Assessment Requirements for HLTRNL002 Provide care and support to a person undergoing renal replacement therapy

Release: 1

Assessment Requirements for HLTRNL002 Provide care and support to a person undergoing renal replacement therapy

Modification History

Release	Comments
Release 1	This version was released in CHC Community Services Training Package release 3.0 and meets the requirements of the 2012 Standards for Training Packages. Merged with HLTRNL602C/HLTRNL603C/HLTRNL604C. Removed pre-requisites. Significant changes to the elements and performance criteria. New evidence requirements for assessment, including volume and frequency requirements. Significant change to knowledge evidence.

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:

performed renal replacement therapy on 3 different people, at least 1 of which must be using peritoneal dialysis and at least 1 of which must be using haemodialysis, including:

identifying signs of uraemia and electrolyte imbalance

identifying signs of fluid overload

identifying signs of dehydration

checking peritoneal dialysis exit site

assessing patency of vascular access including:

palpating fistula for thrill

auscultating fistula for bruit

checking for signs of infection

checking last needle sites.

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:

infection control strategies for management of a person undergoing renal replacement therapies including:

stressing the importance of good hygiene and adequate nutrition in prevention of infection

maintaining cleanliness of exit site or fistula arm

monitoring and maintaining integrity of skin to prevent infection

using no touch technique

pathophysiology of Stage 5 CKD and common pathology tests to diagnose and monitor CKD and their interpretation

reportable limits for a person’s vital signs and biochemical and haematological results for a person undergoing renal replacement therapy

immunity and the importance of vaccinations

management principles for different types of renal replacement therapy including:

haemodialysis

peritoneal dialysis

medicines in common use in management of a person with Stage 5 CKD including basic mechanism of action, precautions and side effects

organisation policy and procedures relating to renal replacement therapy

potential impact of Stage 5 CKD and renal replacement therapy has on quality of life and self-esteem including issues related to:

fluid balance management

nutritional management

prevention of infection

care of dialysis access

care of transplanted kidney

administration of medications and identification of their side effects

signs and symptoms of actual and potential problems of renal replacement therapy and the appropriate response including:

hypertension, hypotension

hyperglycaemia, hypoglycaemia

cardiovascular abnormalities

fluid and electrolyte imbalance due to rapid or excess fluid or electrolyte removal

malnutrition

haemodialysis problems

haemolysis

vascular access problems

clotted or stenosed vascular access

prolonged bleeding

peritoneal dialysis problems

peritonitis

exit site infection signs and symptoms including:

leakage from site, extravasation or bag

blocked catheter due to constipation, catheter movement, fibrin plug

cracking, splitting and discolouration of the catheter

cuff extrusion

mobile catheter

tension of catheter

extravasation to surrounding tissue or along inguinal canal to scrotum or labia

contamination of catheter or ‘Y’ line on bag during exchange process

blocked or split Tenckhoff catheter

accidental break in sterile pathway

hernia

obesity

psychosocial issues

dietary management

potential vascular access site problems including:

decreased thrill

high pitched bruit

difficulty in needling fistula

abnormal arterial and venous pressure readings

pain, swelling, redness or trauma

false aneurysms

blood leak from cannulation site

own role and responsibilities and those of other health care team members in the delivery of care to a person with CKD.

Assessment Conditions

Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions. Where simulation is used, it must reflect real working conditions by modelling industry operating conditions and contingencies, as well as, using suitable facilities, equipment and resources.

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