Unit of competency details

HLT07 Version 4

HLT07 Version 5

Comments

HLTEN519B Administer and monitor intravenous medication in the nursing environment

HLTEN519C Administer and monitor intravenous medication in the nursing environment

Updated pre-requisite units. No change to competency outcome.

Descriptor 

This unit of competency describes the skills and knowledge required of Enrolled/Division 2 nurses to administer and monitor intravenous medications and their effectiveness for clients within the nursing context.

Application 

The knowledge and skills described in this competency unit are to be applied within jurisdictional nursing and midwifery regulatory authority legislative requirements

Enrolled/Division 2 nursing work is to be carried out in consultation/collaboration with registered nurses and under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements

Pre-requisite units 

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

• HLTWHS300A Contribute to WHS processes
• HLTIN301C Comply with infection control policies and procedures
• HLTAP501C Analyse health information
• HLTEN505C Contribute to the complex nursing care of clients
• HLTEN507C Administer and monitor medication in the work environment

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. Minimise risk to the safe administration of intravenous medication

1.1 Check for pharmacology and substance incompatibilities

1.2 Review issues related to drug administration with registered nurse

1.3 Identify common contraindications and adverse reactions of prescribed intravenous medications

1.4 Confirm client identity and check for any known allergies

1.5 Maintain knowledge of drug schedules and classifications as determined by legislation

1.6 Work with a knowledge of various forms of intravenous medication administration

1.7 Assess the intravenous cannula site for any problems

2. Prepare intravenous medications for administration to client

2.1 Work with a knowledge of all intravenous administration routes and associated terminology

2.2 Identify the purpose and function of prescribed intravenous medications for administration

2.3 Identify common contraindications and adverse reactions of prescribed intravenous medications

2.4 Accurately calculate dosages for administration of intravenous drugs

2.5 Work with a knowledge of how intravenous medications are prepared in line with legislative requirements and environmental guidelines

2.6 Use correct intravenous medication administration techniques and precautions specific to each client as per medication orders

3. Administer intravenous medications within legal parameters

3.1 Work with a knowledge of legal parameters for the administration of intravenous medications

3.2 Administer intravenous medications within role responsibility accordance with the legislative requirements and organisation policy

3.3 Store intravenous medications in a safe manner according to legislative requirements and health care organisation policy

3.4 Work with a knowledge of organisation processes for quality management and risk assessment of administration of intravenous medication

4. Monitor client response to administered intravenous medication

4.1 Record administration of intravenous mediations in accordance with organisation policy

4.2 Contribute to information provided to clients and carers on intravenous medication administration (including possible side effects)

4.3 Recognise acute and delayed adverse reactions to intravenous medications and respond within role responsibility

4.4 Implement emergency actions for identified acute and delayed adverse reactions within role responsibility

4.5 Record and report response to emergency strategies

4.6 Implement organisation procedures in the event of an intravenous medication incident

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:

• Approved intravenous medication abbreviations
• Documentation associated with intravenous medication administration
• Factors influencing intravenous medication actions
• Legal requirements for practice parameters of Enrolled/Division 2 nurse
• Major intravenous medication groups
• Methods of storage, handling and usage of intravenous medications
• Relevant medical/medication terminology
• Relevant pathophysiology
• Relevant workplace health and safety policies to ensure safe practice eg management of sharps
• Role of the health care team in the administration of intravenous medications
• Systems of intravenous medication delivery
• Scheduling of medications, including:

• Schedule 2
• Schedule 3
• Schedule 4
• Schedule 8

• Substance incompatibilities may include:

• anaphylactic reactions
• adverse reactions
• contraindications
• precautions
• side effects

• Understanding of the pharmacology of intravenous medications including:

• principles of pharmacokinetics and pharmacodynamics related to major drug groups
• toxicology

• Understanding the legal requirements of each route of intravenous administration
• Understanding of role in medical emergency

Essential skills:

It is critical that the candidate demonstrate the ability 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 formulae for intravenous drug calculation for:

• adult clients
• intravenous therapy
• older clients
• paediatric clients

• Apply Professional Standards of Practice:

• ANMC code of conduct
• ANMC code of ethics
• ANMC national Enrolled/Division 2 nurse competency standards
• state/territory Nurse Regulatory Nurses Act
• state/territory Nursing and Midwifery Regulatory Authority standards of practice
• state/territory Drugs and Poisons Act
• scope of nursing practice decision making framework
• Department of Health Guidelines
• O₂ Therapy
• nurse initiated medication

• Calculate volumes for administration of intravenous medications
• Check intravenous cannula site
• Demonstrate preparation, administration and recording of medication/s via intravenous routes
• Demonstrate professional conduct, skills and knowledge
• Perform emergency management for a client experiencing an adverse intravenous medication reaction
• Use interpersonal skills, including working with others, using sensitivity when dealing with people and relating to persons from differing cultural, social and religious backgrounds
• Use language, literacy and numeracy competence required for intravenous drug calculation, administration and documentation
• Use oral communication skills (language competence) required to fulfil job roles as specified by the organisation/service, including:

• interviewing techniques
• asking questions
• active listening
• asking for clarification

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 performance in a work context is essential for assessment of this unit
• Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion and be assessed by a registered nurse
• Assessment must include a written calculation test with 100% mastery
• Assessment must be undertaken in a simulated clinical laboratory prior to clinical placement

Context of and specific resources for assessment:

• This unit is most appropriately assessed in the clinical workplace
• Simulations may be used to represent workplace conditions as closely as possible
• Where, for reasons of safety, access to equipment and resources and space, assessment takes place away from the workplace, simulations should be used to represent workplace conditions as closely as possible

Method of assessment

Assessment of competency may occur on more than one occasion. Assessment may include but not be limited to:

• Observation in the work place
• Evidence gathered from clinical work environment
• Written assignments/projects
• 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

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

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.

Health environments may include:

• Residential aged care facility
• Community settings
• Hospitals
• Clinics
• Short and long stay centres
• Clients home

Potential risks may include but is not limited to:

• Client Identification
• Allergic reactions
• Immunisation status
• Intravenous medication incompatibilities
• Contra-indications for intravenous drug administration
• Intravenous therapy

Intravenous medication administration methodsinclude:

• Bolus
• Via burette
• Mini infusion pump
• IV piggyback/tandem
• Syringe pump

Legal and regulatory framework include:

• State/territory Nurses Act.
• State/territory Drugs and Poisons Act
• Health (Drugs and Poisons) Regulations
• State/territory Nurse Regulatory Authority Practice Standards
• Documentation legal requirements

Commonly used medications may include:

• Analgesia
• Antibiotics
• Corticosteroids

Administration of oral medications and associated terminology may include:

• Legible medication order
• Preparation of medication by person administering
• 5 'Rights'
• Special precautions including assessment of intravenous cannula site

Checking intravenousmedications and associated terminology include:

• Legal requirements as per jurisdictional regulations
• Understanding of Enrolled/Division 2 nurse role
• Legible medication order
• Absorption rates of intravenous medications
• Preparation of medication by person administering
• Checked by Registered Nurse
• 5 'Rights'
• Special precautions

Problems with intravenous cannula site may include:

• Extravasation
• Signs of inflammation
• Loss of patency

Terminology associated with intravenous medications may include:

• Pharmacology
• Medication
• Administer
• Therapeutic effect
• Side effect/adverse reaction/allergic reaction
• Contraindication
• Anaphylaxis
• Allergy

Calculation of medication dosages must include:

• Calculation formulae
• Calculation of dosages of injectable drugs (liquid, solid, unit dosages)
• Flow rate drops per minute
• Flow rate millilitres per hour
• Paediatric dosage calculations (body weight, surface area, age related dose reduction)
• Geriatric dosage calculations (body weight, surface area and age)