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Evidence Guide: HLTENN027 - Apply nursing practice in the hyperbaric 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!

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HLTENN027 - Apply nursing practice in the hyperbaric environment

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

Elements define the essential outcomes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Work in the hyperbaric environment

  1. Identify roles and responsibilities of members of the interdisciplinary health care team in the hyperbaric environment
  2. Identify potential and actual hazards involved with working in the hyperbaric environment and observe workplace health and safety requirements in own practice
  3. Identify rationale for pre-hyperbaric treatment safety checklists and participate pre-hyperbaric treatment safety processes
  4. Identify potential causes of emergencies associated with the hyperbaric chamber and hyperbaric treatment and use appropriate methods to prevent emergencies
  5. Apply knowledge of the hyperbaric chamber and locate main oxygen valve for situations or emergencies where the valve will need to be shut off
  6. Set up the specific hyperbaric chamber equipment for treatments correctly and use problem-solving skills during hyperbaric treatments.
  7. Identify actual and potential contraindications to hyperbaric therapy both for the person undergoing hyperbaric treatment and for the health care team members
  8. Undertake annual hyperbaric medical and promote this requirement with colleagues
Identify roles and responsibilities of members of the interdisciplinary health care team in the hyperbaric environment

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify potential and actual hazards involved with working in the hyperbaric environment and observe workplace health and safety requirements in own practice

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify rationale for pre-hyperbaric treatment safety checklists and participate pre-hyperbaric treatment safety processes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify potential causes of emergencies associated with the hyperbaric chamber and hyperbaric treatment and use appropriate methods to prevent emergencies

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Apply knowledge of the hyperbaric chamber and locate main oxygen valve for situations or emergencies where the valve will need to be shut off

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Set up the specific hyperbaric chamber equipment for treatments correctly and use problem-solving skills during hyperbaric treatments.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify actual and potential contraindications to hyperbaric therapy both for the person undergoing hyperbaric treatment and for the health care team members

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Undertake annual hyperbaric medical and promote this requirement with colleagues

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Contribute to holistic and specific assessment for hyperbaric treatment

  1. Perform holistic assessment of the person in conjunction with the interdisciplinary health care team using resources and tools specific to the hyperbaric unit in line with organisation policies and procedures
  2. Identify possible psychological and physical complications of hyperbaric treatment for the person including contraindications, based on findings of the person’s assessment
  3. Discuss physical, psychological and social impacts of hyperbaric treatment with the person, family or carer to ensure their knowledge is sufficient for them to make informed consent
  4. Identify when the acuity of a person is beyond own skills and knowledge and promptly consult with registered nurse and relevant interdisciplinary health care team members
Perform holistic assessment of the person in conjunction with the interdisciplinary health care team using resources and tools specific to the hyperbaric unit in line with organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify possible psychological and physical complications of hyperbaric treatment for the person including contraindications, based on findings of the person’s assessment

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Discuss physical, psychological and social impacts of hyperbaric treatment with the person, family or carer to ensure their knowledge is sufficient for them to make informed consent

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify when the acuity of a person is beyond own skills and knowledge and promptly consult with registered nurse and relevant interdisciplinary health care team members

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Perform nursing interventions in the hyperbaric environment

  1. Apply strategies for managing a person’s anxiety during hyperbaric therapy
  2. Monitor and manage a person’s drainage tubes including any interventions that relate to the use of suction in the hyperbaric chamber at depth and at surface
  3. Apply principles related to hyperbaric oxygen therapy when setting up and managing a range of breathing system in the hyperbaric chamber
  4. Perform wound management and record wound response to hyperbaric therapy and report to the interdisciplinary health care team
  5. Respond appropriately to hyperbaric emergencies or toxicity in line with organisation policies and procedures
  6. Use critical thinking and problem-solving approaches to propose and implement nursing interventions to reflect changes in the person’s condition, in consultation with registered nurse
  7. Evaluate nursing interventions provided and consider identified outcomes against evidence-based best practice in hyperbaric nursing care
Apply strategies for managing a person’s anxiety during hyperbaric therapy

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Monitor and manage a person’s drainage tubes including any interventions that relate to the use of suction in the hyperbaric chamber at depth and at surface

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Apply principles related to hyperbaric oxygen therapy when setting up and managing a range of breathing system in the hyperbaric chamber

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Perform wound management and record wound response to hyperbaric therapy and report to the interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Respond appropriately to hyperbaric emergencies or toxicity in line with organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Use critical thinking and problem-solving approaches to propose and implement nursing interventions to reflect changes in the person’s condition, in consultation with registered nurse

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Evaluate nursing interventions provided and consider identified outcomes against evidence-based best practice in hyperbaric nursing care

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Work in the hyperbaric environment

1.1 Identify roles and responsibilities of members of the interdisciplinary health care team in the hyperbaric environment

1.2 Identify potential and actual hazards involved with working in the hyperbaric environment and observe workplace health and safety requirements in own practice

1.3 Identify rationale for pre-hyperbaric treatment safety checklists and participate pre-hyperbaric treatment safety processes

1.4 Identify potential causes of emergencies associated with the hyperbaric chamber and hyperbaric treatment and use appropriate methods to prevent emergencies

1.5 Apply knowledge of the hyperbaric chamber and locate main oxygen valve for situations or emergencies where the valve will need to be shut off

1.6 Set up the specific hyperbaric chamber equipment for treatments correctly and use problem-solving skills during hyperbaric treatments.

1.7 Identify actual and potential contraindications to hyperbaric therapy both for the person undergoing hyperbaric treatment and for the health care team members

1.8 Undertake annual hyperbaric medical and promote this requirement with colleagues

2. Contribute to holistic and specific assessment for hyperbaric treatment

2.1 Perform holistic assessment of the person in conjunction with the interdisciplinary health care team using resources and tools specific to the hyperbaric unit in line with organisation policies and procedures

2.2 Identify possible psychological and physical complications of hyperbaric treatment for the person including contraindications, based on findings of the person’s assessment

2.3 Discuss physical, psychological and social impacts of hyperbaric treatment with the person, family or carer to ensure their knowledge is sufficient for them to make informed consent

2.4 Identify when the acuity of a person is beyond own skills and knowledge and promptly consult with registered nurse and relevant interdisciplinary health care team members

3. Perform nursing interventions in the hyperbaric environment

3.1 Apply strategies for managing a person’s anxiety during hyperbaric therapy

3.2 Monitor and manage a person’s drainage tubes including any interventions that relate to the use of suction in the hyperbaric chamber at depth and at surface

3.3 Apply principles related to hyperbaric oxygen therapy when setting up and managing a range of breathing system in the hyperbaric chamber

3.4 Perform wound management and record wound response to hyperbaric therapy and report to the interdisciplinary health care team

3.5 Respond appropriately to hyperbaric emergencies or toxicity in line with organisation policies and procedures

3.6 Use critical thinking and problem-solving approaches to propose and implement nursing interventions to reflect changes in the person’s condition, in consultation with registered nurse

3.7 Evaluate nursing interventions provided and consider identified outcomes against evidence-based best practice in hyperbaric nursing care

Required Skills and Knowledge

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Work in the hyperbaric environment

1.1 Identify roles and responsibilities of members of the interdisciplinary health care team in the hyperbaric environment

1.2 Identify potential and actual hazards involved with working in the hyperbaric environment and observe workplace health and safety requirements in own practice

1.3 Identify rationale for pre-hyperbaric treatment safety checklists and participate pre-hyperbaric treatment safety processes

1.4 Identify potential causes of emergencies associated with the hyperbaric chamber and hyperbaric treatment and use appropriate methods to prevent emergencies

1.5 Apply knowledge of the hyperbaric chamber and locate main oxygen valve for situations or emergencies where the valve will need to be shut off

1.6 Set up the specific hyperbaric chamber equipment for treatments correctly and use problem-solving skills during hyperbaric treatments.

1.7 Identify actual and potential contraindications to hyperbaric therapy both for the person undergoing hyperbaric treatment and for the health care team members

1.8 Undertake annual hyperbaric medical and promote this requirement with colleagues

2. Contribute to holistic and specific assessment for hyperbaric treatment

2.1 Perform holistic assessment of the person in conjunction with the interdisciplinary health care team using resources and tools specific to the hyperbaric unit in line with organisation policies and procedures

2.2 Identify possible psychological and physical complications of hyperbaric treatment for the person including contraindications, based on findings of the person’s assessment

2.3 Discuss physical, psychological and social impacts of hyperbaric treatment with the person, family or carer to ensure their knowledge is sufficient for them to make informed consent

2.4 Identify when the acuity of a person is beyond own skills and knowledge and promptly consult with registered nurse and relevant interdisciplinary health care team members

3. Perform nursing interventions in the hyperbaric environment

3.1 Apply strategies for managing a person’s anxiety during hyperbaric therapy

3.2 Monitor and manage a person’s drainage tubes including any interventions that relate to the use of suction in the hyperbaric chamber at depth and at surface

3.3 Apply principles related to hyperbaric oxygen therapy when setting up and managing a range of breathing system in the hyperbaric chamber

3.4 Perform wound management and record wound response to hyperbaric therapy and report to the interdisciplinary health care team

3.5 Respond appropriately to hyperbaric emergencies or toxicity in line with organisation policies and procedures

3.6 Use critical thinking and problem-solving approaches to propose and implement nursing interventions to reflect changes in the person’s condition, in consultation with registered nurse

3.7 Evaluate nursing interventions provided and consider identified outcomes against evidence-based best practice in hyperbaric nursing care

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:

undertaken nursing work in accordance with Nursing and Midwifery Board of Australia professional practice standards, codes and guidelines

performed nursing interventions for 3 different people undergoing a session of hyperbaric therapy in the workplace.

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

applicable Australian Standards for work in compressed air and hyperbaric oxygen facilities

basic structure and internal layout of a hyperbaric chamber

common dive tables for hyperbaric treatment and their indications

common treatment profiles for hyperbaric therapy and their indications

conditions indicated and contraindicated for hyperbaric therapy treatment and the mechanisms of therapeutic benefit for each

educational resources and professional organisations associated with hyperbaric therapy

emergencies associated with the hyperbaric chamber and treatment including:

fire inside the chamber

fire outside the chamber

emergency decompression

explosive decompression

uncontrolled compression

power failure

communication failure

chamber atmospheric contamination

isolation emergency including actual or potential violence

pneumothorax

cardiac arrest and airway management

hypoglycaemia

oxygen toxicity (central nervous system and pulmonary)

hyperbaric chamber treatment including:

the chamber and sequence of events that occur during a treatment

how to observe air equalisation techniques

strategies for managing an anxious patient during hyperbaric treatment

prohibited items in the chamber

appropriate clothing for treatments

potential complications

location of main oxygen valve and how to shut it off when required

how to maintain hyperbaric chamber cleanliness

emergency procedures for fire and medical emergencies

symptoms of hyperbaric CNS toxicity and appropriate actions in response to the symptoms

indications for hyperbaric therapy including:

decompression sickness

carbon monoxide poisoning

smoke inhalation

osteoradionecrosis

selected wound healing

mixed non aerobic and aerobicinfections

air or gas embolism

osteomyelitis (refractory)

gas gangrene (clostridial myonecrosis)

soft tissue radionecrosis

crush injuries/compartment syndromes

compromised skin grafts/flaps

thermal burns

blood loss

some spider bites

legislative requirements for practice

potential complications of hyperbaric therapy including:

cardiac arrest and airway management

hypoglycaemia

oxygen toxicity (central nervous system and pulmonary)

isolation emergency including actual or potential violence

pneumothorax

claustrophobia

sinus or dental barotrauma

lung barotrauma

physiological effects of increased atmospheric pressure on the human body and of breathing 100 per cent oxygen (hyper oxygenation), helium or mixed gases under hyperbaric conditions

rationale for annual staff hyperbaric medicals

contraindications for hyperbaric therapy including:

pulmonary function tests

tissue perfusion tests

excessive alcohol intake

dehydration

asthma

anxiety states or claustrophobia

dental work in the previous 24 hours

strenuous exercise before (and after) therapy

flying within 24 hours of treatment (staff and water divers only)

anatomy, physiology and pathophysiology related to hyperbaric issues, sufficiently in-depth and specialised to make considered judgements and to make professional contributions to hyperbaric nursing care

specific procedures for identifying people with diabetes and others who have a pre-procedure blood sugar outside normal range

special considerations for children, infants and babies

theories of physics as they relate to hyperbaric treatments including:

Boyle’s law

Charles’s law

Henry’s law

Dalton’s law.