ACMVET501A Manage nursing requirements for specialised surgical procedures

Revision Number: 2

ACMVET501A Manage nursing requirements for specialised surgical procedures

Modification History

Release	TP Version	Comments
2	ACM10v3	Reference to OHS legislation replaced with generic terminology
1	ACM10v1	Initial release. Supersedes and is equivalent to RUV5601A

Unit Descriptor

This Unit of competency covers the process of conducting admissions for specialised surgical procedures, preparing the theatre environment, performing specific pre-operative procedures, monitoring anaesthesia, providing intra-operative support to surgeons and managing equipment cleaning and maintenance.

Application of the Unit

This Unit is specifically designed for nurses who work in a veterinary clinic or hospital where registered specialists perform specialised surgical procedures. Managing nursing requirements for specialised surgical procedures requires access to a veterinary clinic or hospital where specialised surgical procedures are performed; veterinary surgeons that perform specialised surgical procedures; patients and clients requiring specialised surgical procedures; and the equipment, instruments and resources required to perform specialised surgical procedures.

In addition to legal and ethical responsibilities, all Units of Competency in the ACM10 Animal Care and Management Training Package have the requirement for animals to be handled gently and calmly. The individual is required to exhibit appropriate care for animals so that stress and discomfort is minimised.

Licensing/Regulatory Information

Licensing, legislative, regulatory or certification requirements may apply to this Unit. Therefore, it will be necessary to check with the relevant state or territory regulators for current licensing, legislative or regulatory requirements before undertaking this Unit.

Pre-Requisites

Nil

Employability Skills Information

This Unit contains employability skills.

Elements and Performance Criteria Pre-Content

Elements describe the essential outcomes of a Unit of Competency.	Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the required skills and knowledge section and the range statement. Assessment of performance is to be consistent with the evidence guide.

Elements and Performance Criteria

ELEMENT	PERFORMANCE CRITERIA
1. Conduct admission process for specialised surgical procedures	1.1. Appointment is made and pre-operative instructions and hospital routines information are provided to the client (owner). 1.2. Patient histories and client details are compiled in accordance with surgeon's requirements. 1.3. Referrals and associated documentation are coordinated as required. 1.4. Patient samples are obtained in accordance with workplace health and safety requirements and are submitted for analytical tests as required. 1.5. Pathological and diagnostic aid results are assimilated with patient's history.
2. Prepare the theatre environment	2.1. Theatre is prepared in accordance with workplace health and safety requirements to achieve aseptic conditions prior to and during surgery. 2.2. Specialised materials and equipment are accessed, checked and prepared for use. 2.3. Personal preparation and gloving and gowning of theatre attire by other personnel are supervised as required.
3. Perform specific pre-operative procedures	3.1. Pre-surgical evaluation is performed and observations are reported. 3.2. Patient is stabilised and an individual fluid therapy plan is designed in consultation with the surgeon. 3.3. Patient is prepared for surgery and positioned on the operating table in accordance with the requirements of the procedure and surgeon.
4. Monitor anaesthesia	4.1. Specific anaesthetic procedures are applied under the supervision of the surgeon. 4.2. Specific artificial respiration systems are applied under the supervision of the surgeon. 4.3. Specific intra-operative medication is applied as instructed by the surgeon.
5. Provide intra-operative support to surgeon	5.1. Support is provided for the surgeon's personal preparation for theatre if directed. 5.2. Progress of surgery and surgeon's requirements are anticipated and requirements are met in a timely manner. 5.3. Instruments, materials and equipment are handed to the surgeon in accordance with defined clinic policies. 5.4. Specific surgical operating support is provided as required. 5.5. Specialised bandages or splints are applied and medication is administered as instructed by the surgeon.
6. Manage equipment cleaning and maintenance	6.1. Theatre equipment, drapery and specialised surgical equipment are cleaned and maintained in accordance with clinic policies and workplace health and safety requirements. 6.2. Instruments and specialised surgical equipment are packed and stored in an appropriate environment and atmosphere.

Required Skills and Knowledge

This section describes the skills and knowledge required for this Unit.
Required skills
Ability to: apply and monitor anaesthesia, fluid therapy and radiographic and imaging routines relating to specialised surgical routines complete relevant work-related documentation employ safe and environmentally responsible organisational systems and procedures when working with and handling animals identify appropriate specialised surgical equipment and instruments maintain the highest standards of hygiene and infection control at all times to reduce the risk of infection and cross-infection observe accurately and report animal condition and vital signs recognise, respond to and assist with emergencies undertake routine equipment maintenance schedules in accordance with manufacturers' requirements use literacy skills to read, select and implement policies and procedures, including workplace health and safety, infection control and other clinic policies and procedures; coordinate patient admission and discharge; implement sequenced written and oral instructions; and record patient details accurately and legibly use interpersonal skills to relate to people from a range of social, cultural and ethnic backgrounds and with a range of physical and mental abilities use oral communication skills/language required to fulfil the job role as specified by the clinic, including negotiating and questioning techniques, active listening, asking for clarification from veterinarian, and acknowledging and responding to a range of views use numeracy skills to monitor surgical equipment and patients' vital signs and to measure dosages use problem-solving skills to use available resources, prioritise tasks and anticipate surgeons' requirements use safe manual handling techniques and/or equipment use safe waste handling and disposal procedures work as part of and coordinating a team work with others to achieve optimum aseptic conditions.
Required knowledge
Knowledge of: anaesthetic routines and anaesthetics, including gaseous and injectables animal anatomy and physiology related to specialised surgical procedures AS/NZ 4187:2003 Cleaning, disinfecting and sterilising re-useable medical and surgical instruments and equipment and maintenance of associated environments in health care facilities equipment and instrument requirements for surgery and their use fluid therapy and radiographic and imaging routines relating to specialised surgical routines interpretation of results and surgical approaches intra-operative drugs non-routine surgical procedures pain management techniques principles of animal welfare and ethics how to recognise emergencies relevant state or territory legislation and regulations relating to the practice of veterinary science, workplace health and safety and animal welfare relevant state or territory legislation covering the use of therapeutic and controlled substances safe work practices specialised surgical procedures, including thoracotomy, enterotomy, gastrotomy, cystotomy, spinal surgery, orthopaedic surgery and ophthalmic surgery theatre routines how to use and recording of chemicals and medicines in the clinic according to relevant legislative requirements workplace hygiene standards, disinfectants and sterilisation, cleaning agents, cleaning techniques and cleaning equipment and materials.

Evidence Guide

EVIDENCE GUIDE
The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.
Overview of assessment
Critical aspects for assessment and evidence required to demonstrate competency in this Unit	The evidence required to demonstrate competence in this Unit must be relevant to workplace operations and satisfy all of the requirements of the performance criteria, required skills and knowledge and the range statement of this Unit. Assessors should ensure that candidates can: admit animals for specialised surgical procedures completing all appropriate documentation prepare animals and theatres for specific surgical procedures organise self and clinic personnel in preparing necessary equipment and material for specialised routines identify and safely use appropriate equipment, instruments and materials for specialised surgical procedures monitor anaesthesia throughout surgery and provide specific support to surgeons as required observe and report accurately on animals' condition and vital signs recognise, respond to and assist with emergencies manage theatre requirements and the cleaning and maintenance requirements of specialised surgical equipment.
Context of and specific resources for assessment	Assessment of this Unit is to be practical in nature and must be assessed in a clinic or hospital where registered specialists are performing specialised surgical procedures. There must be access to the appropriate surgical equipment and/or resources relevant to the specialised surgical procedures taking place in the clinic to enable one to demonstrate competence.
Method of assessment	To ensure consistency in one's performance, competency should be demonstrated by managing nursing requirements and carrying out post-operative nursing routines for an extensive range of specialised surgical procedures on a regular basis over a period of time. The assessment strategy must include practical skills assessment. Suggested strategies for this Unit are: written and/or oral assessment of candidate's required knowledge observed, documented and first-hand testimonial evidence of candidate's application of practical tasks simulation exercises that reproduce normal work conditions case study analysis third-party evidence workplace documentation portfolio. This Unit may be assessed in a holistic way with other Units of Competency relevant to the industry sector, workplace and job role.
Guidance information for assessment	Assessment methods should reflect workplace demands (e.g. literacy and numeracy demands) and the needs of particular target groups (e.g. people with disabilities, Aboriginal and Torres Strait Islander people, women, people with a language background other than English, youth and people from low socioeconomic backgrounds).

Range Statement

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. Bold italicised wording, if used in the performance criteria, is detailed below. 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) may also be included.
Specialised surgical procedures may include:	cystotomy enterotomy gastrotomy orthopaedic surgery ophthalmic surgery spinal surgery thoracotomy.
Pre-operative instructions may be given in regard to:	control of exercise fasting medication restricted fluid intake.
Hospital routines information may include:	patient progress patient visiting arrangements referral to specialised advice.
Patient histories and client details may include:	patient histories may be maintained manually or electronically patient histories: referral and associated documentation pathological and diagnostic results client details: owner's name and address emergency contact payment details.
Patient samples may include:	blood obtained by venipuncture faeces collected by direct rectal examination and free catch hair pluckings other exudates skin scrapings tape preparations urine collected by free catch urinary catheterisation under veterinary supervision.
Workplace health and safety risks when working with animals may include:	animal bites, kicks, scratches and crush injuries biological hazardous waste and sharps disposal handling of chemicals and medicines gas leakage inhalation of aerosol particles intraocular contamination manual handling, including carrying, lifting and shifting needle pricks and cuts from other sharps release of infective agents (animal and human) slippery or uneven work surfaces zoonoses.
Specialised materials and equipment may include:	anaesthetic equipment blood pressure monitoring equipment capnographs catheters drains electrocardiogram (ECG) electrosurgical units endoscopes fibroscopes heated operating tables laryngoscopes laparoscopes oesophageal stethoscopes orthopaedic equipment: drills and saws ophthalmic equipment pulse oximeters scavenger suction pumps ventilators.
Personal preparation and preparation of other personnel for the theatre environment will include:	anti-static footwear or shoe covers demonstrating open and closed gloving techniques donning specialised theatre scrub suits gowning using cloth or disposable gowns scrubbing up aseptically surgical caps and masks.
Pre-surgical evaluation may include:	assessment of temperament capillary refill time evaluation of pain prior to sedation and anaesthetic choice under supervision of a surgeon fluid therapy plan under supervision of a surgeon heart rate mucous membrane colour pulse rate and quality rectal temperature respiratory rate and effort.
Actions when stabilising patients may include:	administration of fluid therapy application of restraints calming actions and words clearing the airway as required connection to artificial respiration intubation monitoring vital signs preoperative medications and premedications placement of an intravenous catheter provision of supportive padding.
Preparing patients for specialised surgical procedures may include:	administration of an enema applying splints clipping fitting of surgical drapes limb support scrubbing of surgical area using an aseptic technique taping vacuuming.
Specific anaesthetic procedures may include:	administration of anaesthetic agents and patient monitoring intra-operative drugs intravenous or intraosseous fluid therapy maintaining arterial catheters maintaining peripheral or central intravenous catheters pain management.
Specific artificial respiration systems may include:	constant monitoring of vital signs monitoring and recording of anaesthesia levels administration of oxygen into recovery and may include mechanical or manual artificial ventilation, such as intermittent positive pressure ventilation.
Intra-operative support to surgeon may include:	anaesthesia support maintenance of an aseptic surgical environment.
Anticipating surgeon's requirement may include:	animal restraint cleaning up haemostasis notifying changes in vital signs or level of anaesthesia providing instruments and tray maintenance selecting and providing suture material wet and dry swabbing.
Specific surgical operating support may include:	instrument holding, passage, cleansing and assembly instrument tray maintenance limb positioning, as appropriate organ packing positioning of suction apparatus retraction, as appropriate suture selection and cutting swab counting.
Specialised bandages may include:	abdominal bandages Ehmer slings foot bandages head or ear bandages Robert Jones thoracic bandages.
Maintenance may include:	specialised equipment: calibration checks checks of scavenger checks of heating and cooling systems disassembly and reassembly light globe tests lubrication parts sharpening performance testing general maintenance: identification of damaged and ineffective equipment or parts that are replaced or set aside for repair lubrication of hydraulic lifts, tracks and wheels to ensure smooth operation and optimum performance.
Cleaning may require:	appropriate antibacterial or virucide agents specific cleaning tools use of chemical agents.

Unit Sector(s)

Veterinary nursing