NTISthis.com

Evidence Guide: HLTEN609B - Practise in the respiratory nursing environment

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

 

HLTEN609B - Practise in the respiratory nursing environment

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

Determine the health status of client with acute and/or chronic respiratory conditions

  1. Apply understanding of the pathophysiology of the presenting/underlying respiratory condition
  2. Identify client nursing care needs commonly associated with respiratory impairment
  3. Initiate holistic health assessment and collect accurate client information in accordance with health unit policy
  4. Evaluate, interpret and communicate client respiratory function to the health care team
  5. Use a range of assessment tools relevant to client care requirements
  6. Identify significant alterations in client health status
  7. Ascertain possible factor(s) impacting on client health status
  8. Identify client (and/or identified significant other/s) knowledge regarding respiratory conditions, self management and individual treatment regime
Apply understanding of the pathophysiology of the presenting/underlying respiratory condition

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify client nursing care needs commonly associated with respiratory impairment

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Initiate holistic health assessment and collect accurate client information in accordance with health unit policy

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Evaluate, interpret and communicate client respiratory function to the health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use a range of assessment tools relevant to client care requirements

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify significant alterations in client health status

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ascertain possible factor(s) impacting on client health status

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify client (and/or identified significant other/s) knowledge regarding respiratory conditions, self management and individual treatment regime

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Contribute to multi-disciplinary health care team in caring for clients with respiratory impairment

  1. Interact appropriately with emergency service personnel, referring agencies and other hospital department staff
  2. Work with an understanding of the role of specialist nursing and medical services in the care of clients with chronic respiratory conditions
  3. Collaborate with multi-disciplinary team in partnership with the client (and identified significant other/s with client consent), to maintain continuity of care
  4. Identify factors relevant to client situation, giving consideration to the physical, psychological, social and economic impacts
  5. Review data collected and communicate to relevant members of the health care team
Interact appropriately with emergency service personnel, referring agencies and other hospital department staff

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work with an understanding of the role of specialist nursing and medical services in the care of clients with chronic respiratory conditions

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Collaborate with multi-disciplinary team in partnership with the client (and identified significant other/s with client consent), to maintain continuity of care

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify factors relevant to client situation, giving consideration to the physical, psychological, social and economic impacts

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Review data collected and communicate to relevant members of the health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Plan nursing care for clients with acute and/or chronic respiratory conditions

  1. Ensure nursing care plan reflects specific respiratory care requirements in accordance with health unit policy
  2. Ensure care plan reflects client's current nursing needs and nursing actions designed to maximise respiratory function and minimise potential complications
  3. Apply understanding of risk management principles in planning client care
  4. Ensure planned care and therapeutic interventions aim to assist client/s to achieve optimal health outcomes
  5. Identify client requirements for health promotion and education aspects of the nursing care plan in conjunction with client and significant other/s
  6. Regularly review plan of care and modify to reflect changes in client condition
Ensure nursing care plan reflects specific respiratory care requirements in accordance with health unit policy

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure care plan reflects client's current nursing needs and nursing actions designed to maximise respiratory function and minimise potential complications

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Apply understanding of risk management principles in planning client care

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure planned care and therapeutic interventions aim to assist client/s to achieve optimal health outcomes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify client requirements for health promotion and education aspects of the nursing care plan in conjunction with client and significant other/s

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Regularly review plan of care and modify to reflect changes in client condition

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Perform complex nursing interventions to assist client to attain and maintain optimal respiratory health

  1. Prioritise nursing interventions according to client needs
  2. Modify nursing interventions using critical thinking and problem solving approaches, to reflect changes in client condition
  3. Update nursing interventions, including health promotion and/or education, to assist client and identified significant other/s to achieve expected outcomes
  4. Monitor nursing interventions, review those that fail to address client needs and revise in consultation/collaboration with the health care team
  5. Implement health teaching plans for the client experiencing respiratory problems (and identified significant other/s) with health care team support
  6. Ensure appropriate pre-, intra- and post-diagnostic procedures are undertaken in line with organisation policies and procedures
  7. Ensure medication administration is based on sound knowledge of principles of drug actions and side effects in accordance with health unit policies and procedures
Prioritise nursing interventions according to client needs

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Modify nursing interventions using critical thinking and problem solving approaches, to reflect changes in client condition

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Update nursing interventions, including health promotion and/or education, to assist client and identified significant other/s to achieve expected outcomes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Monitor nursing interventions, review those that fail to address client needs and revise in consultation/collaboration with the health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Implement health teaching plans for the client experiencing respiratory problems (and identified significant other/s) with health care team support

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure appropriate pre-, intra- and post-diagnostic procedures are undertaken in line with organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure medication administration is based on sound knowledge of principles of drug actions and side effects in accordance with health unit policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Evaluate effectiveness of nursing interventions and planned care for clients with acute and/or chronic respiratory conditions

  1. Evaluate responses of client and identified significant other/s to nursing interventions, and modify and document in accordance with health unit policy
  2. Evaluate responses of client and identified significant other/s to health promotion and education and modify and document in accordance with health unit policy
  3. Ensure client, and significant other/s where indicated, are aware of community resources available to them and how to access them
  4. Assess client understanding of their condition, medications and therapeutic regimes prior to discharge
  5. Evaluate client acceptance of specific health promotion initiatives prior to discharge
  6. Assess and review understanding of identified significant other/s in relation to current condition of client and their ongoing management
Evaluate responses of client and identified significant other/s to nursing interventions, and modify and document in accordance with health unit policy

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Evaluate responses of client and identified significant other/s to health promotion and education and modify and document in accordance with health unit policy

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure client, and significant other/s where indicated, are aware of community resources available to them and how to access them

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess client understanding of their condition, medications and therapeutic regimes prior to discharge

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Evaluate client acceptance of specific health promotion initiatives prior to discharge

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess and review understanding of identified significant other/s in relation to current condition of client and their ongoing management

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

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

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 work place

Written assignments/projects

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

Questioning - verbal or written

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

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:

Critical thinking and problem solving

Cultural and spiritual beliefs and practices

Culturally appropriate health promotion activities for clients with respiratory problems

Factors influencing growth and development

Factors influencing self esteem

Legal standards for practice

Medical terminology

Organisation policy and procedure

Participating as a member of the health care team

Principles of health assessment

Reflective practice

Specialised in-depth knowledge of in respiratory anatomy, physiology and pathology

Specialised knowledge and execution relating to emergency care of respiratory

Specialised knowledge of clinical manifestations of chronic respiratory disease states

Workplace health and safety legislation

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 clinical nursing skills, including:

facilitation of activities of daily living

fundamental nursing interventions

complex nursing interventions

physical assessment skills

neurological function

assistance with meeting activities of daily living

medication administration

assessment of physical reflexes

assessment, observation and documentation of:

nutritional status

hydration

respiratory function

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

Apply cognitive processes to reflect problem solving and analysis in the planning implementation and evaluation of care to clients

Apply organisation policy and procedure relating to respiratory management

Apply relevant admission and discharge tools according to organisation policy

Apply relevant health unit assessment tools according to organisation policy

Appropriate use advanced terminology relating to respiratory issues

Demonstrate accountability for personal outputs and broad client group outcomes

Use advanced communication skills

Use education and teaching strategies relating to health promotion and practical task applications for respiratory conditions

Use language, literacy and numeracy competence required to communicate effectively with client, group, colleagues and to record or report client outcomes

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.

Multidisciplinary health care team members could include:

Medical staff

Nursing staff

Social workers

Physiotherapists

Occupational therapists

Speech pathologists

Dietitian

Prosthetists

Special health requirements include:

Nutritional disorders

Health perceptions

Separation from family

Psychomotor dysfunction

Respiratory conditions may include:

Asthma

COAD

Pulmonary oedema

Pneumonia

Emphysema/bronchiotisis

Bronchitis (acute and chronic)

Asthma

Adult Respiratory Distress Syndrome

Lung cancer

Cystic fibrosis

Heamo/pnuemothorax

Surgical procedures

TB

PE

Sleep Apnoea

Actual and potential problems may include:

Hypoxia

Respiratory failure

Hypercapnia

Inability to clear secretions

Inability to cough

Inability to protect airway

Aspiration

Shortness of breath

Nursing interventions may include:

Respiratory assessment - Chest auscultation, Inspection, Pulse oximetry, respiratory rate, pulse rate, blood pressure, sedation score, past medical history, accessory muscles, SOB degree

Changing pleural drains

Assisting with the insertion of pleural drains

Administration of respiratory medication - nebulised, oral

Take blood from an arterial line for blood gas analysis

Instruction in and encouragement of deep breathing and coughing exercises

Pain assessment and management

Spirometry

Administration of non-invasive ventilation - CPAP and BiPAP

Oxygen administration

Tracheal suction via an ETT or Tracheostomy

Management of a client with a tracheostomy - tracheostomy dressing, client assessment

Health promotion goals / outcomes may include:

Effective gas exchange

Protection of own airway

Re-inflation of lungs