Unit of competency details

Version 4

Version 5

Comments

HLTCT402C - Modify casts

HLTCT402D - Modify casts

Unit updated in V5.

ISC upgrade changes to remove references to old OHS legislation and replace with references to new WHS legislation. No change to competency outcome.

Descriptor 

This unit of competency describes the skills and knowledge required to modify casts

Application 

Simple modifications, which do not alter the intent of the cast/splints, may be performed at the technician's discretion

Work is performed at the request of, and in consultation with, medical staff or with own discretion and requires a range of well developed skills where some discretion and judgement is required and individuals take responsibility for the quality of their outputs

Modification of casts may occur in various locations within the hospital environment eg operating theatres, emergency department, wards, and outclient departments

All activities are carried out in accordance with organisation policies, procedures and infection control guidelines

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 to modify cast

1.1 Assemble and check equipment and materials for modification of casts to ensure that it is in clean and in working order

1.2 Receive and confirm if in doubt requirements for modification of cast with relevant personnel

1.3 Assess client's condition and identify precautions and potential complications of modifying cast

1.4 Explain procedure to client and obtain client consent/agreement

1.5 Provide opportunities for the client to ask questions and discuss areas of concern

1.6 Meet the comfort and safety needs of the client and applicator

1.7 Review the condition of wound and pin site and refer to relevant personnel as required

2. Modify cast

2.1 Position area to which cast is to be modified in accordance with industry best practice

2.2 Meet the comfort and safety needs of the client and applicator

2.3 Identify the client's specific needs in relation to modifying the cast

2.4 Modify cast to meet client's needs according to instructions, if required

2.5 Achieve correct handling to maintain/ correct/ modify soft tissue/ fracture position in accordance with pattern and/ or condition of injury

2.6 Complete documentation

3. Undertake post modification procedures

3.1 Clean client at completion of procedure

3.2 Ensure the neurovascular status of limb is within normal limits

3.3 Check the fit and functionality of cast

3.4 Provide written and verbal advice to client and carer regarding the care of the cast and limb

3.5 Fit client with sling, heel/overshoes and ambulation aids, as required

3.6 Instruct client and ensure client is safe on correct use of ambulation aids

3.7 Arrange appropriate support for client

4. Clean working environment

4.1 Dispose of waste in accordance with waste management policies

4.2 Clean equipment in accordance with manufacturer's specifications and stored safely

4.3 Clean work surfaces in accordance with infection control guidelines

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:

• Anatomical positioning in modification of casts
• Anatomy and physiology relevant to cast modification
• Awareness and resolution of complications e.g. pressure sores, foreign objects in casts
• Confidentiality requirements of client information
• Current standards and best practice relevant to cast modification
• Interpretation of documentation relating to modification of casts
• Medical terminology relevant to cast modification
• Organisation policy and procedures, including Infection control and WHS
• Precautions and complications of modification of casts
• Purpose of modification of cast

Essential skills:

It is critical that the candidate demonstrate the ability to

• Comply with policies and procedures including those of WHS and infection control
• Select appropriate material and use correct techniques for modification of casts
• Apply current standards and best practice to meet duty of care to client
• Communicate effectively with clients in relation to the procedure and manage clients' anxiety level
• Demonstrate all steps that must be taken in the correct and safe usage of equipment
• Recognise boundaries of responsibilities and refer problems to supervisor or other appropriate health professional

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:

• Apply current standards and best practice relevant to orthopaedic device application and removal
• Apply general problem solving skills to adjust casts for individual client needs
• Communicate with people from diverse cultural and linguistic backgrounds
• Correctly and safely modify a cast
• Deal with conflict
• Solve problems including an ability to use available resources
• Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues
• Use numeracy skills ranging from the ability to complete basic arithmetic calculations, recording stock levels and statistical information
• Use oral communication skills required to fulfil job roles in a safe manner and as specified by the organisation, including skills in:

• asking questions
• providing clear information
• listening to and understanding workplace instructions
• clarifying workplace instructions when necessary
• competence in English or a community language, depending on client group and organisation requirements

• Use effective verbal and non verbal communication skills with a range of internal and external persons
• Use reading and writing skills required to fulfil job roles in a safe manner and as specified by the organisation to a level of skill required for

• reading and documenting clinical information
• understanding policy and procedure manuals

• Work with others and display empathy with client and carers

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
• Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible
• Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Context of and specific resources for assessment:

• Relevant organisation policy, guidelines, procedures and protocols

Method of assessment:

• Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision
• Observation of work activities when modifying casts
• Observation of simulation and/or role play when modifying casts
• Discussion of physical and/or behavioural contingency scenarios involving duty of care
• Authenticated transcripts of relevant education/training courses
• Recognition of relevant life/work experience
• Questioning, written assessments/projects, e-learning can be used to assess knowledge
• Authenticated reports of experience in modifying casts(Documentation associated with performance reviews, supervisor/co-ordinator evaluations of work performance)
• Training records associated with first aid, work health and safety training, orientation/induction training, safe manual handing, universal infection control procedures
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice

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

Related units:

Holistic assessment practice with other health services units of competency is encouraged

This unit should be assessed in conjunction with:

• HLTAP401B Confirm physical health status
• HLTCT401D Apply casts
• HLTCT403D Remove casts

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.

Types of casts may include:

• Fully circumferential
• Hip spica
• Slab
• Split cast

Equipment may include:

• Benders
• Heat pan
• Plaster trap
• Saw with vacuum
• Scissors
• Shears
• Spreaders
• Vice

Materials may include:

• Abduction bars
• Bandages
• Cast shoes
• Felts/foams
• Hinges
• Plaster
• Quadrilateral bucket
• Stockinettes
• Strapping
• Synthetic materials
• Tapes
• Thermoplastic materials
• Undercast padding

Relevant personnel may include:

• Medical practitioners
• Other health professionals

Clients may include:

• Adolescents
• Adults
• Children
• Elderly
• In-clients/out-clients
• Infants

Assessment of client's condition may include:

• Allergies
• Relevant medical history
• Skin condition eg oedema, blisters, pressure areas, broken skin, fragile skin

Precautions may include:

• Loss of fracture position
• Loss of soft tissue position

Complications may include:

• Cast breakdown
• Cast migration (due to loss of tissue bulk)
• Compromising related injury
• Fracture blisters
• Loss of movement/function
• Malalignment of bone
• Neurovascular complications eg pressure areas
• Reduced range of movement/function of joint
• Secondary infection
• Wound breakdown

Clients specific needs may include:

• Age
• Functional requirements or restrictions
• Mobilisation difficulties or restrictions
• Physical anomalies
• Religious and cultural beliefs

Modifications of cast may include:

• Converting eg completion, addition
• Reinforcing
• Repad
• Splitting/bi-valving
• Tightening
• Trimming
• Wedge
• Windows

Documentation may include:

• Appliance hire documentation
• Appointment forms and books
• Cast check forms
• Client records
• Work log books

Advice given to clients may include:

• Cast, splint and brace care
• Limb care
• Mobilisation exercises/routines
• Oedema control

Appropriate support may include:

• Arrangement of educational material
• Instructions for seeking advice if required
• Organisation of walking aids e.g. crutches, wheelchairs
• Referral to appropriate health professional
• Review client's social situation in relation to their ability to self care with a cast