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Evidence Guide: HLTRNL603B - Provide care and support to client in renal replacement therapy in community setting

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

 

HLTRNL603B - Provide care and support to client in renal replacement therapy in community setting

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

Establish therapeutic relationship with client and their significant others

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

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ask the client questions clearly and 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, and their significant others', needs and concerns, within scope of role and responsibilities

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Encourage client independence according to their level of capability

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the client with Stage 5 chronic kidney disease (CKD) to assess their health status

  1. Complete a health assessment of the client through observation and interview and report to other members of the health care team as required within scope of work role and organisation guidelines
  2. Review pathology results, identify significant variations and refer to other health care team members according to organisation policies and procedures
  3. Identify any significant physical health status issues in relation to current renal replacement therapy
  4. Assist the client to determine if changes to current renal replacement therapy are required and report to other members of the health care team as required within scope of work role and organisation guidelines
  5. Document client assessment and refer actual and potential problems in accordance with organisation policies and procedures
  6. 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 within scope of work role and organisation guidelines
  7. Provide feedback to the client on physical health assessment in order to maintain optimal health status
Complete a health assessment of the client through observation and interview and report to other members of the health care team as required within scope of work role and organisation guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

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

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify any significant physical health status issues in relation to current renal replacement therapy

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the client to determine if changes to current renal replacement therapy are required and report to other members of the health care team as required within scope of work role and organisation guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Document client assessment and refer actual and potential problems in accordance with organisation policies and procedures

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 within scope of work role and organisation guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

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

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Support the client to self-manage their renal replacement therapy

  1. Encourage the client to voice concerns, respond within scope of work role and organisation guidelines and report to other members of the health care team as required
  2. Assist the client adhere to self-care principles
  3. Observe the client manage their renal replacement therapy and provide effective education as required
  4. Assist and empower the client to self-manage the dialysis equipment and consumables
  5. Recognise and respond appropriately to actual and potential problems of renal replacement therapy and report to other members of the health care team as required within scope of work role in consultation with registered nurse and organisation guidelines
  6. Document and report outcomes to the appropriate members of the health care team
  7. Identify situations when the client is not coping with the renal replacement therapy and report to other members of the health care team in consultation with registered nurse
  8. Incorporate referral to community services into advanced care planning strategies in consultation/collaboration with registered nurse and other members of the health care team
Encourage the client to voice concerns, respond within scope of work role and organisation guidelines and report to other members of the health care team as required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist the client adhere to self-care principles

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Observe the client manage their renal replacement therapy and provide effective education as required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assist and empower the client to self-manage the dialysis equipment and consumables

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recognise and respond appropriately to actual and potential problems of renal replacement therapy and report to other members of the health care team as required within scope of work role in consultation with registered nurse and organisation guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

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

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify situations when the client is not coping with the renal replacement therapy and report to other members of the health care team in consultation with registered nurse

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

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 to the management of clients who undergo renal replacement therapies including:

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

no touch technique

Common pathology tests to diagnose and monitor CKD and their interpretation

Fluid, electrolyte and acid base balance

Health status monitoring

Immunity and the importance of vaccinations

Knowledge of disinfection procedures for dialysis equipment and machine according to organisation policies and procedures and infection control guidelines

Management principles for different types of renal replacement therapy including:

haemodialysis

kidney transplant

peritoneal dialysis

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

Organisation policies, procedures and protocols relating to renal replacement therapy

Pathophysiology of Stage 5 CKD

Primary health care assessment and its interpretation

Reportable limits for patients vital signs and biochemical and haematological results for clients undergoing renal replacement therapy

Resources available to support the client

Self-care principles, and commitment required and the potential impact of Stage 5 CKD and renal replacement therapy has on quality of life and self-esteem

Signs and symptoms of actual and potential problems of renal replacement therapy and the appropriate response

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

Assess patency of vascular access

Deliver effective education

Demonstrate accountability for personal outputs and client group outcomes

Demonstrate an understanding of self-care principles, education resources and long term commitment required to support the client to achieve self-care

In consultation with the health care team, contribute to effective plans of care to meet the needs of the client undergoing renal replacement therapy

Monitor the client in the preparation of dialysis equipment

Monitor the client's ability to assess the effectiveness of their current renal replacement therapy

Perform a health status assessment within scope of practice to monitor the health status of the client undergoing renal replacement therapy

Recognise actual and potential problems of renal replacement therapy and respond appropriately

Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues, including appropriate practices to ensure efficient use of resources

Use appropriate communication skills (non-verbal, openness, sensitivity, 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

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

Significant others may include:

Family

Carer

Friend

Assessment of health status mayinclude:

Blood pressure, pulse and respiration

Weight

Evidence of uraemia and electrolyte imbalance e.g. lethargy, anorexia, confusion, 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

Pathology results from routine testing for dialysis clients

Peritoneal dialysis exit site and/or fistula

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 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

Renal replacement therapy includes:

Peritoneal dialysis

Haemodialysis

Kidney transplant

Actual and potential problemsmay include:

Hypertension/hypotension

Hyperglycaemia/hypoglycaemia

Cardiovascular abnormalities

Fluid imbalance

Electrolyte imbalance

Malnutrition

Haemodialysis problems

haemolysis

vascular access problems

infection

clotted or stenosed vascular access

prolonged bleeding

Peritoneal dialysis problems

infection

peritonitis

exit site infection

blocked or split Tenckhoff catheter

accidental break in sterile pathway

hernia

leak

obesity

Psychosocial issues

Dietary management

Self-care principles include:

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

Provide effective education include:

Develop lesson plan

Time management of education session

Evaluating education session

Evaluating client learning

Recognising teachable moments

Assessing teaching and learning resources

Management ofdialysis equipment and 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

Documentation may include:

Record of test procedures

Complete and sign request form

Medical record notation

Labelling specimens and documentation

Data entry on paper and electronically