Unit of competency details

Descriptor 

This unit of competency describes the skills and knowledge required to assist with procedures performed by the podiatrist

Procedures may include surgical procedures of the skin and nails; preparation, modification and repair of orthotic devices and footwear

Application 

The application of knowledge and skills described in this competency unit may relate to functions such as assisting in podiatry surgery and/or the preparation/modification/repair of orthotic devices and footwear

These functions are to be performed in accordance with the directions of a podiatrist or podiatric surgeon

Work performed requires a range of well developed skills where some discretion and judgment is required and individuals will take responsibility for their own outputs

Allied Health Assistants operate within the scope of their defined roles and responsibilities and under supervision of an Allied Health Professional

For training and assessment pathways, experience in workplace application of the skills and knowledge identified in this competency unit should be provided as required to support allied health professions

Pre-requisite units 

This unit must be assessed after successful achievement of pre-requisite units:

• HLTAP301B Recognise healthy body systems in a health care context
• HLTCSD305C Assist with client movement
• HLTAH301B Assist with an allied health program
• HLTIN302B Process reusable instruments and equipment in health work

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Prepare for the surgical podiatry procedure 

1.1 Obtain information  from the podiatrist and the client's record (including the Podiatry Care Plan) relevant to the procedure to be undertaken

1.2 Determine client availability according to organisation protocols

1.3 Conform to all infection control guidelines and requirements specified by the National Infection Control Guidelines for Podiatrists  and the protocols of the organisation

1.4 Ensure the environment in which the procedure is to be performed conforms to OH&S standards and protocols

1.5 Gather necessary equipment, instruments and materials

1.6 Prepare the environment for surgery, including cleansing and disinfecting of surfaces, equipment and materials

1.7 Ensure all instruments, dressings and related materials have undergone sterilisation according to the guidelines and protocols stated above

1.8 Ensure work flow and set up for work flow by additional persons in the environment comply with the guidelines and protocols

2. Assist with the surgical podiatry procedure 

2.1 Determine procedural requirements from the client's record and the treating podiatrist

2.2 Provide the physical environment required to meet procedural requirements in a manner that is safe for the client as directed by the podiatrist

2.3 Follow the directions of the podiatrist to provide assistance during the procedure

2.4 Follow all infection control and OH&S protocols to ensure the procedure conforms to organisation, state, national and legislated requirements

2.5 As required, assist with care and supervision of the patient during procedure

2.6 Follow directions for instrument handling, equipment handling material handling and any additional assistance required from the podiatrist

2.7 Safely and correctly use equipment and instrumentation to collect assessment information

2.8 Follow organisation guidelines and protocols for the safe and appropriate handling and disposal of hazardous and sharps materials

2.9 Provide documentation assistance and support as directed by the podiatrist

3. Assist with templating for manufacture of orthotic devices

3.1 Determine requirements from the client's record and treating podiatrist

3.2 Seek assistance and clarification as required

3.3 Gather equipment and materials required for templating and foot measurement

3.4 Provide the physical environment required to meet procedural requirements in a manner that is safe for the client and operator

3.5 Assist with templating and foot measurement according to podiatrist's instruction

3.6 Work with podiatrist and client, within organisation guidelines, to determine appropriate follow up and further appointments

4. Assist with modification to orthoses and footwear

4.1 Determine procedural requirements from the client's record and the treating podiatrist

4.2 Seek assistance or clarification to procedural directions as required

4.3 Provide the physical environment required to meet procedural requirements in a manner that is safe

4.4 Assist with modifications according to the care plan and prescriptions from supervising podiatrist

4.5 Present modified orthoses or footwear to podiatrist for assessment

4.6 Interpret and respond to instructions from podiatrist regarding further procedural or modification requirements

4.7 Provide instructions and assistance to client as directed by the podiatrist

4.8 Work with podiatrist and client, within organisation guidelines, to determine appropriate follow up and further appointments

4.9 Use machinery and equipment for modifications in accordance with manufacturer's guidelines, OHS requirements and organisation protocols

5. Assist with support and advice to clients in the selection of footwear

5.1 Under the guidance of podiatrist use appropriate devices and procedures to measure for fit

5.2 Confirm measurements with supervising podiatrist

5.3 Under the guidance of supervising podiatrist support and educate client in the selection of footwear and fit

5.4 Seek assistance or clarification to procedural directions as required

5.5 Work with podiatrist and client, within organisation guidelines, to determine appropriate follow up and further appointments

6. Clean, sterilise and store equipment

6.1 Clean equipment according to manufacturers and organisation requirements

6.2 Prepare equipment and instruments for sterilisation according to organisation protocols

6.3 Store equipment according to manufacturers requirements and organisation protocols

6.4 Report equipment faults to appropriate person

6.5 Ensure consultation environment is maintained according to guidelines and organisation protocols

7. Document client information

7.1 Use accepted protocols to document information in line with organisation requirements

7.2 Use appropriate terminology to document client information

8. Comply with supervisory requirements

8.1 Provide podiatry assistance according to the instruction of treating podiatrist

8.2 Provide client progress feedback to the treating podiatrist

8.3 Seek assistance when client presents with needs or signs outside limits of own authority or competence

8.4 Report client difficulties and concerns to the treating podiatrist

8.5 Implement variations to the podiatry care according to the advice of the treating podiatrist

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:

• Podiatry procedures, including orthotic manufacture/modification; assessment; and podiatric surgery
• Conditions treated by a podiatrist
• Basic anatomy and physiology of the skin and nails
• Structure and function of the skin and integuments
• Common pathological conditions of the skin and nails
• Disease processes relevant to the client group/s
• Identification and purpose of podiatry surgical instruments
• First aid, emergency and evacuation protocols of the site
• Basic biomechanics of the lower limb
• Principles and guidelines of orthotic devices
• Principles of footwear selection and fitting
• Relevant organisation policies and procedures
• Client care plans, goals and limitations of podiatry intervention
• Medical terminology
• Roles, responsibilities and limitations of self and other allied health team members and nursing, medical and other personnel
• OHS policy and procedures
• Privacy and confidentiality requirements
• Infection control protocols
• Supervisory and reporting protocols
• Record keeping requirements

Essential skills :

It is critical that the candidate demonstrate the ability to:

• Undertake activity analysis - breaking activities down into component parts
• Identify variations in podiatry conditions
• Establish and maintain sterile field
• Use hygiene practices such as (surgical) handwashing
• Modify orthotic devices
• Modify shoes
• Construct and maintain the environment for safe modification of orthotic devices and footwear
• Communicate effectively with clients
• Provide legible, logical and appropriate documentation

In addition, the candidate must be able 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:

• Use observation and reporting skills
• Work under supervision
• Communicate effectively with supervisors and co-workers
• Work effectively with non-compliant clients
• Operate within OHS and infection control requirements
• Use personal protective equipment
• Work safely and effectively with electrical equipment and machinery
• Work safely with potentially hazardous materials
• Safely and appropriately dispose of hazardous materials
• Provide a safe and effective response in first aid, emergency and evacuation conditions
• Apply time management and personal organisation skills and establish priorities
• Maintain accurate records
• Safely and appropriately use materials including animal derived leathers, synthetics, solvents and adhesives

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Evidence of understanding and application of infection control and OH&S standards and protocols is essential
• Observation of workplace performance is essential for assessment of this unit
• Consistency of performance should be demonstrated for a minimum of seven different procedures (including surgical assistance, basic assessment and orthotic/footwear preparation and modification)
• Consistent adherence to supervisory requirements

Access and equity considerations :

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment :

• Assessment must be completed in the workplace
• Relevant guidelines, standards and procedures
• Supervision from a podiatrist
• Resources essential for assessment include:

• Clients
• Equipment
• Documentation

Method of assessment 

• Observation in the work place
• Written assignments/projects or questioning should be used to assess knowledge, along with structured objective clinical assessment and self reflective tasks such as journaling
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.
• Clinical skills involving direct client care are to be assessed initially in a supported and controlled clinical setting. If successful, a second assessment is to be conducted during workplace application under direct supervision.

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.

Supervision refers to :

• Instructing, advising, and monitoring another person in order to ensure safe and effective performance in carrying out the duties of their position
• The nature of supervision is flexible and may be conducted by various means including:

• in person
• through use of electronic communications media such as telephone or video conferencing, where necessary

• Frequency of supervision will be determined by factors such as:

• the task maturity of the person in that position or clinical placement
• the need to review and assess client conditions and progress in order to establish or alter treatment plans in case of students and assistants
• the need to correct and develop non clinical aspects such as time management, organisation requirements, communication skills, and other factors supporting the provision of clinical care and working within a team

• A person under supervision does not require direct (immediate) and continuous personal interaction, but the method and frequency will be determined by factors outlined above

Clients may include :

• Infants
• Children
• Adolescents
• Adults
• Elderly people

Settings may include 

• Hospitals
• Community health services
• Private practice
• Client homes
• Aged care residential care settings

Surgical podiatry procedures may include 

• Debridement of onychocryptosis under local anaesthesia
• Partial or total nail avulsion with phenolisation
• Curettage
• Conservative sharp debridement of wounds

Equipment may include :

• Personal protective equipment such as eyewear, gloves, masks, surgical gowns, footwear protection, surgical headwear
• Surgical drapes and those materials used to comply with infection control guidelines and protocols
• Podiatry surgery instruments, including:

• scalpel handles and blades
• root elevators
• black's files/files
• nail clippers
• thwaites nippers
• digital torniquets
• rasp
• curette
• excavator
• spatula
• forceps (fine, blunt, locking, straight, spencer wells, cheatles, rampley)
• bailey toe spreader
• burrs
• scissors

• Syringes and needles (disposable and reusable syringes, suture material and needles
• Electrical devices for curettage and haemostasis
• Casting /orthoses/footwear equipment including:

• bench grinder
• solvent and adhesive materials
• synthetic and natural orthotic and footwear materials
• plaster/ plaster bandage
• cleaning and disinfecting equipment
• brannock device

Clinical standards , guidelines , policies and procedures may include :

• Clinical standards (state and national)
• Infection Control Guidelines for Podiatrists, Australasian Podiatry Council, September 2005
• Clinical Guidelines for Orthotic Therapy Provided by Podiatrists
• Relevant Australian Standards

• Australian New Zealand Standard AS/NZS 4815 - 2001 (Office-based health care facilities not involved in complex patient procedures and processes - Cleaning, disinfecting and sterilising reusable medical and surgical instruments and equipment, and maintenance of the associated environment)
• Australian Standard AS 4187 - 1998 (Cleaning, disinfecting and sterilising reusable medical and surgical instruments and equipment and maintenance of associated environments in a health care facilities)
• Australian Standard AS 2182 - 1998 (Sterilisers - steam-bench top)

• Industry professional bodies:

• Australasian Podiatry Council
• Australian Podiatry Association (State)

• Industry standards (state and national)
• Podiatrists Registration Board (State)
• Organisation policy directives
• Privacy Act
• Medical Records Act

Information may include :

• Podiatry care plan
• Client treatment plan
• Supervising podiatrists instructions
• Client record
• Checklists
• Case notes
• Other forms according to procedures of the organisation
• Material Safety Data Sheets
• Manufacturers' instructions and guidelines