Unit of competency details

Unit Descriptor 

This unit deals with the skills and knowledge required to plan and implement basic treatments to address findings from clinical assessments, working under supervision as a member of a multi-disciplinary team with Aboriginal and/or Torres Strait Islander communities

Application 

This unit may be applied by those working individually (e.g. in isolated practice) or as part of a team (e.g. in a clinic or hospital), and work is to be carried out with guidance from and under supervision of a medical practitioner or other appropriate health care professional

It is imperative that cultural issues, including gender and kinship issues, are respected in the delivery, assessment and application of this competency unit

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. Plan care in response to health assessment

1.1 Consider and respect Aboriginal or Torres Strait Islander community values, beliefs and gender roles when developing health care plan 

1.2 Develop care plan in consultation with the client and/or significant others, in line with organisation, community and confidentiality requirements

1.3 Develop care plan to address findings of routine health assessment with due consideration for its holistic impact on the client in line with organisation policies and procedures

1.4 Plan health care services with reference to the primary health care team and other health care providers

1.5 Use standard treatment protocols  as a basis for determining health management plans

1.6 Take immediate action in line with standard treatment protocols to address life-threatening conditions or injuries and cardiovascular or cerebrovascular events

1.7 Document care plan in line with organisation and community requirements

1.8 Communicate care plan to the client and/or their carer(s) and negotiate as required to encourage full understanding and agreement

1.9 Ensure care plan supports clients in taking a self-care approach to health in line with individual needs and organisation requirements

2. Initiate treatment in line within guidelines/ protocols

2.1 Initiate action  as determined by organisation policies (including referral) based on results of clinical assessment and in accordance with accepted procedures and protocols

2.2 Provide health information in language appropriate to the task and supported by visual aids where appropriate

2.3 Explain each aspect of the treatment to the client and check their understanding and agreement

2.4 Deliver health care services with reference to the primary health care team and other health care providers

2.5 Refer to senior health staff for advice about serious or potentially serious health problems  as determined in organisation protocols

2.6 Use, maintain and regularly clean clinical equipment in accordance with generic OH&S and Infection Control guidelines and organisation policies

2.7 Implement basic life support and clinical treatments in line with organisation guidelines and limits of own ability and authority

2.8 Assist clients requiring referral to gain access to appropriate service providers

3. Monitor effectiveness of care

3.1 Monitor health of client in accordance with care plan and as negotiated with the client and/or carer(s)

3.2 Maintain appropriate monitoring and review of chronic conditions , symptoms and potential acute presentations

3.3 Evaluate effectiveness of care as per care plan and in line with organisation guidelines in relation to achieving agreed goals

3.4 Undertake effective networking and liaison with external health care and other service providers to facilitate client access to services

3.5 Document client progress in the client's file in accordance with organisation policies and procedures

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:

• Basic anatomy and physiology of:

• the skin
• musculoskeletal system

• Relevance of treatment to condition assessed
• Basic principles of:

• aseptic technique
• effective bandaging
• infection control and limiting cross infection

• Basic pharmacological principles relevant to specific treatments to be initiated
• Potential impact of each treatment on client as a whole
• Criteria and methods for evaluating effectiveness of care/treatments
• Strategies, methods and tools available for self-management of chronic diseases and to address barriers to self-management
• Relevant workplace policies, guidelines and legislation, specifically in relation to:

• infection control
• occupational health and safety
• client confidentiality
• limits of own authority
• referral and follow up of clients
• reporting procedures
• documentation

• Basic newborn and infant care, including:

• promotion of breast feeding
• growth assessment
• correct use of infant formula
• referral of problems

Essential knowledge  (continued ):

• Links between environment and health, including:

• crowding
• clean water
• sanitation
• food contamination
• insect vectors

• Basic nature of common diseases, including:

• cardiovascular diseases
• rheumatic fever and rheumatic heart disease
• diabetes

• Key elements of accurate reporting via radio/ telephone, in writing and during case discussion
• Important elements of self-management and supporting client self-management of chronic conditions, including an understanding of:

• attributes of self-management
• behavioural change

Essential skills :

It is critical that the candidate demonstrate the ability to:

• Develop and apply knowledge of anatomy and physiology in undertaking clients observations, questioning and measurements to assess health status
• Use medical equipment safely and correctly
• Identify significant variations from normal
• Summarise and communicate health assessment findings

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:

• Work with other members of multi-disciplinary team
• Communicate care plan to client, family and carer and check they understand and agree with it
• Document care plan in accordance to organisational policy and procedure
• Recognise situations requiring immediate or urgent action
• Initiate basic life support treatment where required
• Support client and carers to implement appropriate self-management strategies and address barriers to self-management in partnership with the health team
• Make appropriate referrals, providing accurate and relevant details to clients and referral agencies
• Assist clients to access relevant benefits associated with the health care system, including:

• Medicare benefits
• pharmaceutical benefits
• related benefits

• Initiate routine aspects of care for limited range of common conditions in line with protocols
• Carry out clinical procedures safely, effectively and within guidelines
• Monitor and evaluate effectiveness of care/ treatment and quality of life
• Recognise appropriate progress in relation to identified criteria for client care plan
• Determine further actions to be taken in the context of monitoring and evaluation outcomes
• Communicate effectively with clients and maintain client confidentiality
• Reflect on and improve own level and application of skills and knowledge to achieve desirable outcomes and maintain own capabilities

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 of assessment :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
• 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

Conditions of assessment :

This unit includes skills and knowledge specific to Aboriginal and/or Torres Strait Islander culture

Assessment must therefore be undertaken by a workplace assessor who has expertise in the unit of competency or who has the current qualification being assessed and who is:

• Aboriginal or Torres Strait Islander him/herself

or:

• accompanied and advised by an Aboriginal or Torres Strait Islander person who is a recognised member of the community with experience in primary health care

Context of assessment :

Competence should be demonstrated working individually, under supervision or as part of a primary health care team working with Aboriginal and/or Torres Strait Islander clients

Assessment should replicate workplace conditions as far as possible

Related units :

This unit may be assessed independently or in conjunction with other units with associated workplace application

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.

Cultural respect 

This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples

It recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social well-being, community capacity and governance

Its application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices

Community control 

Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community in this process

Supervision 

Supervision must be conducted in accordance with prevailing State/Territory and organisation legislative and regulatory requirements

References to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionals

A person at this level should only  be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines

Legislative Requirements 

Federal, state or territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of Variables

Aboriginal and/or Torres Strait Islander health workers may be required to operate in situations that do not constitute 'usual practice' due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by 'usual practice circumstances'

Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework

Care plan may include :

• Clinical treatment (from standard treatment protocols)
• Referral for further assessment, counselling and/or treatment
• Administration of medicines
• Self-management for chronic conditions
• Monitoring regime
• Evaluation of care

Related health care providers may include :

• Personnel internal to the service provider
• External health care providers
• Other service provider

Standard treatment protocols include :

• Written guidelines or orders that support the clinical management of presenting health problems
  (e.g. CARPA)
• Standard guidelines for infection control and occupational health and safety

Clinical equipment includes :

• Thermometers
• Stethoscopes
• Peak expiratory flow rate meters
• Auroscope
• Blood glucose testing units
• Nebulisers

Vital signs include :

• Temperature
• Pulse
• Blood pressure
• Respiratory rate

Initiated action must include :

• Application of standard precautions for infection control

Conditions requiring basic life support and urgent referral :

• Raised respiratory rate or other signs of respiratory distress

Clinical treatments that may be initiated at this level include :

• Splinting
• Bandaging
• Basic eye and ear health care, including:

• ear toilets to clear pus and debris from outer ear
• use of appropriate management protocols for ear health

• Application of simple wound dressings, including:

• cleaning and dressing of wounds using wound management protocols
• arrangements for follow up care of wounds and skin infections

• Treating head lice, scabies, common cold, diarrhoea
• Simple podiatry care and referral to specialised podiatry services as indicated
• Assisting diabetic clients to inject insulin

Serious or potentially serious health problems requiring First Aid and /or referral include :

• Clinical signs of or susceptibility to serious infection
• Elevated blood pressure or pulse-rate
• Common sexually transmissible infections
• Eye problems, such as:

• acute deterioration in visual acuity
• sharp or blunt eye trauma
• diplopia
• unilateral red eye
• eye injury relating to hammering or using high speed equipment
• chemicals, concrete or lime in the eye
• 'arc eyes' - welders' flash

• Facial and dental trauma

Other conditions requiring prompt action in line with standard treatment protocols include :

• Foot infection or ulceration in a person with diabetes
• Symptoms of fever
• Eye problems requiring first aid
• Clients with identified chronic diseases
• Clients requiring access dental care
• Women with signs and symptoms of imminent childbirth, potentially serious complications of pregnancy and/or post-partum haemorrhage

Clients with fever who are susceptible to serious infection include :

• Infants
• Elderly
• People with chronic diseases (e.g. diabetes, chronic renal failure or hear disease)
• People with valvular heart disease
• Those with past rheumatic fever

Simple measure to ease symptoms of fever include :

• Administration of paracetamol appropriate to age
• Undressing and tepid sponging without causing discomfort

Monitoring and review of chronic conditions may include :

• Anticipation and recognition of likely signs and symptoms to enable early intervention
• Referral to a medical practitioner or other senior health staff

Appropriate actions to be taken when significant variations from normal are found on urine testing include :

• Referral to a medical practitioner or other senior health staff
• Sending urine samples for further pathology testing (e.g. laboratory microscopy and culture; assay of albumin-creatinine ratio)
• Further pathology tests (e.g. blood for diabetes screening when there is glucose on urinanalysis
• Actions recommended in:

• OATSIH Otitis Media Guidelines
• Communicable Disease Network Australia Trachoma Guidelines

Abnormal appearances of tympanic membrane and ear canal include :

• Inflamed tympanic membrane
• Tympanic membrane perforation
• Past tympanic trauma
• Discharging perforation
• Impacted wax
• Foreign body in ear canal
• Inflamed ear canal
• Ex oma

Ear toilets to clear pus , wax and debris include :

• Gentle syringing using warm water or dilute povidone-iodine solution
• Dry-mopping using 'tissue paper smears'
• Ear drops

Appropriate management of child with trachoma includes :

• Antibiotic treatment of:

• the affected child
• other children in the household and
• immediate care-givers

Assistance to access dental care may include :

• Liaising with local dental services
• Arranging dental appointment
• Providing transport
• Completing dental assistance scheme forms