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Evidence Guide: HLTRNL002 - Provide care and support to a person undergoing renal replacement therapy

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

 

HLTRNL002 - Provide care and support to a person undergoing renal replacement therapy

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

Elements define the essential outcomes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Establish therapeutic relationship with the person to support self-management of renal replacement therapy

  1. Perform an assessment of the person to establish their cognitive ability to support self-management of renal replacement therapy
  2. Provide the person, family or carer with the opportunity to ask questions and discuss areas of concern
  3. Ask the person questions clearly in an appropriate manner, level and pace, and in a way that encourages the person to provide full answers
  4. Assist and empower the person to self-manage their renal replacement therapy, and provide feedback and education as required
  5. Recognise and respond appropriately within scope of work role to identified actual and potential problems of the person’s proposed renal replacement therapy, and report outcomes to interdisciplinary health care team
  6. Incorporate referral to community services into advance care planning strategies in consultation and collaboration with interdisciplinary health care team
Perform an assessment of the person to establish their cognitive ability to support self-management of renal replacement therapy

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide the person, family or carer with the opportunity to ask questions and discuss areas of concern

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ask the person questions clearly in an appropriate manner, level and pace, and in a way that encourages the person to provide full answers

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist and empower the person to self-manage their renal replacement therapy, and provide feedback and education as required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise and respond appropriately within scope of work role to identified actual and potential problems of the person’s proposed renal replacement therapy, and report outcomes to interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Incorporate referral to community services into advance care planning strategies in consultation and collaboration with interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess physical health status of a person undergoing dialysis

  1. Perform a pre-dialysis assessment of the person and report outcomes to interdisciplinary health care team in accordance with scope of work role and organisation policies and procedures
  2. Examine the person’s vascular access for haemodialysis or catheter and exit site for peritoneal dialysis to identify actual and potential problems
  3. Obtain specimen swab from the person’s vascular access site or catheter site if necessary, according to organisation policies and procedures, and send specimen for microbiological analysis
  4. Identify any significant physical health issues for the person in relation to dialysis prescription and any requirement for adjustments, and report to other members of the interdisciplinary health care team
  5. Recognise and refer actual and potential problems related to variations from the person’s normal health status to interdisciplinary health care team
Perform a pre-dialysis assessment of the person and report outcomes to interdisciplinary health care team in accordance with scope of work role and organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Examine the person’s vascular access for haemodialysis or catheter and exit site for peritoneal dialysis to identify actual and potential problems

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain specimen swab from the person’s vascular access site or catheter site if necessary, according to organisation policies and procedures, and send specimen for microbiological analysis

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify any significant physical health issues for the person in relation to dialysis prescription and any requirement for adjustments, and report to other members of the interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise and refer actual and potential problems related to variations from the person’s normal health status to interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the person in self-care management of peritoneal dialysis treatment

  1. Review the person’s understanding of the procedure in accordance with legal requirements and organisation policies and procedures
  2. Assess the person’s self-care strategies
  3. Appraise the person’s technique for dressing exit site and provide effective education as required
  4. Assist the person as necessary with their peritoneal dialysis exchange technique in accordance with organisation policies and procedures and infection control guidelines
  5. Monitor the person during treatment within scope of work role and within organisation policies and procedures
  6. Recognise and respond appropriately to actual and potential problems of peritoneal dialysis treatment
  7. Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis
  8. Assess the person’s response to treatment, and document and report outcomes to interdisciplinary health care team
  9. Assist the person to self-manage peritoneal dialysis consumables using waste minimisation and sustainable practice
Review the person’s understanding of the procedure in accordance with legal requirements and organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess the person’s self-care strategies

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Appraise the person’s technique for dressing exit site and provide effective education as required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the person as necessary with their peritoneal dialysis exchange technique in accordance with organisation policies and procedures and infection control guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Monitor the person during treatment within scope of work role and within organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise and respond appropriately to actual and potential problems of peritoneal dialysis treatment

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess the person’s response to treatment, and document and report outcomes to interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the person to self-manage peritoneal dialysis consumables using waste minimisation and sustainable practice

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Perform peritoneal dialysis exchange for the person unable to undertake procedure

  1. Examine the peritoneal dialysis catheter exit site and perform exit site dressing as required
  2. Prepare peritoneal dialysis additives for dialysis bag in line with delegation, and consider and identify causes of peritoneal fluid failure to drain
  3. Perform peritoneal exchange according to prescribed treatment order, organisation policy and procedures
  4. Monitor person during treatment within scope of work role and within organisation policy and procedures and refer to interdisciplinary health care team
  5. Identify clinical features suggestive of dialysis-related peritonitis and promptly refer a person to interdisciplinary health care team
  6. Assess the person’s response to dialysis additives and treatment as administered within scope of work role
  7. Recognise acute and delayed adverse reactions to dialysis additives and respond within scope of work role
  8. Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis
  9. Document and report treatment outcomes to interdisciplinary health care team
Examine the peritoneal dialysis catheter exit site and perform exit site dressing as required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare peritoneal dialysis additives for dialysis bag in line with delegation, and consider and identify causes of peritoneal fluid failure to drain

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Perform peritoneal exchange according to prescribed treatment order, organisation policy and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Monitor person during treatment within scope of work role and within organisation policy and procedures and refer to interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify clinical features suggestive of dialysis-related peritonitis and promptly refer a person to interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess the person’s response to dialysis additives and treatment as administered within scope of work role

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise acute and delayed adverse reactions to dialysis additives and respond within scope of work role

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Document and report treatment outcomes to interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare equipment and the person for haemodialysis treatment

  1. Explain procedure and prepare the person for treatment and make comfortable
  2. Prepare machine according to organisation policy and procedures
  3. Determine dialysis settings according to the person’s dialysis prescription within scope of work role and organisation policies and procedures
  4. Prepare other interventions, including medications, under the direct supervision of, and as delegated by interdisciplinary health care team within scope of work role and organisation policies and procedures
  5. Prepare consumables for cannulation of the person and connection to machine
  6. Wash hands and use personal protective equipment in accordance with infection prevention and control guidelines
  7. Prepare the person’s access for cannulation according to organisation policies and procedures
  8. Identify appropriate site for cannulation, and check for signs suggesting fistula stenosis or infection and consult with interdisciplinary health care team.
  9. Perform cannulation according to organisation policies and procedures
Explain procedure and prepare the person for treatment and make comfortable

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare machine according to organisation policy and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Determine dialysis settings according to the person’s dialysis prescription within scope of work role and organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare other interventions, including medications, under the direct supervision of, and as delegated by interdisciplinary health care team within scope of work role and organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare consumables for cannulation of the person and connection to machine

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Wash hands and use personal protective equipment in accordance with infection prevention and control guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare the person’s access for cannulation according to organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify appropriate site for cannulation, and check for signs suggesting fistula stenosis or infection and consult with interdisciplinary health care team.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Perform cannulation according to organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Perform haemodialysis

  1. Connect the person to haemodialysis machine according to organisation policies and procedures and infection control guidelines
  2. Monitor the person and refer variations in health status to the interdisciplinary health care team according to organisation policies and procedures
  3. Recognise and respond appropriately to machine alarms and actual and potential problems of haemodialysis
  4. Assess the person’s response to treatment and other interventions as administered within scope of work role and consult with interdisciplinary health care team
  5. Recognise acute and delayed adverse reactions to other interventions and respond within scope of work role
  6. Disconnect the person from haemodialysis machine in accordance with organisation policy and procedures
  7. Clean and dry and store equipment in accordance with infection control and manufacturers’ instructions
  8. Examine vascular access site to identify any actual or potential problems and refer to interdisciplinary health care team
Connect the person to haemodialysis machine according to organisation policies and procedures and infection control guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Monitor the person and refer variations in health status to the interdisciplinary health care team according to organisation policies and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise and respond appropriately to machine alarms and actual and potential problems of haemodialysis

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess the person’s response to treatment and other interventions as administered within scope of work role and consult with interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise acute and delayed adverse reactions to other interventions and respond within scope of work role

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Disconnect the person from haemodialysis machine in accordance with organisation policy and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Clean and dry and store equipment in accordance with infection control and manufacturers’ instructions

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Examine vascular access site to identify any actual or potential problems and refer to interdisciplinary health care team

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Evaluate health status of the person at completion of dialysis

  1. Complete the post-dialysis assessment of the person and document and report outcomes
  2. Evaluate the person’s response to treatment and report to interdisciplinary health care team as required within scope of work role and organisation policy and procedures
  3. Provide feedback to the person on physical health assessment in order to maintain optimal health status
  4. Identify opportunities to encourage the person to voice concerns, and respond appropriately
Complete the post-dialysis assessment of the person and document and report outcomes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Evaluate the person’s response to treatment and report to interdisciplinary health care team as required within scope of work role and organisation policy and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide feedback to the person on physical health assessment in order to maintain optimal health status

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify opportunities to encourage the person to voice concerns, and respond appropriately

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. Establish therapeutic relationship with the person to support self-management of renal replacement therapy

1.1 Perform an assessment of the person to establish their cognitive ability to support self-management of renal replacement therapy

1.2 Provide the person, family or carer with the opportunity to ask questions and discuss areas of concern

1.3 Ask the person questions clearly in an appropriate manner, level and pace, and in a way that encourages the person to provide full answers

1.4 Assist and empower the person to self-manage their renal replacement therapy, and provide feedback and education as required

1.5 Recognise and respond appropriately within scope of work role to identified actual and potential problems of the person’s proposed renal replacement therapy, and report outcomes to interdisciplinary health care team

1.6 Incorporate referral to community services into advance care planning strategies in consultation and collaboration with interdisciplinary health care team

2. Assess physical health status of a person undergoing dialysis

2.1 Perform a pre-dialysis assessment of the person and report outcomes to interdisciplinary health care team in accordance with scope of work role and organisation policies and procedures

2.2 Examine the person’s vascular access for haemodialysis or catheter and exit site for peritoneal dialysis to identify actual and potential problems

2.3 Obtain specimen swab from the person’s vascular access site or catheter site if necessary, according to organisation policies and procedures, and send specimen for microbiological analysis

2.4 Identify any significant physical health issues for the person in relation to dialysis prescription and any requirement for adjustments, and report to other members of the interdisciplinary health care team

2.5 Recognise and refer actual and potential problems related to variations from the person’s normal health status to interdisciplinary health care team

3. Assist the person in self-care management of peritoneal dialysis treatment

3.1 Review the person’s understanding of the procedure in accordance with legal requirements and organisation policies and procedures

3.2 Assess the person’s self-care strategies

3.3 Appraise the person’s technique for dressing exit site and provide effective education as required

3.4 Assist the person as necessary with their peritoneal dialysis exchange technique in accordance with organisation policies and procedures and infection control guidelines

3.5 Monitor the person during treatment within scope of work role and within organisation policies and procedures

3.7 Recognise and respond appropriately to actual and potential problems of peritoneal dialysis treatment

3.8 Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis

3.9 Assess the person’s response to treatment, and document and report outcomes to interdisciplinary health care team

3.10 Assist the person to self-manage peritoneal dialysis consumables using waste minimisation and sustainable practice

4. Perform peritoneal dialysis exchange for the person unable to undertake procedure

4.1 Examine the peritoneal dialysis catheter exit site and perform exit site dressing as required

4.2 Prepare peritoneal dialysis additives for dialysis bag in line with delegation, and consider and identify causes of peritoneal fluid failure to drain

4.3 Perform peritoneal exchange according to prescribed treatment order, organisation policy and procedures

4.4 Monitor person during treatment within scope of work role and within organisation policy and procedures and refer to interdisciplinary health care team

4.5 Identify clinical features suggestive of dialysis-related peritonitis and promptly refer a person to interdisciplinary health care team

4.6 Assess the person’s response to dialysis additives and treatment as administered within scope of work role

4.7 Recognise acute and delayed adverse reactions to dialysis additives and respond within scope of work role

4.8 Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis

4.9 Document and report treatment outcomes to interdisciplinary health care team

5. Prepare equipment and the person for haemodialysis treatment

5.1 Explain procedure and prepare the person for treatment and make comfortable

5.2 Prepare machine according to organisation policy and procedures

5.3 Determine dialysis settings according to the person’s dialysis prescription within scope of work role and organisation policies and procedures

5.4 Prepare other interventions, including medications, under the direct supervision of, and as delegated by interdisciplinary health care team within scope of work role and organisation policies and procedures

5.5 Prepare consumables for cannulation of the person and connection to machine

5.6 Wash hands and use personal protective equipment in accordance with infection prevention and control guidelines

5.7 Prepare the person’s access for cannulation according to organisation policies and procedures

5.8 Identify appropriate site for cannulation, and check for signs suggesting fistula stenosis or infection and consult with interdisciplinary health care team.

5.9 Perform cannulation according to organisation policies and procedures

6. Perform haemodialysis

6.1 Connect the person to haemodialysis machine according to organisation policies and procedures and infection control guidelines

6.2 Monitor the person and refer variations in health status to the interdisciplinary health care team according to organisation policies and procedures

6.3 Recognise and respond appropriately to machine alarms and actual and potential problems of haemodialysis

6.4 Assess the person’s response to treatment and other interventions as administered within scope of work role and consult with interdisciplinary health care team

6.5 Recognise acute and delayed adverse reactions to other interventions and respond within scope of work role

6.7 Disconnect the person from haemodialysis machine in accordance with organisation policy and procedures

6.8 Clean and dry and store equipment in accordance with infection control and manufacturers’ instructions

6.9 Examine vascular access site to identify any actual or potential problems and refer to interdisciplinary health care team

7. Evaluate health status of the person at completion of dialysis

7.1 Complete the post-dialysis assessment of the person and document and report outcomes

7.2 Evaluate the person’s response to treatment and report to interdisciplinary health care team as required within scope of work role and organisation policy and procedures

7.3 Provide feedback to the person on physical health assessment in order to maintain optimal health status

7.4 Identify opportunities to encourage the person to voice concerns, and respond appropriately

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. Establish therapeutic relationship with the person to support self-management of renal replacement therapy

1.1 Perform an assessment of the person to establish their cognitive ability to support self-management of renal replacement therapy

1.2 Provide the person, family or carer with the opportunity to ask questions and discuss areas of concern

1.3 Ask the person questions clearly in an appropriate manner, level and pace, and in a way that encourages the person to provide full answers

1.4 Assist and empower the person to self-manage their renal replacement therapy, and provide feedback and education as required

1.5 Recognise and respond appropriately within scope of work role to identified actual and potential problems of the person’s proposed renal replacement therapy, and report outcomes to interdisciplinary health care team

1.6 Incorporate referral to community services into advance care planning strategies in consultation and collaboration with interdisciplinary health care team

2. Assess physical health status of a person undergoing dialysis

2.1 Perform a pre-dialysis assessment of the person and report outcomes to interdisciplinary health care team in accordance with scope of work role and organisation policies and procedures

2.2 Examine the person’s vascular access for haemodialysis or catheter and exit site for peritoneal dialysis to identify actual and potential problems

2.3 Obtain specimen swab from the person’s vascular access site or catheter site if necessary, according to organisation policies and procedures, and send specimen for microbiological analysis

2.4 Identify any significant physical health issues for the person in relation to dialysis prescription and any requirement for adjustments, and report to other members of the interdisciplinary health care team

2.5 Recognise and refer actual and potential problems related to variations from the person’s normal health status to interdisciplinary health care team

3. Assist the person in self-care management of peritoneal dialysis treatment

3.1 Review the person’s understanding of the procedure in accordance with legal requirements and organisation policies and procedures

3.2 Assess the person’s self-care strategies

3.3 Appraise the person’s technique for dressing exit site and provide effective education as required

3.4 Assist the person as necessary with their peritoneal dialysis exchange technique in accordance with organisation policies and procedures and infection control guidelines

3.5 Monitor the person during treatment within scope of work role and within organisation policies and procedures

3.7 Recognise and respond appropriately to actual and potential problems of peritoneal dialysis treatment

3.8 Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis

3.9 Assess the person’s response to treatment, and document and report outcomes to interdisciplinary health care team

3.10 Assist the person to self-manage peritoneal dialysis consumables using waste minimisation and sustainable practice

4. Perform peritoneal dialysis exchange for the person unable to undertake procedure

4.1 Examine the peritoneal dialysis catheter exit site and perform exit site dressing as required

4.2 Prepare peritoneal dialysis additives for dialysis bag in line with delegation, and consider and identify causes of peritoneal fluid failure to drain

4.3 Perform peritoneal exchange according to prescribed treatment order, organisation policy and procedures

4.4 Monitor person during treatment within scope of work role and within organisation policy and procedures and refer to interdisciplinary health care team

4.5 Identify clinical features suggestive of dialysis-related peritonitis and promptly refer a person to interdisciplinary health care team

4.6 Assess the person’s response to dialysis additives and treatment as administered within scope of work role

4.7 Recognise acute and delayed adverse reactions to dialysis additives and respond within scope of work role

4.8 Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis

4.9 Document and report treatment outcomes to interdisciplinary health care team

5. Prepare equipment and the person for haemodialysis treatment

5.1 Explain procedure and prepare the person for treatment and make comfortable

5.2 Prepare machine according to organisation policy and procedures

5.3 Determine dialysis settings according to the person’s dialysis prescription within scope of work role and organisation policies and procedures

5.4 Prepare other interventions, including medications, under the direct supervision of, and as delegated by interdisciplinary health care team within scope of work role and organisation policies and procedures

5.5 Prepare consumables for cannulation of the person and connection to machine

5.6 Wash hands and use personal protective equipment in accordance with infection prevention and control guidelines

5.7 Prepare the person’s access for cannulation according to organisation policies and procedures

5.8 Identify appropriate site for cannulation, and check for signs suggesting fistula stenosis or infection and consult with interdisciplinary health care team.

5.9 Perform cannulation according to organisation policies and procedures

6. Perform haemodialysis

6.1 Connect the person to haemodialysis machine according to organisation policies and procedures and infection control guidelines

6.2 Monitor the person and refer variations in health status to the interdisciplinary health care team according to organisation policies and procedures

6.3 Recognise and respond appropriately to machine alarms and actual and potential problems of haemodialysis

6.4 Assess the person’s response to treatment and other interventions as administered within scope of work role and consult with interdisciplinary health care team

6.5 Recognise acute and delayed adverse reactions to other interventions and respond within scope of work role

6.7 Disconnect the person from haemodialysis machine in accordance with organisation policy and procedures

6.8 Clean and dry and store equipment in accordance with infection control and manufacturers’ instructions

6.9 Examine vascular access site to identify any actual or potential problems and refer to interdisciplinary health care team

7. Evaluate health status of the person at completion of dialysis

7.1 Complete the post-dialysis assessment of the person and document and report outcomes

7.2 Evaluate the person’s response to treatment and report to interdisciplinary health care team as required within scope of work role and organisation policy and procedures

7.3 Provide feedback to the person on physical health assessment in order to maintain optimal health status

7.4 Identify opportunities to encourage the person to voice concerns, and respond appropriately

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:

performed renal replacement therapy on 3 different people, at least 1 of which must be using peritoneal dialysis and at least 1 of which must be using haemodialysis, including:

identifying signs of uraemia and electrolyte imbalance

identifying signs of fluid overload

identifying signs of dehydration

checking peritoneal dialysis exit site

assessing patency of vascular access including:

palpating fistula for thrill

auscultating fistula for bruit

checking for signs of infection

checking last needle sites.

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:

infection control strategies for management of a person undergoing renal replacement therapies including:

stressing the importance of good hygiene and adequate nutrition in prevention of infection

maintaining cleanliness of exit site or fistula arm

monitoring and maintaining integrity of skin to prevent infection

using no touch technique

pathophysiology of Stage 5 CKD and common pathology tests to diagnose and monitor CKD and their interpretation

reportable limits for a person’s vital signs and biochemical and haematological results for a person undergoing renal replacement therapy

immunity and the importance of vaccinations

management principles for different types of renal replacement therapy including:

haemodialysis

peritoneal dialysis

medicines in common use in management of a person with Stage 5 CKD including basic mechanism of action, precautions and side effects

organisation policy and procedures relating to renal replacement therapy

potential impact of Stage 5 CKD and renal replacement therapy has on quality of life and self-esteem including issues related to:

fluid balance management

nutritional management

prevention of infection

care of dialysis access

care of transplanted kidney

administration of medications and identification of their side effects

signs and symptoms of actual and potential problems of renal replacement therapy and the appropriate response including:

hypertension, hypotension

hyperglycaemia, hypoglycaemia

cardiovascular abnormalities

fluid and electrolyte imbalance due to rapid or excess fluid or electrolyte removal

malnutrition

haemodialysis problems

haemolysis

vascular access problems

clotted or stenosed vascular access

prolonged bleeding

peritoneal dialysis problems

peritonitis

exit site infection signs and symptoms including:

leakage from site, extravasation or bag

blocked catheter due to constipation, catheter movement, fibrin plug

cracking, splitting and discolouration of the catheter

cuff extrusion

mobile catheter

tension of catheter

extravasation to surrounding tissue or along inguinal canal to scrotum or labia

contamination of catheter or ‘Y’ line on bag during exchange process

blocked or split Tenckhoff catheter

accidental break in sterile pathway

hernia

obesity

psychosocial issues

dietary management

potential vascular access site problems including:

decreased thrill

high pitched bruit

difficulty in needling fistula

abnormal arterial and venous pressure readings

pain, swelling, redness or trauma

false aneurysms

blood leak from cannulation site

own role and responsibilities and those of other health care team members in the delivery of care to a person with CKD.