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Unit of competency details

HLTENN021 - Apply nursing practice in the critical care setting (Release 1)

Summary

Usage recommendation:
Superseded
Mapping:
MappingNotesDate
Supersedes HLTEN607B - Practise in the critical care environmentThis version was released in HLT Health Training Package release 3.0 and meets the requirements of the 2012 Standards for Training Packages. Significant changes to the elements and performance criteria. New evidence requirements for assessment, including volume and frequency requirements. Minimal change to knowledge evidence. 07/Dec/2015
Is superseded by and equivalent to HLTENN053 - Apply nursing practice in the critical care settingThis version was released in HLT Health Training Package Release 6.0 and meets the requirements of the 2015 Standards for Training Packages. Mapping information updated. Updated to reflect current industry practices and terminology. 29/Apr/2021

Releases:
ReleaseRelease date
1 1 (this release) 08/Dec/2015


Classifications

SchemeCodeClassification value
ASCED Module/Unit of Competency Field of Education Identifier 060309 Critical Care Nursing  

Classification history

SchemeCodeClassification valueStart dateEnd date
ASCED Module/Unit of Competency Field of Education Identifier 060309 Critical Care Nursing  29/Apr/2016 
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Unit of competency

Modification History

Release 

Comments 

Release 1

This version was released in HLT Health Training Package release 3.0 and meets the requirements of the 2012 Standards for Training Packages.

Significant changes to the elements and performance criteria. New evidence requirements for assessment, including volume and frequency requirements. Minimal change to knowledge evidence.

Supersedes HLTEN607B

Application

This unit describes the skills and knowledge required to practise within the critical care environment.

Enrolled nurses working in critical care nursing need to hold and apply in-depth knowledge, effectively integrate theory and practice, and make reliable clinical assessments and judgements.

This unit applies to enrolled nurses, registered with the Nursing and Midwifery Board of Australia, seeking specialisation in enrolled nurse work that is carried out in consultation and collaboration with registered nurses, and under direct or indirect supervisory arrangements aligned to the Nursing and Midwifery Board of Australia regulatory authority legislative requirements.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

Elements and Performance Criteria

ELEMENT 

PERFORMANCE CRITERIA 

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.

1. Apply theoretical concepts and principles in providing critical care nursing

1.1 Identify the person’s current health status and limitations and their medications and therapeutic regimes in the critical care setting with the person, family or carer

1.2 Identify factors impacting the person’s health status and report to the registered nurse significant alterations in the person’s health status

1.3 Identify and respond to the psychosocial needs of the person in the critical care environment

1.4 Identify and apply a systems approach to nursing care

2. Contribute to interdisciplinary health care team in caring for a person in the critical care environment

2.1 Identify role of specialist nursing and medical services in care of the person in the critical care environment and work effectively with others

2.2 Collaborate with interdisciplinary health care team in partnership with the person, family or carer to maintain continuity of nursing care planning

2.3 Identify factors relevant to the person’s situation, giving consideration to physical, psychological, social and economic impacts

2.4 Review care plan and data collected, and communicate to relevant members of the interdisciplinary health care team

2.5 Recognise the person’s choices and any advance care planning, and advocate for the rights and responsibilities of the person in critical care

3. Perform complex nursing interventions to assist a person in critical care to attain and maintain optimal health

3.1 Manage nursing workload according to a person’s needs and re-prioritise care activities for the person rapidly when circumstances change

3.2 Undertake appropriate pre-, intra- and post-diagnostic procedures in line with scope of practice and organisation policy and procedures, and in collaboration with the registered nurse

3.3 Respond rapidly to adverse and emergency events applying knowledge of pathophysiology and using problem-solving approaches in line with organisation policy and procedures and within scope of practice

3.4 Identify when the acuity of a person’s critical care needs is beyond own skill and knowledge, and refer promptly to registered nurse and relevant interdisciplinary health care team members

4. Develop own practice in the critical care nursing environment

4.1 Make appropriate proposals for nursing interventions in consultation with registered nurse to promote improved outcomes for the person and their condition

4.2 Evaluate nursing interventions provided and evaluate the outcomes against evidence-based best practice in critical care nursing

4.3 Recognise symptoms of stress and professional burnout in self, peers and colleagues, and refer to appropriate services within organisation policies and procedures and scope of practice

4.4 Seek out opportunities and participate in professional development, acquiring knowledge to guide own practice and acting as a resource for colleagues

Foundation Skills

The Foundation Skills describe those required skills (language, literacy, numeracy and employment skills) that are essential to performance.

Foundation skills essential to performance are explicit in the performance criteria of this unit of competency.

Unit Mapping Information

No equivalent unit.

Links

Companion Volume implementation guides are found in VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=ced1390f-48d9-4ab0-bd50-b015e5485705

 

Assessment requirements

Modification History

Release 

Comments 

Release 1

This version was released in HLT Health Training Package release 3.0 and meets the requirements of the 2012 Standards for Training Packages.

Significant changes to the elements and performance criteria. New evidence requirements for assessment, including volume and frequency requirements. Minimal change to knowledge evidence.

Supersedes HLTEN607B

Performance Evidence

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:

  • undertaken nursing work in accordance with Nursing and Midwifery Board of Australia professional practice standards, codes and guidelines
  • performed the following nursing care interventions on no fewer than 3 people in a critical care setting in the workplace:
  • care of an arterial line
  • care of central venous line
  • assessment of chest pain
  • monitoring of electrocardiograph readings for abnormalities
  • administration of (non-invasive) continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP)
  • care of permanent and temporary mechanical ventilation including suctioning and bagging
  • peripherally inserted central catheter (PICC)/midline management
  • under water seal drain management
  • in undertaking the above, use advanced communication skills and medical terminology to communicate effectively with the person, family or carer, and the registered nurse and other health professionals to record or report the person’s outcomes.

Knowledge Evidence

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:

  • advanced life support including advanced cardiopulmonary resuscitation
  • complex nursing procedures relevant to care of a person in a critical care environment including infusion pumps and patient controlled analgesia pumps and syringe drivers
  • specialised knowledge of anatomy, physiology and pathophysiology related to critical care issues
  • specialised knowledge and skill relating to prioritising care in an emergency situation of a person in the critical care environment
  • actual and potential problems in critical care including:
  • respiratory failure
  • increased intracranial pressure
  • deteriorating person and levels of consciousness
  • haemorrhage
  • hypercapnia
  • inability to clear secretions
  • inability to cough
  • aspiration
  • shortness of breath
  • electrolyte imbalance
  • fluid overload
  • hypoxia and hypoxaemia
  • chest pain
  • stroke
  • vessel occlusion
  • pneumothorax
  • pacemaker lead displacement
  • arrhythmia
  • allergic reaction.

Assessment Conditions

Skills must have been demonstrated in the workplace with the addition of simulations and scenarios where the full range of contexts and situations cannot be provided in the workplace. The following conditions must be met for this unit:

  • use of suitable facilities, equipment and resources in line with the Australian Nursing and Midwifery Accreditation Council’s Standards including:
  • simulation models or manikins suitable for advanced cardiopulmonary resuscitation and clinical skills
  • arterial lines
  • CPAP and BiPAP machines
  • PICC lines
  • underwater seal drains and tubes
  • ventilation equipment
  • progressive notes of a de-identified person’s medical history
  • infusion pumps, patient controlled analgesia pumps and syringe drivers
  • organisation policy and procedures on which the candidate bases the planning
  • modelling of industry operating conditions including access to real people for simulations and scenarios in enrolled nursing work.

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

In addition, assessors must hold current registration as a Registered Nurse with Nursing and Midwifery Board of Australia.

Links

Companion Volume implementation guides are found in VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=ced1390f-48d9-4ab0-bd50-b015e5485705