Unit of competency details

HLT07 Version 4

HLT07 Version 5

Comments

HLTAN402C Prepare and assist with the preparation of the client for anaesthesia

HLTAN402D - Prepare and assist with the preparation of the client for anaesthesia

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 provide assistance in the preparation of the client prior to administration of anaesthesia

Application 

Work is performed under the direction of the anaesthetist and requires broad knowledge, a range of well developed skills. Individuals use discretion and judgement and take responsibility for the quality of their outputs

Clients' dignity and confidentiality is maintained, and reassurance provided throughout the preparation phase

There is a significant range of client positioning and the attaching/detaching of equipment to/from clients during transfer, and the provision of assistance during such transfers and the ability for appropriately trained technicians to carry out intravenous cannulation according to regional and national guidelines

Administration of anaesthesia may occur in various locations within the hospital environment e.g. operating theatres, emergency department, intensive care unit (ICU), radiology department

All activities are carried out in accordance with relevant Australian and New Zealand College of Anaesthetists' Policy Documents, 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. Receive client

1.1 Greet and reassure client prior to administration of anaesthesia

1.2 Inform client about the preparation to be completed by anaesthetic technician

1.3 Carry out checks to confirm that all required preparation has been completed

1.4 Correlate client's identification wristband, client notes, consent form and confirm operating list

1.5 Obtain verbal confirmation of client's identity, type and site of operation from the client where condition permits and according to organisation policy

1.6 Monitor the client's safety through continual observation, as required

1.7 Identify, record and immediately report any variations, discrepancies and changes to the client, their documentation or their wishes to the anaesthetist and other relevant personnel

1.8 Acknowledge accompanying relatives and carers sensitively and appropriately

1.9 Label client property and store securely and in accordance with organisation policy

2. Attach/detach equipment to/from client

2.1 Select required equipment in accordance with anaesthetist's preference and attach correctly

2.2 Utilise personal protective equipment in accordance with standard and additional precautions

2.3 Undertake skin preparation prior to attachment of equipment, as necessary

2.4 Set equipment in operation

2.5 Carefully detach equipment with minimum risk of damage to client, staff or equipment, once the anaesthetist indicates that it is no longer required

2.6 Clean equipment in accordance with departmental infection control policies and manufacturer's instructions prior to storage

2.7 Safely store equipment in accordance with manufacturer's recommendations, or prepare for re-use

2.8 Follow established procedures if equipment is found to be faulty

3. Provide assistance in siting intra-vascular cannula

3.1 Check anaesthetist's requirements

3.2 Utilise personal protective equipment in accordance with standard and additional precautions

3.3 Check individual needs of the client and provide the appropriate equipment for the anaesthetist

3.4 Select and prepare required equipment in an aseptic manner

3.5 Provide optimum conditions to facilitate access

3.6 Following insertion, adequately and safely secure the cannula and provide accessibility

3.7 Dispose of waste/sharps in accordance with waste management policies and infection control guidelines

4. Assist with transfer of clients

4.1 Plan to transfer client into procedural/operating room under the direction of the anaesthetist is confirmed

4.2 Ensure relevant personnel are aware of the actions to be performed

4.3 Detach equipment not required from the client before the transfer takes place as directed by the anaesthetist

4.4 Ensure equipment attached to the client is safely and correctly adjusted during transfer

4.5 Employ safe lifting and handling techniques during client transfer

4.6 Conduct the client transfer at the direction of the anaesthetist and ensure movement is conducted safely and client discomfort minimised

4.7 Correctly re-connect and adjust equipment on completion of transfer, as necessary

4.8 Maintain client's dignity and give reassurance when necessary

5. Assist with positioning clients for clinical/operative procedures

5.1 Inform client of positioning procedures to be completed by technician, reassure, as far as possible, and seek his/her cooperation when appropriate

5.2 Position client under the direction of the anaesthetist to meet the requirements of the anaesthetist and surgeon

5.3 Ensure all relevant equipment is available, is functioning correctly and is correctly attached/placed in accordance with the anaesthetist's and surgeon's preferences and the individual needs of the client

5.4 Ensure client is protected from injury in collaboration with other relevant health professionals

5.5 Obtain assistance to position client when necessary

5.6 Observe any abnormal responses and report any action required to be taken to the anaesthetist/medical officer

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:

• Anaesthetic procedures relevant to providing assistance in anaesthesia
• Anatomy and physiology relevant to providing assistance in anaesthesia
• Boundaries of responsibilities and ability to refer problems to supervisor, anaesthetist or other appropriate health professional
• Client monitoring during transfer and the risks associated with transfer
• Clinical/operative procedures and the interrelationship with anaesthesia relevant to providing assistance in anaesthesia
• Common cannulation sites and principles for selection and contra-indication of site
• Fluid balance, including regulation and use relevant to providing assistance in anaesthesia
• General knowledge of pathophysiology of disease relevant to providing assistance during anaesthesia
• Manual handling and safe client positioning techniques relevant to providing assistance during anaesthesia
• Medical terminology relevant to providing assistance in anaesthesia
• Medico-legal requirements relevant to providing assistance during anaesthesia
• Occupational health and safety and infection control procedures/regulations
• Pre-medications and their effects relevant to providing assistance in anaesthesia
• Types and functions of equipment, their indications and limitations for use
• Types and functions of infusion and transfusion equipment, their indications and limitations for use
• Use of pain management equipment relevant to providing assistance during anaesthesia

Essential skills:

It is critical that the candidate demonstrate the ability to:

• Assist with transfer and positioning of client
• Attach equipment to and detach from client
• Identify and manage faults in anaesthetic and monitoring equipment
• Prepare and calibrate anaesthetic and monitoring equipment for use
• Prepare client sites correctly to interface with equipment
• Secure an arterial/venous cannula

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:

• Assist in preparation of clients with regard to their safety, comfort and individual rights
• Comply with organisation policies and procedures including those of work health and safety (WHS) and infection control, and current standards
• Deal with conflict
• Display empathy with client and relatives if required
• Identify and manage equipment faults
• Recognise and manage barriers to effective communication
• Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues
• Use numeracy skills including 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
• using effective verbal and non verbal communication with a range of personnel, within and outside of the organisation
• competence in English or a community language, depending on client group and organisation requirements

• Use problem solving skills required, including an ability to use available resources
• Use reading and writing skills required to fulfil job roles in a safe manner and as specified by the organisation at a level of skill that includes reading and documenting clinical information and understanding complex policy and procedure manuals
• Work with others within a team

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
• Observation of workplace performance is essential for assessment of this unit
• 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

Context of and specific resources for assessment:

• Resources essential for assessment include:

• access to appropriate workplace where assessment can take place
• simulation of realistic workplace setting for assessment
• relevant organisation policy, guidelines, procedures and protocols

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

Method of assessment

• Observation in the workplace
• Evidence gathered from clinical work environment
• Written assignments/projects or questioning should be used to assess knowledge
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice
• Questioning - verbal and written
• Role play/simulation
• 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

Related units:

This unit can be assessed independently, however holistic assessment practice with other health services units of competency is encouraged

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 requiring anaesthetics may include:

• Neonates
• Infants
• Children
• Adolescents
• Adults
• Elderly

Required client preparation may include:

• Fasting
• Premedication
• Procedural investigations
• Preparation of procedural site e.g. bowel preparation, shave, nail polish removed

Clients condition may include:

• Conscious
• Unconscious
• Traumatised
• Compromised
• Pregnancy

Client property may include:

• Dentures
• Prosthesis
• Clothing
• Toys

Equipment to be attached/detached may include:

• Breathing systems and attachments

Monitoring equipment includes:

• Electrocardiography (ECG)
• Pulse oximetry
• Non-invasive and invasive blood pressure monitoring
• Temperature monitoring
• Central venous pressure (CVP) monitoring
• Intravascular monitoring
• Gas analysers, including oxygen, carbon dioxide and anaesthetic agent
• Expired/inspired volume/pressure
• Neuromuscular transmission
• Cardiac output monitoring
• Cerebral activity monitoring
• Stethoscopes, including oesophageal

Other equipment includes:

• Infusion equipment, including rapid transfusion equipment
• Warming/cooling equipment for client and intravenous fluids
• Equipment to minimise heat loss
• Tourniquets and exsanguinators
• Neuromuscular function monitor
• Operating table and attachments for positioning and pressure care
• Anti-embolus equipment
• Humidifiers
• Scissors, clamps and forceps
• Materials for fibreoptic intubation
• Materials for subarachnoid epidural or regional nerve blocks, all eye blocks

Intra-vascular cannulation must include:

• Venous
• Peripheral
• Central
• Arterial
• Pulmonary artery catheter

Anaesthetist's requirements may include:

• Client details e.g. age, gender, health status, problems anticipated
• Procedure to be undertaken
• Equipment and materials for procedure

Preparation and assistance when required by the anaesthetist may include:

• Siting venous cannula in accordance with state/territory legislation and organisation policies and procedures ensuring:

• anaesthetist's requirements are checked
• personal protective equipment are utilised in accordance with standard and additional precautions
• individual needs of the client are checked and action to meet those needs is completed
• client is informed and reassured throughout the procedure
• optimum conditions to facilitate access are provided
• cannulation is completed in an aseptic manner
• cannula is adequately and safely secured and accessibility provided
• documentation is completed
• waste/sharps are disposed of in accordance with waste management policies and infection control guidelines

Transfer of clients may include movement to and from:

• Trolleys
• Beds
• Operating table
• Wheelchairs

Attached equipment may include:

• Monitoring equipment
• Infusions
• Airways
• Drains
• Neonatal transfer equipment
• Catheters
• Traction equipment

Safe transfer of the client may include:

• Client remains informed
• Head and limbs of client are protected
• Smooth movements
• Wheel brakes are locked

Client positions may include:

• Supine
• Prone
• Lithotomy
• Trendelenberg/reverse
• Lateral
• Jack knife
• Sitting
• Specific positioning related to the operative/clinical procedure

Clinical procedures covers the surgical procedure and the type of anaesthetic which may include:

• General/regional/local anaesthetic and sedation
• Fibreoptic intubation
• Radiology/radiotherapy anaesthesia
• General surgery
• Gastro-intestinal surgery
• Ear, nose and throat surgery
• Ophthalmic surgery
• Gynaecological surgery
• Obstetric surgery
• Orthopaedic surgery
• Vascular surgery
• Urologic surgery
• Oral/dental/maxillofacial surgery
• Cardiothoracic surgery
• Neurological surgery
• Plastic surgery
• Trauma/emergency surgery

Protecting client from injury may include:

• Support/padding
• Careful movement of joints
• Avoiding sudden and abnormal movements
• Protection from large temperature changes
• Protection from pressure