with others, empathising with client and relatives, using sensitivity when dealing with people and relating to persons from differing cultural, social and religious backgrounds

Use oral communication skills (language competence) required to fulfil job roles as specified by the organisation/service. Advanced oral communication skills include interviewing techniques, asking questions, active listening, asking for clarification from client or other persons at the scene, negotiating solutions, acknowledging and responding to a range of views. The work may involve using interpreters

Use written communication skills (literacy competence) required to fulfil job roles as specified by organisation/service. The level of skill may range from reading and understanding incident reports and case management materials to preparing handover reports for receiving agency staff

Work effectively with older people, carers, colleagues and other health care providers

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. 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.

Theories of ageing could include:

Biological theories

Psychosocial theory

Disengagement theory

Social exchange theory

Wear and tear theory

Activity theory

Social attitudes and beliefs could include:

Fear of ageing

Definitions of aging

Demographics of aging

Changing attitudes

Culture

Religion

Normal ageing process

Normal physiological changes of aging

Age related laboratory values

Age related physical changes

Age related psychosocial changes

Age-related adjustments could include:

Role changes

Retirement

Multiple losses

Loneliness

Depression and suicide

Fear of death

Changes in body image

Preventative health care include:

Health screenings

Dental health

Vision/hearing

Cancer screenings

Immunisations

Activities of daily living include:

Maintaining a safe environment

Communication

Breathing

Eating and drinking/eliminating

Personal cleansing and dressing/grooming

Controlling body temperature

Mobilising/Working and playing

Expressing sexuality

Sleeping

Dying

Spiritual needs

Expressing sexuality

Tools for functioning assessment may include:

Katz Index

Barthel Index and Scale

Norton Scale

Water Low Scale

Functional health patterns

Activities of daily living tool

Geriatric Depression Scale

Special health problems may include:

Common psychiatric problems

Delirium

Dementia

Prevention of illness and injury

Risk of falls

Depression

Disease processes include:

Alterations in sensory function

Alterations in cardiac function

Alterations in respiratory function

Alterations in neurological function

Alterations in musculoskeletal function

Alterations in genitourinary function

Alterations in endocrine function

Alterations in renal function

Oncological disorders

Palliative care

Legal and ethical issues include:

Rights and responsibilities of older persons

Consent

Power of attorney

Advocacy

Elder abuse

Restraint

Advanced care directives

Legislation affecting older persons

Research and the older person

Ethical principles

Community services for the older person include:

Advocacy services

Meals on wheels

Home help

Hospice care

Respite services

Support groups and information (e.g. Council on the Ageing, Alzheimers Australia)

Strategies to respond to challenging behaviours include:

Distraction, for example reminiscences, walking and music

Behaviour modification

Addressing physical triggers to behaviour including pain

Complementary therapies

Ensuring safety and comfort of aged person while addressing the risks associated with:

Ability to find their own way

Wandering or other behaviours relating to agitation

Behaviours relating to psychotic experiences or mood disorders

Ability to recognise dangers in their environment

Environmental strategies may include:

Orientation to day, date, time of day, place, person, carer, family relationships, weather

Adequate lighting to decrease risk of misinterpreting their environment

Manipulate stimuli such as activity, noise, music, lighting, decor

Provision of safe space (to pace, wander)

Security

Validation strategies to relieve distress and agitation in clients may include:

Acknowledgment

Allowing expressions of distress

Providing verbal and/or physical reassurance

Use reminiscences routinely to connect with clients