Provide support and management of the client undergoing peritoneal dialysis therapy Evidence Guide

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Evidence Guide: HLTRNL602C - Provide support and management of the client undergoing peritoneal dialysis 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

HLTRNL602C - Provide support and management of the client undergoing peritoneal dialysis therapy

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

Establish a therapeutic relationship with the client

Provide the client with the opportunity to ask questions and discuss areas of concern
Ask the client questions clearly, in an appropriate manner, level and pace, and in a way that encourages the client to provide full answers
Provide accurate feedback and education, appropriate to the client's needs and concerns, within scope of role and responsibilities
Encourage client independence throughout the procedure according to their level of capability

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

Completed
Date:

Teacher:

Evidence:

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

Completed
Date:

Teacher:

Evidence:

Provide accurate feedback and education, appropriate to the client's needs and concerns, within scope of role and responsibilities

Completed
Date:

Teacher:

Evidence:

Encourage client independence throughout the procedure according to their level of capability

Completed
Date:

Teacher:

Evidence:

Assess physicalhealth status of client undergoing peritoneal dialysis

Complete a dialysis assessment of the client through observation and interview and report to other members of the health care team if required in accordance with scope of work role and organisation guidelines
Review pathology results, identify significant variations and report to other members of the health care team according to organisation policies and procedures
Examine the catheter and exit site to identify any problems
Obtain specimen swab from catheter site if necessary, according to organisation policies and procedures, and send for microbiological analysis
Identify any significant physical health issues in relation to dialysis prescription and requirement for adjustments and report to other members of the health care team in accordance with scope of work role and organisation guidelines
Recognise and refer actual and potential problems that vary from the client's normal health status to other members of the health care team as required in consultation with registered nurse and within scope of work role and organisation guidelines

Complete a dialysis assessment of the client through observation and interview and report to other members of the health care team if required in accordance with scope of work role and organisation guidelines

Completed
Date:

Teacher:

Evidence:

Review pathology results, identify significant variations and report to other members of the health care team according to organisation policies and procedures

Completed
Date:

Teacher:

Evidence:

Examine the catheter and exit site to identify any problems

Completed
Date:

Teacher:

Evidence:

Obtain specimen swab from catheter site if necessary, according to organisation policies and procedures, and send for microbiological analysis

Completed
Date:

Teacher:

Evidence:

Identify any significant physical health issues in relation to dialysis prescription and requirement for adjustments and report to other members of the health care team in accordance with scope of work role and organisation guidelines

Completed
Date:

Teacher:

Evidence:

Recognise and refer actual and potential problems that vary from the client's normal health status to other members of the health care team as required in consultation with registered nurse and within scope of work role and organisation guidelines

Completed
Date:

Teacher:

Evidence:

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

Review the client's understanding of the procedure in accordance with legal requirements and organisation policies and procedures
Assess the client's self-care strategies
Appraise the client's technique for dressing exit site and provide effective education as required
Assist the client as necessary with their peritoneal exchange according to organisation policies and procedures and infection control guidelines
Assess the client's peritoneal dialysis exchange technique in accordance with organisation and infection control guidelines
Monitor the client during treatment within scope of work role and within organisation guidelines and refer to other members of the health care team
Recognise and respond appropriately to actual and potential problems of peritoneal dialysis treatment
Obtain an effluent specimen if necessary, according to organisation policies and procedures, and send for microbiological analysis
Assess the client's response to treatment within scope of work role and organisation policies and procedures
Document and report outcomes to appropriate members of the health care team
Assist the client manage peritoneal dialysis consumables

Review the client's understanding of the procedure in accordance with legal requirements and organisation policies and procedures

Completed
Date:

Teacher:

Evidence:

Assess the client's self-care strategies

Completed
Date:

Teacher:

Evidence:

Appraise the client's technique for dressing exit site and provide effective education as required

Completed
Date:

Teacher:

Evidence:

Assist the client as necessary with their peritoneal exchange according to organisation policies and procedures and infection control guidelines

Completed
Date:

Teacher:

Evidence:

Assess the client's peritoneal dialysis exchange technique in accordance with organisation and infection control guidelines

Completed
Date:

Teacher:

Evidence:

Monitor the client during treatment within scope of work role and within organisation guidelines and refer to other members of the health care team

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 policies and procedures, and send for microbiological analysis

Completed
Date:

Teacher:

Evidence:

Assess the client's response to treatment within scope of work role and organisation policies and procedures

Completed
Date:

Teacher:

Evidence:

Document and report outcomes to appropriate members of the health care team

Completed
Date:

Teacher:

Evidence:

Assist the client manage peritoneal dialysis consumables

Completed
Date:

Teacher:

Evidence:

Perform peritoneal dialysis exchange for the client unable to undertake procedure

Examine the peritoneal dialysis exit site and perform exit site dressing as required
Prepare peritoneal dialysis additives for dialysis bag in line with delegation
Perform peritoneal exchange according to organisation policies and procedures and infection control guidelines
Monitor client during treatment within own scope of practice and within organisation guidelines and refer to other members of the health care team
Recognise and respond appropriately to actual and potential problems of peritoneal dialysis treatment
Assess the client's response to dialysis additives as administered within scope of work role
Recognise acute and delayed adverse reactions to dialysis additives and respond within scope of work role
Obtain an effluent specimen if necessary, according to organisation policies and procedures, and send for microbiological analysis
Assess the client's response to treatment within scope of work role and organisation policies and procedures
Document and report outcomes to appropriate members of the health care team
Assist the client manage peritoneal dialysis consumables

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

Completed
Date:

Teacher:

Evidence:

Prepare peritoneal dialysis additives for dialysis bag in line with delegation

Completed
Date:

Teacher:

Evidence:

Perform peritoneal exchange according to organisation policies and procedures and infection control guidelines

Completed
Date:

Teacher:

Evidence:

Monitor client during treatment within own scope of practice and within organisation guidelines and refer to other members of the health care team

Completed
Date:

Teacher:

Evidence:

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

Completed
Date:

Teacher:

Evidence:

Assess the client's response to dialysis additives 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 policies and procedures, and send for microbiological analysis

Completed
Date:

Teacher:

Evidence:

Assess the client's response to treatment within scope of work role and organisation policies and procedures

Completed
Date:

Teacher:

Evidence:

Document and report outcomes to appropriate members of the health care team

Completed
Date:

Teacher:

Evidence:

Assist the client manage peritoneal dialysis consumables

Completed
Date:

Teacher:

Evidence:

Assess physical health status of the client at completion of peritoneal dialysis

Complete the post-dialysis assessment of the client
Evaluate the client's response to treatment within scope of work role and organisation guidelines
Document and report outcomes to the appropriate members of the health care team
Provide feedback to the client on physical health assessment in order to maintain optimal health status
Encourage the client to voice concerns and respond appropriately
Incorporate referral to community services into advanced care planning strategies in consultation/collaboration with registered nurse and other members of the health care team

Complete the post-dialysis assessment of the client

Completed
Date:

Teacher:

Evidence:

Evaluate the client's response to treatment within scope of work role and organisation guidelines

Completed
Date:

Teacher:

Evidence:

Document and report outcomes to the appropriate members of the health care team

Completed
Date:

Teacher:

Evidence:

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

Completed
Date:

Teacher:

Evidence:

Encourage the client to voice concerns and respond appropriately

Completed
Date:

Teacher:

Evidence:

Incorporate referral to community services into advanced care planning strategies in consultation/collaboration with registered nurse and other members of the health care team

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 competency in this unit	Candidates must demonstrate their ability to apply essential knowledge identified for this unit of competency before undertaking workplace application Observation of performance in a work context is essential for assessment of this unit of competency Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion Assessment of medication administration must include a written calculation test with 100% mastery

Context of and specific resources for assessment	This unit of competency is most appropriately assessed in the clinical workplace and under the normal range of clinical environment conditions

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 written Role play

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/or Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and/or 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:

Application of infection control principles, including environmental hazards, relating to peritoneal dialysis

Common pathology tests to diagnose and monitor CKD and their interpretation

Concepts of ideal weight and assessment of ideal body weights in clients undergoing peritoneal dialysis

Consumables and equipment relating to peritoneal dialysis

Fluid, electrolyte and acid base balance

Health status monitoring of client undergoing peritoneal dialysis

Immunity and the importance of vaccinations

Medications associated with the dialysis process such as intra-peritoneal antibiotics, heparin and insulin including basic mechanism of action, precautions, contraindications and side effects

Medicines in common use in management of clients with Stage 5 CKD including basic mechanism of action, precautions, contraindications and side effects

Organisation policies, procedures and protocols relating to peritoneal dialysis

Pathophysiology of Stage 5 chronic kidney disease (CKD)

Physiological principles of osmosis, diffusion, ultra filtration and convection

Principles of peritoneal dialysis including:

dialysis adequacy

dwell time

fluids - osmotic agent, volume

frequency of exchanges

modalities

number of exchanges

the differences of performing peritoneal dialysis in a variety of environments

Relevant medical/medication terminology and approved abbreviations

Reportable limits for patients vital signs and biochemical and haematological results for clients undergoing peritoneal dialysis

Signs and symptoms of actual and potential problems associated with peritoneal dialysis and the appropriate response

Structure and function of the peritoneum

Structure and function of the urinary, cardiovascular, lymphatic and immune systems

Understanding of own role and responsibilities and those of other health care team members in the delivery of care to clients with CKD

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 formulae for drug calculations for administration of medications via dialysis

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

Collect specimens in accordance with organisation and infection control guidelines

Correctly instruct client in the preparation for peritoneal dialysis

Correctly prepare equipment for peritoneal dialysis

Demonstrate accountability for personal outputs and broad client group outcomes

Evaluate the impact of peritoneal dialysis treatment on the client - physically, psychologically and emotionally

In consultation with the health care team contribute to effective plans of care to meet the needs of the peritoneal dialysis patient

Monitor the health status of the client undergoing peritoneal dialysis

Perform emergency treatment for a client experiencing an adverse response to medications administered via dialysis

Perform, and assist client to perform, a peritoneal dialysis exchange

Recognise actual and potential problems associated with peritoneal dialysis and respond appropriately

Safely administer additives to a peritoneal dialysis bag (e.g. antibiotics, heparin, insulin)

Use appropriate communication skills (non-verbal, openness, sensitivity and non-judgemental attitudes)

Use oral communication skills (language competence) required to fulfil job roles as specified by the organisation/service, including:

interviewing techniques

asking questions

active listening

asking for clarification

Use written communication skills (literacy competence) required to fulfil job roles as specified by organisation/service at a level of skill that may range from reading and understanding client documentation to completion of written reports

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

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.

Clients are limited to:	Adolescent Adult

Assessment of physical health status may include:	Blood pressure, pulse and respiration Weight Evidence of uraemia and electrolyte imbalance e.g. lethargy, confusion, anorexia, nausea and vomiting Signs of fluid overload e.g. dyspnoea, tachypnoea, ankle oedema, weight gain over a short period of time and high blood pressure readings Signs of dehydration e.g. dry mouth, dizzy, postural drop in blood pressure, low blood pressure and weight loss over short period of time Blood sugar levels Pathology results from routine testing for dialysis clients Peritoneal dialysis exit-site status Abnormalities of peritoneal dialysis fluid Returns on peritoneal dialysis exchanges Evidence of infection

Peritoneal dialysis may include:	Continuous ambulatory peritoneal dialysis (CAPD) Automated peritoneal dialysis (APD)

Members of the health care team may include:	Enrolled/Division 2 nurse Registered nurse Nurse practitioner General practitioner Renal physician Chronic disease management team Dietitian Social worker Pharmacist Podiatrist Aboriginal and/or Torres Strait Islander health worker

Scope of work role refers to:	Enrolled/Division 2 nurses Aboriginal and/or Torres Strait Islander health workers

Pathology resultsmay include:	Haematological tests: haemoglobin iron studies Biochemical tests: urea creatinine calcium phosphate Dialysis adequacy tests: Kt/Vs urea reduction ratio fraction reduction urea

Catheter and exit site problemsmay include:	Exit site infection, signs and symptoms: redness and tenderness at exit site exudate at exit site soiling of exit site dressing with blood-stained or pus discharge 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 Leakage from site, extravasation or bag Blocked catheter due to constipation, catheter movement, fibrin plug

Actual and potential problemsmay include:	Peritonitis, signs and symptoms: fever cloudy bag abdominal pain nausea and vomiting Hypertension/hypotension Fluid imbalance: dehydration fluid overload Electrolyte imbalance: hyperglycaemia Inadequate dialysis Malnutrition/obesity Large amount of weight loss Failure of peritoneal fluid to drain in or out of peritoneal dialysis cavity during an exchange Excessive or insufficient ultra filtration leading to overload or dehydration Infusion of incorrect peritoneal dialysis fluid: incorrect osmotic agent incorrect volume incorrect concentration of osmotic agent Raised intra-abdominal pressure

Provide effective education includes:	Develop lesson plan Time management of education session Evaluating education session Evaluating client learning Recognising teachable moments Assessing teaching and learning resources

Infection control guidelines may include:	Standard and additional precautions Aseptic technique Collection site preparation Sample collection procedures Waste handling and disposal

Response to treatment may include:	Change in client's hydration status Signs and symptoms of uraemia Move towards client's ideal weight Stabilisation of blood pressure

Documentation may include:	Record of test procedures Complete and sign request form Medical record notation Labelling specimens and all documents Data entry on paper and electronically

Management ofperitoneal dialysis consumables may include:	Stock management principles: stocktake ordering cycle count stock on hand ordering supplies method of ordering check expiry dates Delivery mode Timeframes Storage requirements Requirement to rotate stock Check equipment

Prepare peritoneal dialysis additives must include:	Identification of contraindications of medications Confirmation of client identity and check for known allergies Identification of the purpose and function of prescribed medication 100% accurate calculation of medication doses for administration as prescribed Contributing to the provision of information provided to clients and carers on side effects of medication administration

Peritoneal dialysis additives may include:	Heparin Antibiotics Insulin

Delegation refers to:	Conferring of authority to perform specific medication administration activities to a worker not usually authorised but who has been determined as appropriate for the task by the delegating health professional Delegation is within the context of a care plan or other written instruction Where delegation is provided verbally it must be confirmed as soon as practicable according to organisation procedures in writing and incorporated in the care plan The authority is specific to an individual client within a specific care context and is not transferable Delegation instructions must include: medication and its purpose dosage and related instructions route contraindications any other relevant instructions or information, especially information specific to the client

NTISthis.com

Evidence Guide: HLTRNL602C - Provide support and management of the client undergoing peritoneal dialysis therapy

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

HLTRNL602C - Provide support and management of the client undergoing peritoneal dialysis therapy

Establish a therapeutic relationship with the client

Assess physicalhealth status of client undergoing peritoneal dialysis

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

Perform peritoneal dialysis exchange for the client unable to undertake procedure

Assess physical health status of the client at completion of peritoneal dialysis

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

Instructions to Assessors

Teacher: ___________________________ Date: _